Epidemiology

Anaphylaxis is underreported and it is difficult to estimate as study definitions and criteria are not always comparable.[1][6][7]

US and European studies estimate lifetime prevalence of anaphylaxis to be between 1.6% and 5.1%, with an incidence rate of 42 per 100,000 person-years.[8][9][10][11][12] These estimates vary by population, identification method, and classification employed. Incidence and prevalence differ for specific allergens.

The incidence of food allergic reactions that are coded as anaphylaxis is highest in young children.[13] In children, food allergy is most prevalent in the industrialized world and the emerging economies of southeast Asia, possibly due to an increased exposure to processed food. Food allergy affects both sexes equally.[14] There are reports of slightly higher rates of anaphylaxis to food in males in Hong Kong and in females in Australia.[15][16] In North America, Europe, and Australia, food-induced anaphylaxis is thought to account for one third to one half of anaphylaxis cases presenting to emergency departments.[17]

Medicines, notably penicillin and nonsteroidal anti-inflammatory drugs (NSAIDs), are common causes of anaphylaxis in adults.[18][19][20]

The risk of anaphylaxis after vaccine administration is low. A review of the Vaccine Safety Datalink estimated the risk of anaphylaxis after vaccination to be 1.31 per million doses.[21]

Risk factors

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<30 years old: food-associated, exercise-induced

Food-associated, exercise-induced anaphylaxis is more common in young people.[17]

atopy/asthma

Atopy is a risk factor for food-induced anaphylaxis, and has been associated with increased risk of life-threatening reactions.[35][36]

Asthma is a risk factor for anaphylaxis; more severe asthma increases the risk for anaphylaxis.[1]​[37]​​​

history of anaphylaxis

Individuals with previous anaphylactic reactions are at higher risk for recurrence.[23]​​[38] However, the severity of a previous reaction does not necessarily predict the severity of a subsequent reaction.[39]

exposure to a common sensitizer (e.g., latex)

Exposure history to latex and latex sensitivity occurs in a significant percentage of health care workers.[40]

Patients with spina bifida and those undergoing multiple surgeries are at increased risk of latex allergy.[41][42]

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adult age: food-, insect venom-, and medication-related

Reactions to shellfish are the most commonly reported food-associated reactions in adults.[30]

Among 1598 adult patients (ages ≥15 years) with a discharge diagnosis of food-induced anaphylaxis, two-thirds of cases were among women (n=978).[31] The highest rates of food-induced anaphylaxis were among people ages 25 to 34 years (n=361), and the lowest among older adults (ages ≥65 years).

Fatal venom-associated anaphylaxis is predominantly seen in adult men aged 50 to 60 years.[32][33]

Medicines, notably penicillin and nonsteroidal anti-inflammatory drugs (NSAIDs), are common causes of anaphylaxis in adults.​[18][19][20][34]​

female sex

Food-associated, exercise-induced anaphylaxis is more common in women.[17]

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