Join Us! Professor Ruby Pawankar, President of the World Allergy Organization (WAO), and Professor Motohiro Ebisawa, Chair of the WAO Communications Council, warmly welcome WAO Member Societies to World Allergy Week 2013 (8-14 April). This year’s theme is “Food Allergy—A Rising Global Health Problem”, and there are many ways Member Societies can participate to help highlight food allergies, provide information about the their increasing prevalence, and explain the need for enhanced education and patient care services to improve safey, prevention, and quality of life. WAO will again provide resources for its member societies to use for local activities.

1. Food Allergy – A Rising Global Health Problem
World Allergy Week 2013
8‐14 April 2013
www.worldallergyweek.org

2. Welcome to
World Allergy Week 2013
Ruby Pawankar, MD, PhD
President, World Allergy Organization
The World Allergy Organization welcomes all of you to join us and all of the
educators, healthcare practitioners, policymakers, parents, patients,
advocates and media professionals around the world to mark the third
consecutive year of World Allergy Week by organizing and participating in
activities that bring attention to the rising global prevalence of food allergies
and ways to address them.
Motohiro Ebisawa, MD, PhD
Chair, Communications Council
In keeping with the World Allergy Week tradition of bringing attention to a
specific allergic disease each year, the World Allergy Organization has
selected Food Allergy – A Rising Global Health Problem,
emphasizing the great need for increased awareness, training, and
resources that lead to improved safety and quality of life.
www.worldallergyweek.org

3. Food Allergy –
A Rising Global Health Problem
Food allergies are increasing in both developed and developing
countries, especially in children.
The severity and complexity of food allergy is also increasing.
Food allergies are complicated by other allergic diseases such as
asthma and atopic eczema.
Food allergy can be fatal, and appropriate diagnosis is essential.
There is a need for food labeling worldwide.
There is a need for more clinical knowledge as well as resources to
treat food allergy, including the availability of life‐saving medications
such as epinephrine (adrenaline).
www.worldallergyweek.org

4. Adverse Food Reactions
Immunologic
IgE‐Mediated Non‐IgE Mediated
(most common) Mixed Cell‐Mediated
Immediate type Eosinophilic digestive Newborn and infantile
reactions ‐ skin, digestive disorders
disorders
gastrointestinal,
respiratory symptoms, Atopic dermatitis
systemic (anaphylaxis) (eczema)
Pollen‐fruits allergy
syndrome
Food‐dependent
exercise induced
anaphylaxis (FEIAn or
FDEIA) Source: Sampson H. J Allergy Clin Immunol 2004;113:805‐9,
Chapman J et al. Ann Allergy Asthma & Immunol 2006;96:S51‐68.
www.worldallergyweek.org

5. Food Allergy Symptoms
IgE‐mediated reactions tend to occur immediately or within one to two
hours of ingestion of a food, whereas non‐IgE‐mediated reactions
present later.
Skin manifestations: itching, hives or welts, flush and swelling
Gastrointestinal manifestations: mouth and lip itching, abdominal pain,
vomiting and diarrhea
Respiratory manifestations: runny nose, sneezing, cough, wheezing,
tightness in throat and dyspnea
Generalized manifestations: anaphylaxis – may be the most severe
manifestation of food allergy
Cardiovascular: shock
Source: Fiocchi A, Sampson HA, et al. “Food Allergy”, Section 2.5, in WAO White Book on Allergy, Pawankar R,
Canonica GW, Holgate ST, and Lockey RF, editors (Milwaukee, Wisconsin: World Allergy Organization, 2011),
pp 47‐53.
www.worldallergyweek.org

6. The Growing
Food Allergy Problem
Globally, 220‐520 million people may suffer from food allergy.*
Food allergy has a significant socio‐economic impact.
Food allergy significantly affects the quality of life of sufferers
(mainly children).
The incidence of food allergy (often life‐threatening) is
commonly estimated to be greater in children (5‐8%) than in
adults (1‐2%).
*Extrapolated from European population statistics in: Mills EN, Mackie AR, Burny P, Beyer K, Frewer L et al.
The prevalence, cost and basis of food allergy across Europe. Allergy 2007; 62:717‐722.
Source: Fiocchi A, Sampson HA et al. “Food Allergy”, Section 2.5, in WAO White Book on Allergy, Pawankar R,
Canonica GW, Holgate ST, and Lockey RF, editors (Milwaukee, Wisconsin: World Allergy Organization, 2011),
pp 47‐53.
www.worldallergyweek.org

7. The Burden of Food Allergy Is
Rising in Most Countries
As reported in a survey underway of the Member Societies of the World
Allergy Organization:
The vast majority of countries surveyed so far have reported an increase
in food allergy
No countries have reported a decline in food allergies over the past 10
years
The burden is rising in both developed and developing countries: Many
of the countries surveyed have reported a lack of reliable data and the
need for more studies.
WAO‐WUN Survey on Food Allergy 2013, in progress, contact WAO President
www.worldallergyweek.org

8. Increasing Challenges of Food
Allergy Need to Be Addressed
The disease of food allergy results in exclusion of children from school
canteens and prevents their full participation in school life and society.
Given the current and future public health, social and economic
consequences, the prevention and treatment of allergic reactions to foods
is a major challenge that must be addressed.
Stakeholders must be prepared to meet the needs of patients by
enhancing the diagnostic process, the traceability of responsible foods,
and the availability of substitute foods, assisting hospitalized patients, and
preventing mortality.
Large areas in the world lack legislation on food labeling.
Source: Fiocchi A, Sampson HA et al. “Food Allergy”, Section 2.5, in WAO White Book on Allergy,
Pawankar R, Canonica GW, Holgate ST, and Lockey RF, editors (Milwaukee, Wisconsin: World Allergy
Organization, 2011), pp 47‐53.
www.worldallergyweek.org

9. Causes of Food‐induced
Anaphylaxis in Children
Caused by
Publication food‐induced anaphylaxis Cases
Study Country Ref.
year (n)
1st 2nd 3rd
Järvinen KM et al. USA 2008 Peanuts Cow’s milk Nuts 95 J Allergy Clin Immunol.
Rudders SA et al. USA 2010 Peanuts Cow’s milk Nuts 846 J Allergy Clin Immunol.
Russell S et al. USA 2010 Peanuts shellfish Cow’s milk 124 Pediatr Emerg Care.
Braganza SC et al. Australia 2006 Dairy Egg Peanuts 57 Arch Dis Child.
de Silva IL et al. Australia 2008 Peanuts cashew nut Cow milk 104 Allergy
Crustacean
D. L. M. Goh et al. Singapore 1999 Bird's nest Egg and milk 124 Allergy
seafood
Asian Pac J Allergy
Piromrat K et al. Thailand 2008 Prawn Immunol.
Imai T Japan* 2004 Hen's egg Cow’s milk Wheat 408 Arerugi
*Infant only
www.worldallergyweek.org

10. Food‐induced Anaphylaxis
A case of anaphylaxis
during wheat oral food
challenge: A boy, 4 years
old, developed skin flush
with wheezing and
dyspnea.
Source: Ebisawa M, “Food‐induced anaphylaxis and food associated exercise‐induced anaphylaxis,” in Food Allergy,
James J, Burks W, and Eigenmann P, editors (Elsevier, 2012), pp 113‐128.
www.worldallergyweek.org

11. Worldwide Cases of Fatal
Food‐induced Anaphylaxis
UK 1999‐2006, 48 cases
Peanut 9
Nuts 9
Milk 6
Fish 1
Shellfish 1
Snail 1
Sesame 1
Egg 1
Tomato 1
(uncertain 18)
USA 2001‐2006, 31 cases JACI 2007,119:1018‐9
Peanut 17
Japan 1999‐2004, 4 cases
Tree nuts 8
Shrimp 1
Milk 4
Buckwheat 1
Shrimp 1
Fish 1
JACI 2007,119:1016‐8
Chocolate 1
Nihon Kyukyu Igakukai
USA 1994‐1999, 32 Zasshi2005,16：564‐6
cases*
Peanut 20
Tree nuts 10
Milk 1
Fish 1
*Including a case of Australia 1997‐2005, 7
antigen suspected to cases
cause Peanut 3
JACI 2001,107:191‐3 Fish 1
(no information 1)
(undetermined 2)
JACI 2009,123:434‐42
www.worldallergyweek.org

12. Food Allergy Management and
Anaphylaxis Plans
Challenges:
In many regions autoinjectors are expensive and
not subsidized (especially in countries in Asia,
South America, Middle East, Eastern Europe and
Africa).
Some countries have standardized action plans but no ready access to autoinjectors;
others have autoinjectors but no standardized action plans.
Recommendations:
Implement standardized national ‘anaphylaxis action plans’ for food allergy in countries
where they still are needed.
Improve access to adrenaline autoinjectors in countries where it is limited.
Based on WAO‐WUN Survey on Food Allergy 2013, in progress, contact WAO President
www.worldallergyweek.org

13. To view or download the
WAO White Book on Allergy
visit:
www.worldallergy.org/definingthespecialty/white_book.php
More resources and information about
World Allergy Week 2013
are online at:
www.worldallergyweek.org
www.worldallergyweek.org

14. About the
World Allergy Organization
The World Allergy Organization is an international alliance of 93
regional and national allergy, asthma and immunology societies.
Through collaboration with its Member Societies WAO provides a
wide range of educational and outreach programs, symposia and
lectureships to allergists/immunologists around the world and
conducts initiatives related to clinical practice, service provision, and
physical training in order to better understand and address the
challenges facing allergists/immunologists worldwide.
www. worldallergy.org
www.worldallergyweek.org