Mari Sasaki

Factors associated with asthma control in children: findings from a national Web-based survey

Although achieving and maintaining control of asthma is considered to be the goal of asthma treatment, determinants of asthma control are not fully understood. Our aim was to assess factors associated with asthma control among paediatric patients in the general population.

Prevalence of clinic-defined food allergy in early adolescence: The SchoolNuts study

Background: Rising rates of food‐induced anaphylaxis have recently been shown in the adolescent age group, following earlier descriptions of a rise in children younger than 5 years. However, few population‐based studies have examined the prevalence of food allergy in adolescence using objective measures such as oral food challenge (OFC). Objective: We sought to determine the prevalence of food allergy among a population‐based sample of 10‐ to 14‐year‐old adolescents using clinical evaluation including OFC to confirm the diagnosis. Methods: Schools were randomly selected from greater metropolitan Melbourne, Australia. Students aged 10 to 14 years, and their parents, were asked to complete a questionnaire regarding the adolescents food allergy or food‐related reactions. Clinic evaluation, which consisted of skin prick tests and OFC where eligible, was undertaken if students were suspected to have current food allergy from parent response. Among 9816 students assessed, 5016 had complete parent response and clinic evaluation when eligible. An additional 4800 students had student questionnaires only. Results: The prevalence of clinic‐defined current food allergy based on history, sensitization data, and OFC results was 4.5% (95% CI, 3.9‐5.1), with the most common food triggers being peanut, 2.7% (95% CI, 2.3‐3.2), and tree nut, 2.3% (95% CI, 1.9‐2.8). Among the additional group of 4800 adolescents who had only self‐reported food allergy status available, the prevalence of self‐reported current food allergy was 5.5% (95% CI, 4.9‐6.2), with peanut, 2.8% (95% CI, 2.3‐3.3), and tree nut, 2.3% (95% CI, 1.9‐2.8), the most common. Conclusions: Approximately 1 in 20 10‐ to 14‐year‐old school students in Melbourne has current food allergy. This high prevalence suggests that the previously reported rise in food‐induced anaphylaxis in this age group may reflect an increasing prevalence of food allergy rather than simply increased reporting of anaphylaxis.

Anaphylactic shock after the ingestion of jellyfish without a history of jellyfish contact or sting

We read with interest the article entitled “Anaphylaxis caused by ingestion of jellyfish” by Imamura et al. in this journal [1]. They stated that their case subject was sensitized through the skin by jellyfish stings and that subsequent jellyfish intake induced anaphylaxis. However, we experienced a case of anaphylaxis after jellyfish ingestion without any history of jellyfish contact or sting.A 14-year-old boy developed a cough, urticaria and dyspnea 30 minutes after he ate a breakfast that [...]

Factors associated with the severity of childhood rhinoconjunctivitis

BACKGROUND Allergic rhinitis is one of the most common chronic diseases in children. Although it has a large impact on the patients quality of life, little is known about the factors associated with its severity. The aim of this study was to assess the factors associated with the severity of rhinoconjunctivitis among children in the general population. METHODS A survey was conducted using an online research panel in 2012. Parents were asked to answer an International Study of Asthma and Allergies in Childhood-based questionnaire to identify children with current rhinoconjunctivitis and evaluate factors associated with the severity of its symptoms. Severity was rated according to the degree of impairment caused by the symptoms in the patients daily life. RESULTS Among 26,725 children aged 6-12 years old, rhinoconjunctivitis was defined in 5175 (19.4%), and of these, 688 children (13.3% of children with current rhinoconjunctivitis) presented severe symptoms. Living in areas with a high cedar and cypress pollen count and having concurrent eczema were associated with severe rhinoconjunctivitis [adjusted OR (95% CI): 1.21 (1.00-1.46) and 1.45 (1.20-1.75), respectively]. Further, a maternal history of asthma and allergic rhinitis was a significant risk factor for severe rhinoconjunctivitis [1.34 (1.04-1.74) and 1.30 (1.10-1.53), respectively]. However, living with fur-bearing animals (pets) before 1 year of age proved to be a protective factor against severe rhinoconjunctivitis [0.70 (0.52-0.94)]. CONCLUSIONS Environmental factors such as pets and pollen, together with comorbidities and a maternal history of allergic diseases, play an important role in determining the severity of rhinoconjunctivitis.

Self-reported adverse food reactions and anaphylaxis in the SchoolNuts study: A population-based study of adolescents

Background: Adolescents are at the highest risk of death from anaphylaxis, yet few population‐based studies have described the frequencies and risk factors for allergic reactions caused by accidental allergen ingestion in this group. Methods: We describe the prevalence, frequency, and associated risk factors for recent adverse food reactions in 10‐ to 14‐year‐olds in Melbourne, Australia, recruited from a stratified, random, population‐based sample of schools (SchoolNuts, n = 9663; 48% response rate). Self‐reported food allergy and adverse reaction details, including anaphylaxis, were identified by using a student questionnaire over the past year. Results: Of 547 students with possible IgE‐mediated food allergy, 243 (44.4%; 95% CI, 40.3% to 48.7%) reported a reaction to a food. Fifty‐three (9.7%; 95% CI, 7.2% to 12.2%) students reported 93 anaphylaxis episodes. Peanut and tree nuts were the most common food triggers. Among students with current IgE‐mediated food allergy, those with resolved or current asthma (adjusted odds ratio [aOR], 1.9 [95% CI, 1.1–1.3] and 1.7 [95% CI, 1.1–2.6]) and those with more than 2 food allergies (aOR, 1.9 [95% CI, 1.1–3.1]) were at greatest risk of any adverse food reaction, and those with nut allergy were most at risk of severe reactions (aOR, 2.9 [95% CI, 1.1–4.4]). Resolved or current asthma was not associated with increased risk of severe reactions (aOR, 0.8 [95% CI, 0.3–2.2] and 1.6 [95% CI, 0.7–3.7]). Conclusions: Adolescents with food allergy are frequently exposed to food allergens. Those with asthma and more than 2 food allergies were at the greatest risk for adverse food reactions. Those with nut allergies were most at risk of severe reactions.

Time-dependent variation in the responses to the web-based ISAAC questionnaire

BACKGROUND Epidemiologic studies have shown seasonal variations in responses to the written questionnaire for rhinitis symptoms. OBJECTIVE To evaluate whether the timing of data collection affected responses to the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire in a Web-based study. METHODS The Web-based ISAAC questionnaires were completed by parents with children 6 to 12 years old using an online research system. The authors conducted surveys of asthma symptoms every month for 1 year and surveys of rhinitis and eczema symptoms every season throughout 1 entire year. RESULTS There was a significant fluctuation in the positive responses to questions about wheezing in the past 12 months (P < .001) but not in the positive responses to questions about exercise-induced wheezing in the past 12 months and asthma ever (P = .75 and P = .15, respectively). The positive responses to questions about rhinitis and allergic rhinoconjunctivitis in the past 12 months and pollinosis ever exhibited significant seasonal variations (P = .002, P < .001, and P < .001, respectively). In contrast, there were no significant variations in positive responses regarding eczema in the past 12 months and eczema ever (P = .33 and P = .55, respectively). CONCLUSION There were time-dependent fluctuations in responses to the Web-based questionnaire regarding allergic symptoms. Timing of data collection should be taken into account when evaluating prevalence of asthma and rhinitis in children.

Patterns of Carriage of Prescribed Adrenaline Autoinjectors in 10- to 14-Year-Old Food-Allergic Students: A Population-Based Study

BACKGROUND Adolescence is well recognized as a period of increased risk for severe and fatal food-induced anaphylaxis. Current Australian adrenaline autoinjector (AAI) prescription guidelines therefore suggest that consideration be given to AAI prescription in all adolescents with a food allergy. To date, however, few studies have assessed the AAI carriage behavior of adolescents prescribed AAI devices. OBJECTIVE To determine the carriage behavior of prescribed AAI devices in a population-based sample of young Australian adolescents. METHODS Students aged 10 to 14 years (and their parents) from randomly selected schools in metropolitan Melbourne completed self-administered questionnaires regarding the history and management of food allergy, including prescription and carriage of AAI device in different domains of school and social life. RESULTS A total of 9816 students completed the questionnaire (46% response): 620 students were assessed to have likely IgE-mediated food allergy and 234 (38%) of these had been prescribed an AAI. Most students (93%; 95% CI, 89%-96%) who were prescribed AAIs reported that they provided their AAI and anaphylaxis action plan to their school. Adherence to AAI carriage in other domains of social life was poor, with 49% (95% CI, 42%-56%) never carrying their AAI in 1 or more locations. Carriage of the AAI device was particularly poor when students were independent of parental supervision: 32% (95% CI, 25%-39%) never carried it when they were by themselves, 28% (95% CI, 22%-36%) never carried it while out with friends, and 36% (95% CI, 30%-43%) never carried their AAI to sporting activities. CONCLUSIONS Carriage of AAI devices is suboptimal in young adolescents prescribed AAIs, particularly when young adolescents are independent of parental supervision.

Ultraviolet index is associated with childhood eczema prevalence: Sex and age differences

Eczema is a chronic inflammatory skin condition whose development is related to environmental and genetic factors. The report of a positive association of latitude with the prevalence of childhood eczema suggests an important role for climate in the pathogenesis of eczema (1). The effect of ultraviolet (UV) radiation exposure is one of the candidate explanations for this observation, and is corroborated by a study in the United States reporting an inverse relationship between UV index and the prevalence of childhood eczema (2). We aimed to verify this association by further evaluating sex and age differences. This article is protected by copyright. All rights reserved.