Epidemiology

Neither age, occupation, race, gender, nor geographic factors have been shown to increase the risk of anaphylaxis. 3 Most studies indicate that atopic individuals (sufferers of asthma, allergic rhinitis, atopic dermatitis, etc.) are at no greater risk for anaphylaxis from insect stings or drugs reactions than are nonatopic individuals. 1 Atopy is a risk factor, however, for idiopathic anaphylaxis.4 The only other factors known to increase the risk of anaphylaxis are a previous exposure to a sensitizing antigen and a previous anaphylactic reaction. Notably, anaphylaxis recurrence risks are not 100 percent for reexposure. The reoccurrence rate is 40 to 60 percent for insect stings, 20 to 40 percent for radiocontrast agents, and 10 to 20 percent for penicillin. 1

Limited data are available on the incidence and prevalence of anaphylaxis. The rate of fatal anaphylaxis is approximately 4 deaths per 10 million people per year. 5 The incidence of allergic reactions and anaphylaxis in one study at a university hospital emergency department was 0.5 percent (5 per 1000) and 0.02 percent (2 per 10,000) of the total emergency department population, respectively.6 The most common causes of serious anaphylaxis are antibiotics, such as penicillin, and radiocontrast agents.1 Penicillin is estimated to cause 100 to 500 deaths in the United States annually, with a systemic allergic reaction occurring in 1 per 10,000 exposures.3 Hymenoptera stings constitute the next most common cause of anaphylaxis, with fewer than 100 deaths in the United States annually.1 T§ble.30:1i contains a partial list of some of the more common causative agents.

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