Minimum estimated incidence in Japan of anaphylaxis to live virus vaccines including gelatin.
ABSTRACT We have previously found that most occurrences of anaphylaxis to live virus vaccines are caused by gelatin present in the vaccines as a stabilizer. After we published the evidence for the role of gelatin in anaphylaxis, vaccine manufacturers in Japan began to eliminate gelatin from live virus vaccines. In the present study, we tried to estimate its incidence before the gelatin elimination was started. Physicians and vaccine manufacturers submitted serum samples from children with anaphylaxis to measles, mumps, rubella or varicella vaccine to National Institute of Infectious Diseases (NIID) for 3 years from April 1994 to March 1997. Specific IgE to gelatin was assayed at NIID or two manufacturers by the CAP and ELISA methods. There were 44 children with life-threatening severe anaphylaxis (airway obstruction or anaphylactic shock) during the 3-year period, 41 of whom had anti-gelatin IgE. There were 64 children with mild anaphylaxis (without airway obstruction); 62 had anti-gelatin IgE. There were 100 children with only systemic cutaneous signs; 81 had anti-gelatin IgE. The estimates for the incidence of the severe anaphylaxis in 1994-1996 are: 6.84, 7.31, 4. 36, and 10.3 cases per million doses of gelatin-containing measles, rubella, mumps, and varicella vaccines, respectively.
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ABSTRACT: Excipients are substances in pharmaceuticals other than the active ingredients. Some excipients are foods or substances derived from foods, raising the possibility that these substances would pose a hazard to patients with food allergy. This review describes which food-derived substances are used as pharmaceutical excipients in which medications and reviews published data regarding the safety of the administration of these medications to recipients with food allergy. Such reactions are rare, usually because the amount of food protein is not present in a large enough quantity to elicit a reaction. When a food protein appears as an unintentional contaminant, the amount, if any, that is present might be variable and might elicit reactions only from some lots of medication or only in some patients. In most circumstances these medications should not be routinely withheld from patients who have particular food allergies because most will tolerate the medications uneventfully. However, if a particular patient has had an apparent allergic reaction to the medication, potential allergy to the food component should be investigated.Journal of Allergy and Clinical Immunology 06/2014; 133(6):1509–1518. DOI:10.1016/j.jaci.2014.03.011 · 11.25 Impact Factor
Article: [Epidemiology of anaphylaxis.][Show abstract] [Hide abstract]
ABSTRACT: Anaphylaxis is the most severe manifestation of a mast cell dependent hypersensitivity reaction. Recent data on epidemiology indicate that food and drug induced anaphylaxis has increased within the last years. The epidemiological data on anaphylaxis vary throughout the world as the overall incidence and also relevant elicitors depend on different endogenous, but also exogenous factors (e.g. ICD-code, life style, comorbidities). Data from the anaphylaxis registry has shown that venom, drugs and foods are the most frequent elicitors for anaphylaxis within German-speaking countries, while the ranking of the elicitors is age-dependent. Risk factors for anaphylaxis are comorbidities like asthma or mastocytosis or other circumstances, which can increase either the relative risk or the severity. Further risk factors are age, gender and the concomitant intake of drugs like ACE inhibitors or acetylsalicylic acid but also exercise. Data on the clinical epidemiology of anaphylaxis are essential to follow up the most frequent elicitors and risk factors over time and accumulate data about diagnostic and therapeutic procedures in patients suffering from a potential fatal manifestation of an IgE-dependent disease. The anaphylaxis registry within the German-speaking area achieved to provide data of the most frequent elicitors, risk factors and the medical treatment from affected individuals to optimize the management of patients with anaphylaxis.Der Hautarzt 01/2013; DOI:10.1007/s00105-012-2449-1 · 0.54 Impact Factor
Indian Journal of Critical Care Medicine 06/2014; 18(6):410-1. DOI:10.4103/0972-5229.133956