Rationale: Peanut allergy is one of the most common and severe food allergies among children in the US. Better understanding racial differences and trends in diagnosis can help us understand the etiology of food allergy. The objective of this study is to determine the distribution of peanut allergy as well as reaction history and diagnosis trends among US children.
Methods: Data was collected through a randomized, cross-sectional survey administered to parents belonging to a representative sample of US households with children between June 2009 and February 2010. 38,480 parents were surveyed regarding demographic characteristics, allergic symptoms associated with food ingestion, and methods used to diagnose food allergy were collected and analyzed as weighted proportions. Adjusted models were estimated to examine association of these aspects with the odds of peanut allergy.
Results: 754 of the 3,218 food allergic children in the sample of US households were reported as having peanut allergy (23.4%). Though evenly distributed by gender, peanut allergies were most commonly reported in children aged 6 to 10 years (25.5%). There were no significant differences in peanut allergy prevalence among by race, gender, age or household income. However, children living in homes with an annual household income of less than $50,000 were significantly less likely (OR=0.6) to receive a formal physician diagnosis than children living in homes with a >$50,000 annual income. 53.7% of all cases of peanut allergy reported severe allergic reactions, a significantly higher instance in comparison to food allergy in general (p<0.001). The three most common symptoms reported were hives (63.1%); swelling of lips, eyes or face (53.6%); and trouble breathing (35.2%).
Conclusion: Childhood peanut allergy impacts almost 1 in 4 children with food allergy. Peanut allergy is also the most common childhood food allergy and is evenly distributed by gender, race, and socioeconomic status. Given that over half of these children experience severe allergic reactions upon exposure, it is critical to improve awareness of prevention and management strategies in households, schools and communities.