Anaphylaxis: An Unpredictable Danger

Anaphylactic events may occur at school, even in kids without known allergies

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) Anaphylaxis can occur within seconds of exposure to an allergen like a peanut or a bee sting. But new evidence suggests that many US schools may be ill-prepared to deal with such events.

A new study from the Institute for Asthma & Allergy in Maryland found that more than 1 in 10 US schools responding to a survey reported at least one severe allergic reaction during the 2013-14 school year. And 22 percent of those reactions occurred in kids and teens with no known allergies.

These findings highlight the unpredictable nature of anaphylaxis (a severe allergic reaction that can come on quickly and without warning) and the importance of training parents and teachers to recognize and treat anaphylactic events, the authors of this study said.

"There's always a first time for a reaction — it can be at home, it can be in school, it can be in a restaurant, it can be on the soccer field," said lead study author Martha V. White, MD, research director at the Institute for Asthma & Allergy, in a press release. "But the bottom line is that many students experiencing anaphylaxis in school had no prior known allergies and would not have had medication there or at home."

That's why the EPIPEN4SCHOOLS program was launched in 2012 — to provide free epinephrine auto-injectors (EpiPens) to more than 59,000 public and private kindergarten, elementary, middle and high schools in the US. These devices are used for the emergency treatment of anaphylaxis.

For this study, Dr. White and team surveyed 6,019 US schools that participated in the EPIPEN4SCHOOLS program. A total of 919 anaphylactic events were reported during the 2013-14 school year in these schools.

The most common triggers reported included food and insect stings. Triggers could not be identified in 20 percent of the cases.

The majority (75 percent) of cases were treated with EpiPens. About 18 percent were treated with antihistamines. According to Dr. White and team, EpiPens are the first-line therapy for anaphylaxis. Using other treatments like antihistamines could put students at risk of negative outcomes, they said.

About 36 percent of these schools also reported only training the school nurse and select staff to recognize anaphylaxis. Fifty-four percent reported only permitting select staff to administer EpiPens to patients having an anaphylactic event, Dr. White and team found.

Dr. White and team called for greater access to EpiPens in schools and other public places and more comprehensive training to properly identify and treat anaphylactic events in US schools.

This study will be presented Oct. 24 at the 2015 American Academy of Pediatrics National Conference & Exhibition in Washington, DC. Research presented at conferences may not have been peer-reviewed.

Mylan Specialty, a company that distributes EpiPens, funded this research. No conflicts of interest were disclosed.

Review Date: 
October 21, 2015
Last Updated:
October 23, 2015