Food Allergy – A Rising Global Health Problem                           World Allergy Week 2013                           ...
Welcome to                                              World Allergy Week 2013                           Ruby Pawankar, M...
Food Allergy –                           A Rising Global Health Problem          Food allergies are increasing in both dev...
Adverse Food Reactions                                           Immunologic    IgE‐Mediated                              ...
Food Allergy Symptoms     IgE‐mediated reactions tend to occur immediately or within one to two      hours of ingestion of...
The Growing                                                            Food Allergy Problem        Globally, 220‐520 milli...
The Burden of Food Allergy Is                                        Rising in Most Countries      As reported in a survey...
Increasing Challenges of Food                                    Allergy Need to Be Addressed         The disease of food ...
Causes of Food‐induced                                                                 Anaphylaxis in Children            ...
Food‐induced Anaphylaxis    A case of anaphylaxis     during wheat oral food     challenge: A boy, 4 years     old, develo...
Worldwide Cases of Fatal                                 Food‐induced Anaphylaxis                                      UK ...
Food Allergy Management and                                             Anaphylaxis Plans  Challenges:     In many regions...
To view or download the                       WAO White Book on Allergy                                    visit:      www...
About the                                 World Allergy Organization       The World Allergy Organization is an internatio...
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World Allergy Week 2013 - Slide deck


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Join Us! Professor Ruby Pawankar, President of the World Allergy Organization (WAO), and Professor Motohiro Ebisawa, Chair of the WAO Communications Council, warmly welcome WAO Member Societies to World Allergy Week 2013 (8-14 April). This year’s theme is “Food Allergy—A Rising Global Health Problem”, and there are many ways Member Societies can participate to help highlight food allergies, provide information about the their increasing prevalence, and explain the need for enhanced education and patient care services to improve safey, prevention, and quality of life.

WAO will again provide resources for its member societies to use for local activities.

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World Allergy Week 2013 - Slide deck

  1. 1. Food Allergy – A Rising Global Health Problem World Allergy Week 2013 8‐14 April
  2. 2. Welcome to  World Allergy Week 2013 Ruby Pawankar, MD, PhD President, World Allergy Organization The World Allergy Organization welcomes all of you to join us and all of the educators, healthcare practitioners, policymakers, parents, patients, advocates and media professionals around the world to mark the third consecutive year of World Allergy Week by organizing and participating in activities that bring attention to the rising global prevalence of food allergies and ways to address them. Motohiro Ebisawa, MD, PhD Chair, Communications Council In keeping with the World Allergy Week tradition of bringing attention to a specific allergic disease each year, the World Allergy Organization has selected Food Allergy – A Rising Global Health Problem, emphasizing the great need for increased awareness, training, and resources that lead to improved safety and quality of
  3. 3. Food Allergy – A Rising Global Health Problem Food allergies are increasing in both developed and developing  countries, especially in children. The severity and complexity of food allergy is also increasing. Food allergies are complicated by other allergic diseases such as  asthma and atopic eczema. Food allergy can be fatal, and appropriate diagnosis is essential. There is a need for food labeling worldwide. There is a need for more clinical knowledge as well as resources to  treat food allergy, including the availability of life‐saving medications  such as epinephrine (adrenaline)
  4. 4. Adverse Food Reactions Immunologic IgE‐Mediated Non‐IgE Mediated (most common) Mixed Cell‐Mediated Immediate type  Eosinophilic digestive  Newborn and infantile  reactions ‐ skin,  digestive disorders disorders gastrointestinal,  respiratory symptoms,  Atopic dermatitis  systemic (anaphylaxis) (eczema) Pollen‐fruits allergy  syndrome Food‐dependent  exercise induced  anaphylaxis (FEIAn or  FDEIA) Source: Sampson H. J Allergy Clin Immunol 2004;113:805‐9,  Chapman J et al. Ann Allergy Asthma & Immunol 2006;96:S51‐
  5. 5. Food Allergy Symptoms IgE‐mediated reactions tend to occur immediately or within one to two  hours of ingestion of a food, whereas non‐IgE‐mediated reactions  present later. Skin manifestations: itching, hives or welts, flush and swelling Gastrointestinal manifestations: mouth and lip itching, abdominal pain, vomiting and diarrhea Respiratory manifestations: runny nose, sneezing, cough, wheezing, tightness in throat and dyspnea Generalized manifestations: anaphylaxis – may be the most severe manifestation of food allergy Cardiovascular: shock Source: Fiocchi A, Sampson HA, et al. “Food Allergy”, Section 2.5, in WAO White Book on Allergy, Pawankar R,  Canonica GW, Holgate ST, and Lockey RF, editors (Milwaukee, Wisconsin: World Allergy Organization, 2011),  pp 47‐
  6. 6. The Growing  Food Allergy Problem Globally, 220‐520 million people may suffer from food allergy.* Food allergy has a significant socio‐economic impact. Food allergy significantly affects the quality of life of sufferers  (mainly children). The incidence of food allergy (often life‐threatening) is  commonly estimated to be greater in children (5‐8%) than in  adults (1‐2%). *Extrapolated from European population statistics in: Mills EN, Mackie AR, Burny P, Beyer K, Frewer L et al.  The prevalence, cost and basis of food allergy across Europe. Allergy 2007; 62:717‐722.  Source: Fiocchi A, Sampson HA et al. “Food Allergy”, Section 2.5, in WAO White Book on Allergy, Pawankar R,  Canonica GW, Holgate ST, and Lockey RF, editors (Milwaukee, Wisconsin: World Allergy Organization, 2011),  pp 47‐
  7. 7. The Burden of Food Allergy Is  Rising in Most Countries As reported in a survey underway of the Member Societies of the World  Allergy Organization: The vast majority of countries surveyed so far have reported an increase  in food allergy No countries have reported a decline in food allergies over the past 10  years The burden is rising in both developed and developing countries: Many  of the countries surveyed have reported a lack of reliable data and the  need for more studies. WAO‐WUN Survey on Food Allergy 2013, in progress, contact WAO
  8. 8. Increasing Challenges of Food  Allergy Need to Be Addressed The disease of food allergy results in exclusion of children from school  canteens and prevents their full participation in school life and society. Given the current and future public health, social and economic  consequences, the prevention and treatment of allergic reactions to foods  is a major challenge that must be addressed. Stakeholders must be prepared to meet the needs of patients by  enhancing the diagnostic process, the traceability of responsible foods,  and the availability of substitute foods, assisting hospitalized patients, and  preventing mortality. Large areas in the world lack legislation on food labeling. Source: Fiocchi A, Sampson HA et al. “Food Allergy”, Section 2.5, in WAO White Book on Allergy,  Pawankar R, Canonica GW, Holgate ST, and Lockey RF, editors (Milwaukee, Wisconsin: World Allergy  Organization, 2011), pp 47‐
  9. 9. Causes of Food‐induced  Anaphylaxis in Children Caused by  Publication food‐induced anaphylaxis Cases Study Country Ref. year (n) 1st 2nd 3rd Järvinen KM et al. USA 2008 Peanuts Cow’s milk Nuts 95 J Allergy Clin Immunol. Rudders SA et al. USA 2010 Peanuts Cow’s milk Nuts 846 J Allergy Clin Immunol. Russell S et al. USA 2010 Peanuts shellfish Cow’s milk 124 Pediatr Emerg Care. Braganza SC et al. Australia 2006 Dairy Egg Peanuts 57 Arch Dis Child. de Silva IL et al. Australia 2008 Peanuts cashew nut Cow milk 104 Allergy Crustacean  D. L. M. Goh et al. Singapore 1999 Birds nest Egg and milk 124 Allergy seafood Asian Pac J Allergy  Piromrat K et al. Thailand 2008 Prawn Immunol. Imai T Japan* 2004 Hens egg Cow’s milk Wheat 408 Arerugi *Infant
  10. 10. Food‐induced Anaphylaxis A case of anaphylaxis  during wheat oral food  challenge: A boy, 4 years  old, developed skin flush  with wheezing and  dyspnea. Source: Ebisawa M, “Food‐induced anaphylaxis and food associated exercise‐induced anaphylaxis,” in Food Allergy,  James J, Burks W, and Eigenmann P, editors (Elsevier, 2012), pp 113‐
  11. 11. Worldwide Cases of Fatal  Food‐induced Anaphylaxis UK 1999‐2006, 48 cases Peanut 9 Nuts 9 Milk 6 Fish 1 Shellfish 1 Snail 1 Sesame 1 Egg 1 Tomato 1 (uncertain 18)USA 2001‐2006, 31 cases JACI 2007,119:1018‐9Peanut 17 Japan 1999‐2004, 4 casesTree nuts 8 Shrimp 1Milk 4 Buckwheat 1Shrimp 1 Fish 1JACI 2007,119:1016‐8 Chocolate 1 Nihon Kyukyu Igakukai  USA 1994‐1999, 32  Zasshi2005,16:564‐6 cases* Peanut 20 Tree nuts 10 Milk 1 Fish 1 *Including a case of  Australia 1997‐2005, 7  antigen suspected to  cases cause Peanut 3 JACI 2001,107:191‐3 Fish 1 (no information 1) (undetermined 2) JACI 2009,123:434‐
  12. 12. Food Allergy Management and  Anaphylaxis Plans Challenges: In many regions autoinjectors are expensive and  not subsidized (especially in countries in Asia,  South America, Middle East, Eastern Europe and  Africa). Some countries have standardized action plans but no ready access to autoinjectors;  others have autoinjectors but no standardized action plans. Recommendations: Implement standardized national ‘anaphylaxis action plans’ for food allergy in countries  where they still are needed.  Improve access to adrenaline autoinjectors in countries where it is limited. Based on WAO‐WUN Survey on Food Allergy 2013, in progress, contact WAO
  13. 13. To view or download the  WAO White Book on Allergy visit: More resources and information about  World Allergy Week 2013 are online at:
  14. 14. About the  World Allergy Organization The World Allergy Organization is an international alliance of 93  regional and national allergy, asthma and immunology societies.  Through collaboration with its Member Societies WAO provides a  wide range of educational and outreach programs, symposia and  lectureships to allergists/immunologists around the world and  conducts initiatives related to clinical practice, service provision, and  physical training in order to better understand and address the  challenges facing allergists/immunologists worldwide. www.