Rationale: The purpose of this study was to describe the characteristics of anaphylactic events and epinephrine auto-injector (EAI) use in children and adults in US schools.
Methods: This exploratory, cross-sectional, web-based survey of schools participating in the EPIPEN4SCHOOLS® program (Mylan Specialty L.P., Canonsburg, PA) captured characteristics of anaphylactic events and EAI use during the 2013-2014 school year.
Results: A total of 5683 schools responded to questions on the occurrence of anaphylactic events. A total of 919 anaphylactic events were reported by 11% of schools (607/5683). Most schools (89%, 5076/5683) reported no anaphylactic events, and 10% (543/5683) reported 1 to 2 anaphylactic events. Most anaphylactic events occurred in students, 89% (757/852), 22% (187/852) of which occurred in those with no known allergies. In 9% (75/852), allergy status was unknown. Of the 919 events, triggers were reported for 847 events (92%); most triggers, 62% (n=529), were listed as food, 10% (n=81) were listed as insect stings, 7% (n=56) as environmental/medication/health-related factors, and 1% (n=9) as latex. Approximately 20% of events (172/847) had an unknown trigger. Although food allergy triggers were predominant throughout the year, prevalence of certain triggers varied seasonally. Insect stings were relatively less frequent during winter, 4% (5/143), vs fall,13% (31/243), and spring, 10% (26/268), months, whereas unknown triggers reached a high of 27% (71/268) during spring.
Conclusions: More than 1 in 10 schools reported an anaphylactic event in a single school year, many of which were associated with unknown triggers. These data indicate the unpredictable nature of anaphylaxis and the importance of anaphylaxis training for staff and caregivers.
