The Prevalence of Food Sensitization Appears Not to Have Changed between 2 Melbourne Cohorts of High-Risk Infants Recruited 15 Years Apart

Rachel L Peters; Jennifer J Koplin; Katrina J Allen; Adrian J Lowe; Caroline J Lodge; Mimi L K Tang; Melissa Wake; Anne-Louise Ponsonby; Bircan Erbas; Michael J Abramson; David Hill; Lyle C Gurrin; Shyamali C Dharmage

doi:10.1016/j.jaip.2017.11.018

The Prevalence of Food Sensitization Appears Not to Have Changed between 2 Melbourne Cohorts of High-Risk Infants Recruited 15 Years Apart

J Allergy Clin Immunol Pract. 2018 Mar-Apr;6(2):440-448.e2. doi: 10.1016/j.jaip.2017.11.018. Epub 2017 Dec 18.

Authors

Affiliations

¹ Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Victoria, Australia.
² Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; School of Population and Global Health, University of Melbourne, Parkville, Melbourne, Victoria, Australia.
³ Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Victoria, Australia; University of Manchester, Manchester, UK; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia.
⁴ School of Population and Global Health, University of Melbourne, Parkville, Melbourne, Victoria, Australia.
⁵ Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Victoria, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia.
⁶ Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Victoria, Australia; Department of Paediatrics and the Liggins Institute, The University of Auckland, Auckland, New Zealand.
⁷ Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Victoria, Australia; School of Population and Global Health, University of Melbourne, Parkville, Melbourne, Victoria, Australia.
⁸ School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.
⁹ School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
¹⁰ Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia.
¹¹ School of Population and Global Health, University of Melbourne, Parkville, Melbourne, Victoria, Australia. Electronic address: s.dharmage@unimelb.edu.au.

PMID: 29248387
DOI: 10.1016/j.jaip.2017.11.018

Abstract

Background: Although food allergy has probably risen over recent decades, recent reports suggest that the prevalence of food sensitization in the general population has not changed. However, this has not been analyzed in infants at high risk of food allergy.

Objective: The objective of this study was to compare the prevalence of food sensitization in high-risk infants from 2 cohorts recruited 15 years apart in the same region.

Methods: This study includes 620 high-risk infants with a family history of allergy (Melbourne Atopy Cohort Study [MACS]) born 1990-1994, and a subgroup of high-risk infants from the population-based HealthNuts study (n = 3,661/5,276), born 2006-2010. Both studies undertook skin prick tests (SPT) to peanut, egg, and milk at age 12 months. A logistic regression model generated adjusted prevalences to account for differences in sampling frame. SPT ≥ 95% positive predictive values (PPVs) for food allergy were used as proxies for food allergy.

Results: The adjusted prevalence of sensitization in MACS was similar to the observed prevalence of sensitization in the high-risk subgroup of HealthNuts: 7.9% (95% confidence interval 6.8-8.9) and 7.9% (7.0-8.8) respectively for peanut, 15.0% (13.4-16.6) and 14.5% (13.4-15.7) respectively for egg, and 2.4% (1.6-3.1) and 2.6% (2.0-3.4) respectively for cow's milk. The prevalence of SPT ≥ 95% PPVs was similar between the 2 studies.

Conclusions: The prevalence of food sensitization among high-risk infants has remained stable in Australia since the 1990s, despite the reported increase in food-related anaphylaxis in the same period. This discrepancy could be due to increased food allergy in the low-risk population, increased conversion of food sensitization to allergy, or increased number of high-risk infants. Alternatively, increased awareness or severity of reactions may have led to an apparent increase in food allergy.

Keywords: Cow's milk allergy; Egg allergy; Food allergy; Food sensitization; Peanut allergy; Time trends.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia / epidemiology
Child, Preschool
Cities / epidemiology
Cohort Studies
Food Hypersensitivity / diagnosis
Food Hypersensitivity / epidemiology*
Humans
Infant
Prevalence
Risk Factors
Skin Tests