Prevalence of seafood allergy in the United States determined by a random telephone survey☆
Received 27 February 2004; received in revised form 2 April 2004; accepted 2 April 2004.
Abstract
Background
Seafood allergy is potentially severe, but the prevalence of this group of food allergies in the US population has not been determined.
Objective
To estimate the prevalence of seafood (fish, shellfish) allergy in the United States.
Methods
We performed a nationwide, cross-sectional, random telephone survey by using a standardized questionnaire. Criteria were established in advance to define seafood allergy by report of convincing symptoms and physician evaluation.
Results
A total of 5529 households completed the survey (67.3% participation rate), representing a census of 14,948 individuals. Fish or shellfish allergy defined by established criteria was reported in 5.9% (95% CI, 5.3%-6.6%) of households and among individuals as follows: 2.3% (95% CI, 2%-2.5%) for any seafood allergy, 2% for shellfish, 0.4% for fish, and 0.2% for both types. Seafood allergy was more common in adults compared with children (2.8% vs 0.6%; P < .001) and in women compared with men (3.6% vs 2%; P < .001). Recurrent reactions were reported by 58%, dyspnea or throat tightness was reported by more than 50%, and 16% were treated with epinephrine. Despite this level of acuity, only 8.6% were prescribed self-injectable epinephrine. The rate of reactions to multiple fish among those with any fish allergy was 67%; for Crustacea the rate was 38%, and for mollusks the rate was 49%; only 14% with crustacean allergy reported a mollusk allergy.
Conclusions
Physician-diagnosed and/or convincing seafood allergy is reported by 2.3% of the general population, or approximately 6.6 million Americans. Affected individuals typically report recurrent and sometimes severe reactions, indicating that seafood allergy represents a significant health concern.
From athe Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai School of Medicine, New York, and bthe Food Allergy and Anaphylaxis Network, Fairfax USA
Reprint requests: Scott H. Sicherer, MD, Division of Allergy and Immunology, Jaffe Food Allergy Institute, Mount Sinai Hospital, Box 1198, One Gustave L. Levy Place, New York, NY 10029-6574.
☆ Disclosure of potential conflict of interest: Funding sources paid for administrative costs and use of the company that performed the actual survey. The same funding sources have ties to the authors in other ways, but the authors do not perceive a conflict of interest on these accounts, and the relationships are public knowledge. Dr Sampson and Dr Sicherer work at the Jaffe Food Allergy Institute, have other ongoing projects funded by the Food Allergy Initiative and the Food Allergy and Anaphylaxis Network, and act as medical advisors and consultants to these organizations. Ms Muñoz-Furlong is chief executive officer of the Food Allergy and Anaphylaxis Network.
Supported by the Food Allergy Initiative, New York; the Jaffe Family Foundation; and the Food Allergy and Anaphylaxis Network. Dr Sicherer is supported by K23 AI 01709 from the National Institutes of Allergy and Infectious Diseases, and Dr Sampson is supported by AI 44236 and AI 43668.
ABSTRACT