null Spike in peanut and nut anaphylaxis in children at Halloween and Easter

New study suggests education and awareness are needed to help reduce risk of anaphylaxis at specific times of the year

Dr. Moshe Ben-Shoshan is a scientist in the Infectious Diseases and Immunity in Global Health Program at the Research Institute of the MUHC
Dr. Moshe Ben-Shoshan is a scientist in the Infectious Diseases and Immunity in Global Health Program at the Research Institute of the MUHC

September 21, 2020

Montreal, - A new study looking at the link between peanut and tree-nut anaphylaxis in children and holidays found spikes at Halloween and Easter. The study, led by a team of researchers from the Montreal Children’s Hospital of the McGill University Health Centre (MCH-MUHC), and published today in CMAJ (Canadian Medical Association Journal) found that most were previously unknown allergies, calling for increased awareness.

“Identifying certain times associated with an increased risk of anaphylaxis – a serious and life-threatening allergic reaction – could help to raise community awareness, support and vigilance,” writes Dr. Melanie Leung, fourth-year medical student at McGill University, and Dr. Moshe Ben-Shoshan, a pediatric allergist and immunologist at the MCH-MUHC and scientist at the Research Institute of the MUHC, with coauthors. “This information would identify the best timing for public awareness campaigns to prevent allergic reactions.”

Researchers compared anaphylaxis at Halloween, Easter, Christmas, Diwali, Chinese New Year and Eid al-Adha.

The study included 1,390 patients visiting participating pediatric emergency departments between 2011 and 2020 in four Canadian provinces: British Columbia, Ontario, Quebec, and Newfoundland and Labrador. The median age of patients was 5.4 years and 62 percent were boys.

For peanut-triggered anaphylaxis, there was an 85 percent increase in daily average cases during Halloween and a 60 percent increase during Easter compared with the rest of the year. For anaphylaxis triggered by unknown nuts, there was a 70 percent increase during Halloween and Easter compared with the rest of the year. However, the researchers did not find an increase at Christmas, Diwali, Chinese New Year or Eid al-Adha.

“The difference in the anaphylaxis incidence among holidays may have been due to the social setting in which each holiday takes place,” write the authors. “At Halloween and Easter, children often receive candies and other treats from people who may be unaware of their allergies. The absence of such an association at Christmas may be because Christmas is a more intimate celebration among family members and close friends, who are more vigilant regarding allergen exposure.”

Canadian labelling may also be a factor, as individual packages of one-bite candies and snacks, which are exempt from labelling requirements listing ingredients, are popular at Halloween and Easter.

The authors suggest education and awareness may help reduce the risk of anaphylaxis.

“Our findings suggest that educational tools to increase vigilance regarding the presence of potential allergens is required among children with food allergies, their families and lay people interacting with children who have food allergies. Newer strategies targeting intervals associated with high anaphylaxis risk are required.”

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Credit : CMAJ

About the study

The study was conducted by Mélanie Leung, Ann E. Clarke, Sofianne Gabrielli, Judy Morris, Jocelyn Gravel, Rodrick Lim, Edmond S. Chan, Ran D. Goldman, Paul Enarson, Andrew O’Keefe, Jennifer Gerdts BComm, Derek Chu, Julia Upton, Xun Zhang, Greg Shand and Moshe Ben-Shoshan.

Visual abstract:

DOI: 10.1503/cmaj.200034

Funding acknowledgement

This study was supported by operating grant GEN 10-203 from AllerGen Canada

About the RI-MUHC

The Research Institute of the McGill University Health Centre (RI-MUHC) is a world-renowned biomedical and healthcare research centre. The Institute, which is affiliated with the Faculty of Medicine of McGill University, is the research arm of the McGill University Health Centre (MUHC) – an academic health centre located in Montreal, Canada, that has a mandate to focus on complex care within its community. The RI-MUHC supports over 420 researchers and close to 1,200 research trainees devoted to a broad spectrum of fundamental, clinical and health outcomes research at the Glen and the Montreal General Hospital sites of the MUHC. Its research facilities offer a dynamic multidisciplinary environment that fosters collaboration and leverages discovery aimed at improving the health of individual patients across their lifespan. The RI-MUHC is supported in part by the Fonds de recherche du Québec – Santé (FRQS).

Media contact

Ms. Sandra Sciangula
Communications Department
Montreal Children's Hospital
Phone: +1 514 293 2575

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