Allergy Asthma Immunol Res.  2017 Sep;9(5):410-416. 10.4168/aair.2017.9.5.410.

Prevalence of Immediate-Type Food Allergy in Korean Schoolchildren in 2015: A Nationwide, Population-based Study

• Kim M
• Lee JY
• Jeon HY
• Yang HK
• Lee KJ
• Han Y
• Kim YH
• Kim J
• Ahn K

• KMID: 2383988
• DOI: http://doi.org/10.4168/aair.2017.9.5.410

Abstract

PURPOSE
This study aimed to determine the prevalence of immediate-type food allergy (FA) among schoolchildren in Korea.
METHODS
A nationwide, cross-sectional study was performed in September 2015. A stratified random sample of 50,000 participants was selected from children and adolescents aged 6-7 years (n=17,500), 9-10 years (n=17,500), 12-13 years (n=7,500), and 15-16 years (n=7,500). Parents were asked to complete a questionnaire on the detailed history of immediate-type FA.
RESULTS
A total of 32,001 (64.0%) responded to the questionnaire survey, and 29,842 children (59.7%) were analyzed after adjusting for missing data. The number of the cases in each age group was 9,671 (6-7 years), 9,756 (9-10 years), 5,169 (12-13 years), and 5,246 (15-16 years). The prevalence of lifetime perceived FA was 15.82%. The prevalence of current immediate-type FA was 4.06% in total, with 3.15% in 6- to 7-year-olds, 4.51% in 9- to 10-year-olds, 4.01% in 12- to 13-year-olds, and 4.49% in 15- to 16-year-olds. Among individual food items, peanut (0.22%) was the most frequent causative food, followed by hen's egg (0.21%), cow's milk (0.18%), and buckwheat (0.13%). Among the food groups, fruits (1.41%), crustaceans (0.84%), tree nuts (0.32%), and fish (0.32%) were the most common offending foods. The prevalence of food-induced anaphylaxis was 0.97%. The most frequent causative food of anaphylaxis was peanut (0.08%), followed by cow's milk (0.07%), buckwheat (0.06%), and hen's egg (0.06%), while fruits (0.28%), crustaceans (0.18%), tree nuts (0.12%), and fish (0.09%) were the most commonly responsible food groups.
CONCLUSIONS
The prevalence of current immediate-type FA and food-induced anaphylaxis in Korean schoolchildren in 2015 was 4.06% and 0.97%, respectively. Peanuts, cow's milk, hen's egg, fruits, crustaceans, and tree nuts are common allergens.

Keyword

Immediate type; children; food allergy

MeSH Terms

Adolescent
Allergens
Anaphylaxis
Arachis
Child
Cross-Sectional Studies
Fagopyrum
Food Hypersensitivity*
Fruit
Humans
Korea
Milk
Nuts
Ovum
Parents
Prevalence*
Trees
Allergens

Figure

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  Fig. 1 Algorithm for identifying immediate-type FA. FA, food allergy.

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  Fig. 2 Prevalence of perceived FA and current immediate-type FA in Korean schoolchildren in 2015. FA, food allergy.

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  Fig. 3 Prevalence of current immediate-type FA in Korean schoolchildren in 2015, according to allergen. FA, food allergy.

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  Fig. 4 Prevalence of food-induced anaphylaxis in Korean schoolchildren in 2015, according to allergen.

Reference

1. Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol. 2011; 127:594–602.

2. Lee AJ, Thalayasingam M, Lee BW. Food allergy in Asia: how does it compare? Asia Pac Allergy. 2013; 3:3–14.

3. Sicherer SH, Sampson HA. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014; 133:291–307.

4. McGowan EC, Keet CA. Prevalence of self-reported food allergy in the National Health and Nutrition Examination Survey (NHANES) 2007-2010. J Allergy Clin Immunol. 2013; 132:1216–1219.e5.

5. Soller L, Ben-Shoshan M, Harrington DW, Fragapane J, Joseph L, St Pierre Y, et al. Overall prevalence of self-reported food allergy in Canada. J Allergy Clin Immunol. 2012; 130:986–988.

6. Muraro A, Werfel T, Hoffmann-Sommergruber K, Roberts G, Beyer K, Bindslev-Jensen C, et al. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014; 69:1008–1025.

7. Wu TC, Tsai TC, Huang CF, Chang FY, Lin CC, Huang IF, et al. Prevalence of food allergy in Taiwan: a questionnaire-based survey. Intern Med J. 2012; 42:1310–1315.

8. Ho MH, Lee SL, Wong WH, Ip P, Lau YL. Prevalence of self-reported food allergy in Hong Kong children and teens--a population survey. Asian Pac J Allergy Immunol. 2012; 30:275–284.

9. Ebisawa M, Nishima S, Ohnishi H, Kondo N. Pediatric allergy and immunology in Japan. Pediatr Allergy Immunol. 2013; 24:704–714.

10. Oh JW, Pyun BY, Choung JT, Ahn KM, Kim CH, Song SW, et al. Epidemiological change of atopic dermatitis and food allergy in school-aged children in Korea between 1995 and 2000. J Korean Med Sci. 2004; 19:716–723.

11. Kim J, Chang E, Han Y, Ahn K, Lee SI. The incidence and risk factors of immediate type food allergy during the first year of life in Korean infants: a birth cohort study. Pediatr Allergy Immunol. 2011; 22:715–719.

12. Ahn K, Kim J, Hahm MI, Lee SY, Kim WK, Chae Y, et al. Prevalence of immediate-type food allergy in Korean schoolchildren: a population-based study. Allergy Asthma Proc. 2012; 33:481–487.

13. Park M, Kim D, Ahn K, Kim J, Han Y. Prevalence of immediate-type food allergy in early childhood in Seoul. Allergy Asthma Immunol Res. 2014; 6:131–136.

14. Urisu A, Ebisawa M, Mukoyama T, Morikawa A, Kondo N. Japanese Society of Allergology. Japanese guideline for food allergy. Allergol Int. 2011; 60:221–236.

15. Antolín-Amérigo D, Manso L, Caminati M, de la Hoz Caballer B, Cerecedo I, Muriel A, et al. Quality of life in patients with food allergy. Clin Mol Allergy. 2016; 14:4.

16. Cummings AJ, Knibb RC, King RM, Lucas JS. The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review. Allergy. 2010; 65:933–945.

17. MacKenzie H, Roberts G, van Laar D, Dean T. Teenagers' experiences of living with food hypersensitivity: a qualitative study. Pediatr Allergy Immunol. 2010; 21:595–602.

18. Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2006; 117:391–397.

19. Nwaru BI, Hickstein L, Panesar SS, Roberts G, Muraro A, Sheikh A. EAACI Food Allergy and Anaphylaxis Guidelines Group. Prevalence of common food allergies in Europe: a systematic review and meta-analysis. Allergy. 2014; 69:992–1007.

20. Shek LP, Cabrera-Morales EA, Soh SE, Gerez I, Ng PZ, Yi FC, et al. A population-based questionnaire survey on the prevalence of peanut, tree nut, and shellfish allergy in 2 Asian populations. J Allergy Clin Immunol. 2010; 126:324–331. 331.e1–331.e7.

21. Venter C, Maslin K, Patil V, Kurukulaaratchy R, Grundy J, Glasbey G, et al. The prevalence, natural history and time trends of peanut allergy over the first 10 years of life in two cohorts born in the same geographical location 12 years apart. Pediatr Allergy Immunol. 2016; 27:804–811.

22. Sicherer SH, Muñoz-Furlong A, Godbold JH, Sampson HA. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. J Allergy Clin Immunol. 2010; 125:1322–1326.

23. Panjari M, Koplin JJ, Dharmage SC, Peters RL, Gurrin LC, Sawyer SM, et al. Nut allergy prevalence and differences between Asianborn children and Australian-born children of Asian descent: a state-wide survey of children at primary school entry in Victoria, Australia. Clin Exp Allergy. 2016; 46:602–609.

24. Brough HA, Liu AH, Sicherer S, Makinson K, Douiri A, Brown SJ, et al. Atopic dermatitis increases the effect of exposure to peanut antigen in dust on peanut sensitization and likely peanut allergy. J Allergy Clin Immunol. 2015; 135:164–170.

25. Venkataraman D, Soto-Ramírez N, Kurukulaaratchy RJ, Holloway JW, Karmaus W, Ewart SL, et al. Filaggrin loss-of-function mutations are associated with food allergy in childhood and adolescence. J Allergy Clin Immunol. 2014; 134:876–882.e4.

26. Brough HA, Simpson A, Makinson K, Hankinson J, Brown S, Douiri A, et al. Peanut allergy: effect of environmental peanut exposure in children with filaggrin loss-of-function mutations. J Allergy Clin Immunol. 2014; 134:867–875.e1.

27. Du Toit G, Katz Y, Sasieni P, Mesher D, Maleki SJ, Fisher HR, et al. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol. 2008; 122:984–991.

28. Venter C, Hasan Arshad S, Grundy J, Pereira B, Bernie Clayton C, Voigt K, et al. Time trends in the prevalence of peanut allergy: three cohorts of children from the same geographical location in the UK. Allergy. 2010; 65:103–108.

29. Savage J, Sicherer S, Wood R. The natural history of food allergy. J Allergy Clin Immunol Pract. 2016; 4:196–203.

30. Wood RA, Sicherer SH, Vickery BP, Jones SM, Liu AH, Fleischer DM, et al. The natural history of milk allergy in an observational cohort. J Allergy Clin Immunol. 2013; 131:805–812.

31. Savage JH, Matsui EC, Skripak JM, Wood RA. The natural history of egg allergy. J Allergy Clin Immunol. 2007; 120:1413–1417.

32. Skripak JM, Matsui EC, Mudd K, Wood RA. The natural history of IgE-mediated cow's milk allergy. J Allergy Clin Immunol. 2007; 120:1172–1177.

33. Sicherer SH, Wood RA, Vickery BP, Jones SM, Liu AH, Fleischer DM, et al. The natural history of egg allergy in an observational cohort. J Allergy Clin Immunol. 2014; 133:492–499.

34. Kim J, Hahm MI, Lee SY, Kim WK, Chae Y, Park YM, et al. Sensitization to aeroallergens in Korean children: a population-based study in 2010. J Korean Med Sci. 2011; 26:1165–1172.

35. D'Amato G, Pawankar R, Vitale C, Lanza M, Molino A, Stanziola A, et al. Climate change and air pollution: effects on respiratory allergy. Allergy Asthma Immunol Res. 2016; 8:391–395.

36. Lau CH, Springston EE, Smith B, Pongracic J, Holl JL, Gupta RS. Parent report of childhood shellfish allergy in the United States. Allergy Asthma Proc. 2012; 33:474–480.

37. Umasunthar T, Leonardi-Bee J, Turner PJ, Hodes M, Gore C, Warner JO, et al. Incidence of food anaphylaxis in people with food allergy: a systematic review and meta-analysis. Clin Exp Allergy. 2015; 45:1621–1636.

38. Grabenhenrich LB, Dölle S, Moneret-Vautrin A, Köhli A, Lange L, Spindler T, et al. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. J Allergy Clin Immunol. 2016; 137:1128–1137.e1.

39. Lee SY, Ahn K, Kim J, Jang GC, Min TK, Yang HJ, et al. A multicenter retrospective case study of anaphylaxis triggers by age in Korean children. Allergy Asthma Immunol Res. 2016; 8:535–540.

40. Jiang N, Yin J, Wen L, Li H. Characteristics of anaphylaxis in 907 Chinese patients referred to a tertiary allergy center: a retrospective study of 1,952 episodes. Allergy Asthma Immunol Res. 2016; 8:353–361.