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ALLERGEN AWARENESS
Clinical Syndromes and Public Health Impact
The prevalence of food allergies in America is estimated to be around 8% in children
somewhere
less than 10% in the populations as a whole.
The number of people with food allergies appears to
be growing, but explanations for the increase are uncertain, and studies are complicated by
inconsistent case definitions. According to a study released in 2013 by the CDC, food allergies
among children 0 – 17 years of age increased from 3.4% to 5.1%, an increase of 50%, between 1997
and 2011.
The eight most common food allergens, which account for 90% of food allergies,
include cow’s milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat.
When an individual
with a food allergy consumes food containing their allergen, the spectrum of reactions may range
from mild to severe. Symptoms may range from itching and tingling all the way to severe and
potentially fatal reactions such as anaphylaxis involving circulatory collapse and cardiac arrest.
Although scientific studies are ongoing, there is currently no preventive treatment or cure for food
allergies; only strict avoidance will avert a reaction. Although specific estimates are unavailable for
Maryland, a recent study estimated the national cost of food allergies in 2007 was $225 million in
direct medical services, with another $115 million in indirect costs.
See Appendix 4 for a more detailed overview of the issues associated with living with allergies.
Food Service Facility Operational Issues
Most food service facilities are designed to provide a hygienic environment in which food can be
safely prepared, cooked and served to customers. As such the primary focus of a food service
facility is to minimize the risk of microbial contamination of prepared food. This is achieved by
adequate sanitation of the facilities, cooking to the appropriate temperatures and avoiding cross-
contamination between raw and ready to eat products during service and preparation.
Allergens require a new awareness by food service facilities that can necessitate a more
individualized approach to minimize the risk of potentially hazardous cross-contact. This approach
will require knowledge of the ingredients of all food components in the facility and strategies to
minimize cross-contact risks at all stages, in food storage, preparation and serving for food allergic
individuals.
Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, Holl JL. The prevalence, severity, and
distribution of childhood food allergy in the United States. Pediatrics. 2011 Jul;128(1):e9-17. doi: 10.1542/peds.2011-
0204. Epub 2011 Jun 20.
Chafen JJ, Newberry SJ, Riedl MA, Bravata DM, Maglione M, Suttorp MJ, Sundaram V, Paige NM, Towfigh A,
Hulley BJ, Shekelle PG. Diagnosing and managing common food allergies: a systematic review. JAMA. 2010 May
12;303(18):1848-56. doi: 10.1001/jama.2010.582.
U.S. National Center for Health Statistics. Trends in Allergic Conditions Among Children: United States, 1997–2011.
NCHS Data Brief (No. 121), May 2013. Accessed 12/22/2013 at: http://www.cdc.gov/nchs/data/databriefs/db121.pdf.
3.Boyce JA, Assa'ad A, Burks AW, et al; NIAID-Sponsored Expert Panel. Guidelines for the diagnosis and
management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol.
2010;126(suppl 6):S1-S58.
Patel DA, Holdford DA, Edwards E, et al.. Estimating the economic burden of food-induced allergic reactions and
anaphylaxis in the United States. J Allergy Clin Immunol. 2011; 128: 110–115.