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Severe and fatal allergic reactions to food in children are rare

March 21, 2002

Fears that the rates of severe or fatal allergic reactions to food are increasing dramatically are unfounded, finds a national, 10 year, study in the Archives of Disease in Childhood. Such reactions are rare in the UK, but children who have asthma are at greater risk, the findings show.

The research team examined national death statistics for children up to the age of 15 years from 1990 to 1998. They also analysed monthly reports generated by the British Paediatric Surveillance System (BPSU) from 1998 to 2000. This collects data from all UK consultant paediatricians, almost 95 per cent of whom participate.

The data showed that over the past 10 years eight children died from an allergic reaction to food. Milk was responsible for four of the deaths. No child under 13 died from peanut allergy. One child with a mixed food allergic reaction died from an overdose of epinephrine, which is used to treat it.

As the UK population of children up to the age of 16 is 13 million, that gives a rate of 0.006 deaths for every 100,000 children, say the authors.

Between 1998 and 2000 there were six near deaths, none of which was caused by peanut, and 49 severe reactions, 10 of which were. Mixed food and cashew nuts accounted for 16. This gives a rate of 0.2 near deaths and 0.19 severe reactions for every 100,000 children.

Coexisting asthma featured in three of the deaths, five of the near deaths, and over half of the severe reactions.

The authors calculate that if 5 per cent of the population of children in the UK has a food allergy, the risk of that child dying from his or her allergy would be 1 in 800,000 a year.

They conclude: “The finding of so few deaths in such a large population should reassure parents and doctors that the risk of death is small.” This is particularly important for children under the age of 10, they say, in whom the risk was even smaller, and many of whom grow out of their allergic responses.

Nevertheless, a second study warns that schools are poorly informed about nut allergy or what to do in the event of a severe allergic reaction in a pupil.

A survey of 83 randomly selected schools in South West England, showed that 54 per cent (45) had at least one child who was known to be allergic. But only a third of the children had access to treatment at school.

Around a third of schools with an allergic child were unable to name the signs of either a mild or severe allergic reaction to nuts. More than four out of 10 either had no staff suitably trained in the use of appropriate treatment, or did not respond to the question. Less than half of these schools gave information about nut allergy to dinner supervisors.

British Medical Journal (BMJ)