A team of researchers from Mount Sinai School of Medicine and four other institutions have found that young children with documented or likely allergies to milk and/or eggs, whose families were instructed on how to avoid these and other foods, still experienced allergic reactions at a rate of almost once per year. Of severe cases, less than a third received epinephrine, a medication used to counter anaphylaxis, a life-threatening allergic condition.
The findings are from an ongoing Consortium of Food Allergy Research (CoFAR) study that has been following more than 500 children with food allergies since infancy. The results of the three-year study appear online in the June 25 issue of Pediatrics.
Nearly 72 percent of the participants experienced a reaction, with 1,171 allergic reactions in total. Allergic reactions were attributed to such factors as a lack of close supervision, misreading ingredient labels, cross-contamination, or errors in food preparation. Participating families had been given written and verbal food avoidance instruction, and written prescriptions for self-injectable epinephrine, beforehand.
"This study reinforces the importance of educating parents and other caregivers of children with food allergy about avoiding allergenic foods and using epinephrine to treat severe food-allergic reactions," said Scott Sicherer, MD, Professor of Pediatrics and Chief of the Division of Allergy and Immunology at Mount Sinai School of Medicine. "We must work harder to thoroughly educate parents about the details of avoidance and when and how to correctly use epinephrine to manage this life-threatening condition."
Approximately 11 percent of the children experienced anaphylaxis, which can include symptoms such as swelling in the throat, asthma, sudden drop in blood pressure, dizziness or fainting. The children's parents or caregivers administered epinephrine in only 30 percent of the cases of children having severe reactions to food. Investigators found children did not receive epinephrine because either the drug was not available, or parents and caregivers were too afraid to administer the drug, or they did not recognize the reaction as severe and waited to see more symptoms.
"We found a significant number of young children received allergenic foods from caregivers other than their parents," said Hugh Sampson, MD, Dean for Translational Biomedical Sciences, Professor of Pediatrics, and Director of the Jaffe Food Allergy Institute at Mount Sinai School of Medicine. "This underscores the need to educate everyone who is responsible for the child, including grandparents, older siblings and teachers."
Dr. Sampson is the lead investigator for COFAR, which is also performing numerous food allergy treatment trials.
The study is taking place at The Mount Sinai Medical Center as well as research hospitals in Baltimore, MD; Denver, CO; Durham, NC; and Little Rock, Ark., with support from The National Institutes of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health. NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses.
About The Mount Sinai Medical Center
The Mount Sinai Medical Center encompasses both The Mount Sinai Hospital and Mount Sinai School of Medicine. Established in 1968, Mount Sinai School of Medicine is one of the leading medical schools in the United States. The Medical School is noted for innovation in education, biomedical research, clinical care delivery, and local and global community service. It has more than 3,400 faculty in 32 departments and 14 research institutes, and ranks among the top 20 medical schools both in National Institutes of Health (NIH) funding and by U.S. News & World Report.
The Mount Sinai Hospital, founded in 1852, is a 1,171-bed tertiary- and quaternary-care teaching facility and one of the nation's oldest, largest and most-respected voluntary hospitals. In 2011, U.S. News & World Report ranked The Mount Sinai Hospital 16th on its elite Honor Roll of the nation's top hospitals based on reputation, safety, and other patient-care factors. Of the top 20 hospitals in the United States, Mount Sinai is one of 12 integrated academic medical centers whose medical school ranks among the top 20 in NIH funding and U.S. News & World Report and whose hospital is on the U.S. News & World Report Honor Roll. Nearly 60,000 people were treated at Mount Sinai as inpatients last year, and approximately 560,000 outpatient visits took place.