RATIONALE: The EPIPEN4SCHOOLS® program (Mylan Specialty L.P., Canonsburg, PA) provides EpiPen® (epinephrine injection) Auto-Injectors to qualifying public and private US schools. Results of a pilot survey described characteristics of anaphylactic events occurring in an initial set of participating schools during the 2013-2014 school year. This survey was subsequently readministered to large US school districts (greater than or equal to 50 schools per district), which were underrepresented in initial survey findings. Here, data from schools in large districts were added to initial findings in a comprehensive combined analysis.
METHODS: A cross-sectional, web-based pilot survey was distributed to US schools participating in the EpiPen4Schools® program.
RESULTS: A total of 1140 anaphylactic events were reported among 6574 participating US schools. Status of the affected individual was reported for 1063 events; of these, 89.5% (951/1063) occurred in students, 9.2% (98/1063) occurred in staff members, and 0.8% (8/1063) occurred in visitors. Of the events occurring in students with data on grade level (n=891), 44.9% (400/891) occurred in students in high school, 18.9% (168/891) occurred in students in middle school, and 32.5% (290/891) occurred in students in elementary school. Twenty-five percent of all reported events (262/1049) occurred in individuals with no known allergies. Triggers were reported for 1035 events. Among these, food triggers were most frequent (60.1%, 622/1035); however, triggers were unknown in 21.6% of events (224/1035).
CONCLUSIONS: The unpredictability of anaphylaxis is highlighted by the frequency of events with unknown triggers (21.6%) and of events occurring in individuals with no known allergies (25.0%). Results underscore the necessity for comprehensive preparedness training in US schools.
