Impact of public health interventions for food allergy prevention on rates of infant anaphylaxis

Background: Eleven percent of Australian infants have confirmed food allergy. We hypothesized earlier introduction may lead to higher rates of infant anaphylaxis, irrespective of whether the overall rate of food allergy in the population was ultimately reduced.Objective: To determine whether a public health campaign, targeting earlier introduction of allergenic foods, affected rates of infant anaphylaxis.Methods: Data were obtained from St John Ambulance (SJA) Western Australia and Western Australian emergency departments (ED) on infant (<= 12 months) anaphylaxis over a 5-year period (July 1, 2015 to June 30, 2020). Adrenaline administration data were collected in the SJA dataset. Poisson regression was undertaken to assess trends in anaphylaxis over time. Segmented regression analysis was undertaken to assess differences in anaphylaxis rates before and after intervention.Results: The SJA and ED datasets included 172 and 294 events, respectively, coded as infant anaphylaxis. Rates of infant anaphylaxis increased over time for both SJA and ED datasets, with a 1-year increase rate ratio of 1.21 (95% confidence interval, 1.09-1.35; P value < .01) and 1.11 (95% confidence interval, 1.02-1.20; P = .01), respectively. Segmented regression indicated no significant difference in rates after intervention. Adrenaline was not coded as being administered in 109 of the 172 anaphylaxis events. Conclusion: Rates of infant anaphylaxis increased over the 5-year reporting period; however, there was no clear increase related to the timing of the public health campaign implementation. Reported adrenaline use was suboptimal. Assessing rates of food allergy in all age groups is required to determine whether there has been an overall reduction in food allergy owing to the intervention.(c) 2022 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc.

Automated summary

This study examined the impact of a public health campaign promoting earlier introduction of allergenic foods on rates of infant anaphylaxis. The results showed that rates of infant anaphylaxis increased over the past 5 years, but there was no clear association with the timing of the public health campaign. Assessing rates of food allergy in all age groups is necessary to determine whether the intervention has led to an overall reduction in food allergy.