Anaphylaxis in America - Results from a National Telephone Survey

Abstract

S U N D A Y 501 Anaphylaxis in America Results from a National Telephone Survey J. Boyle, C. A. Camargo, P. Lieberman, H. Sampson, L. B. Schwartz, F. E. R. Simons, M. Zitt, M. Wilkinson, C. Collins, M. Tringale, R. Wood; Abt SRBI, Silver Spring, MD, Massachusetts General Hospital, Boston, MA, University of Tennessee College of Medicine, Germantown, TN, Mount Sinai School of Medicine, New York, NY, Virginia Commonwealth University, Richmond, VA, University of Manitoba, Winnipeg, MB, CANADA, State University of NY Stony Brook, Stony Brook, NY, Asthma and Allergy Foundation of America, Landover, MD, Johns Hopkins University School of Medicine, Baltimore, MD. RATIONALE: To delineate triggers of anaphylaxis and compare awareness, knowledge and behaviors among patients at-risk for anaphylaxis. METHODS: A nationwide, cross-sectional random-digit-dial telephone survey was conducted using a standardized questionnaire. Household members were screened for allergic reactions to foods, insect stings, latex, medications, and other allergens, and for idiopathic reactions. When multiple householdmembers had allergies, the person with the most severe allergic reaction was chosen for the interview. Participants were asked over 100 questions about anaphylaxis awareness, triggers, symptoms, treatments, knowledge, perceptions, behaviors, and quality of life. RESULTS: Over 20,000 phone calls weremade to identify and interview a nationally representative sample of 1,000 persons who had experienced allergic reactions within the past ten years. The survey found that 18% of persons with these types of allergies had experienced at least one likely anaphylactic reaction. Among those reporting anaphylactic reactions, 42% occurred within 15 minutes of exposure and the most common triggers were medications (33%), followed by foods (28%), insect stings (21%), other (15%), unknown (7%), and latex (3%). Also among those reporting anaphylaxis, 38% sought emergency room care, 28% self-treated with antihistamines, 13% went to a doctor’s office, and 13% self-administered epinephrine. Although 57% reported two or more lifetime episodes, only 18% of the individuals reporting anaphylaxis currently carry epinephrine. CONCLUSIONS: Severe allergic reactions consistent with anaphylaxis are common among persons reporting allergic reactions in the general population. This comprehensive national survey on anaphylaxis, including its triggers and treatment, supports the need for public health initiatives to improve anaphylaxis practices and education.