Rising prevalence of allergy to peanut in children: Data from 2 sequential cohorts

doi:10.1067/mai.2002.128802

Journal of Allergy and Clinical Immunology

Volume 110, Issue 5, November 2002, Pages 784-789

https://doi.org/10.1067/mai.2002.128802 Get rights and content

Abstract

Background: Allergy to peanut is common. However, it is not known whether the prevalence of sensitization and clinical allergy to peanut is increasing. Objective: We sought to determine any change in the prevalence of peanut sensitization and reactivity in early childhood in 2 sequential cohorts in the same geographic area 6 years apart. Methods: Of 2878 children born between September 1, 1994, and August 31, 1996, living on the Isle of Wight, 1273 completed questionnaires, and 1246 had skin prick tests at the age of 3 to 4 years. Those with positive skin prick test responses to peanut were subjected to oral peanut challenges, unless there was a history of immediate systemic reaction. These data were compared with information on sensitization and clinical allergy to peanut available from a previous cohort born in 1989 in the same geographic area. Results: There was a 2-fold increase in reported peanut allergy (0.5 % [6/1218] to 1.0 % [13/1273]), but the difference was nonsignificant (P = .2). Peanut sensitization increased 3-fold, with 41 (3.3 %) of 1246 children sensitized in 1994 to 1996 compared with 11 (1.1 %) of 981 sensitized 6 years ago (P = .001). Of 41 sensitized children in the current study, 10 reported a convincing clinical reaction to peanut, and 8 had positive oral challenge results, giving an overall estimate of peanut allergy of 1.5% (18/1246). Conclusions: Sensitization to peanut had increased between 1989 and 1994 to 1996. There was a strong but statistically nonsignificant trend for increase in reported peanut allergy. (J Allergy Clin Immunol 2002;110:784-9.)

Section snippets

Methods

Parents of all children (n = 2878) born between September 1, 1994, and August 31, 1996, and registered with a general practitioner on the Isle of Wight were approached just after the child's third birthday as part of a study that examined the effect of artificial food additives on behavior and allergy. Approval for the study was obtained from the local research ethics committee. Parents of 1273 (44%) children (mean age, 3.2 years [SD 7.6]) agreed to participate and completed a questionnaire

Results

In the current study SPTs were performed on 1246 children (98% of those who consented, n = 1273) and 43% of the whole-population cohort (n = 2878). Forty-one (3.3%) children had a positive SPT response to peanut (Fig 1).

. Flow diagram of children recruited to the study.

Children sensitized to peanut were highly atopic; half of them had a history of asthma, and nearly all of them had had eczema (Table I).

. Comparison of allergic morbidity according to the International Study of Asthma and Allergy

Discussion

Studies from the United States⁴ and the United Kingdom⁶ have estimated the prevalence of peanut allergy to be around 0.5% to 1% of the population. However, these studies were questionnaire surveys and are likely to overestimate the prevalence because self-reported food allergies are generally higher than can be proved with oral challenge.⁷ Moreover, there is a risk of bias because those with peanut allergy are more likely to agree to participate in any questionnaire surveys. Our previous

Acknowledgements

We acknowledge the enthusiasm shown by the children and their parents who have participated in this study. We thank Linda Terry and Brenda Fishwick for administrative help and Carole Gant and Carina Venter for the dietetic support.

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^☆: Supported by the Ministry of Agriculture, Fisheries and Food, and The David Hide Asthma and Allergy Research Centre Trust.

^☆☆: Reprint requests: Syed Hasan Arshad, FRCP, Consultant Physician and Director, The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight PO30 5TG, United Kingdom.

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Food and Drug Reactions and AnaphylaxisRising prevalence of allergy to peanut in children: Data from 2 sequential cohorts☆,☆☆

Abstract

Section snippets

Methods

Results

Discussion

Acknowledgements

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Pediatr

J Allergy Clin Immunol

J Allergy Clin Immunol

Clinical study of peanut and nut allergy in 62 consecutive patients: new features and association

Br Med J

The clinical spectrum of anaphylaxis in North-West England

Clin Exp Allergy

Perceived prevalence of peanut allergy in Great Britain and its association with other atopic conditions and with peanut allergy in other household members

Allergy

Prospective appraisal of complaints of adverse reactions to foods in children during the first three years of life

Pediatrics

Peanut allergy in relation to heredity maternal diet, and other atopic diseases: results of a questionnaire survey, skin prick testing, and food challenges

Br Med J

Food and Drug Reactions and Anaphylaxis
Rising prevalence of allergy to peanut in children: Data from 2 sequential cohorts☆,☆☆