BACKGROUND: Food-induced anaphylaxis is potentially fatal, but preventable. Considerable public health attention has been given to preventing anaphylaxis from nut exposure among school-aged children. We characterized food-related anaphylactic fatalities in New York City (NYC) and examined changes in incidence during 2000–2014, beginning four years before NYC started supplying epinephrine auto-injectors to schools in 2004.
METHODS: We identified food-related anaphylaxis deaths by using death certificates. A case was defined as a death in a NYC resident during 2000–2014 with an ICD-10 code or literal text indicating mortality attributable to food. To obtain further details regarding circumstances leading to death, we reviewed medical examiner reports. Rates were calculated by using U.S. Census Bureau annual population estimates and compared by using Poisson regression.
RESULTS: Twenty-four food-related deaths were reported among NYC residents during 2000–2014, an average of 1.6/year (range: 0–5); rate of 2.0/10 million person-years. Seafood was the most common cause (9 deaths), followed by nuts (5). Other foods were milk, eggs, chickpeas, and chocolate (1 death each); food was unknown in 6 reports. All seafood-related deaths occurred among persons aged ≥18 years (median age 65 years). Of 5 nut-related deaths, 3 were among persons aged <18 years, including 1 where exposure occurred at school. Rates of fatal anaphylaxis did not differ with regard to time period, age, sex, race/ethnicity, or nativity (U.S. versus non-U.S.).
CONCLUSIONS: Preliminary results indicate that deaths from food-related anaphylaxis in NYC are rare, with no substantial rate change during the 15-year span studied. In NYC, prevention of anaphylaxis deaths in adults with seafood allergies should become a focus of public health efforts to help further reduce food-related anaphylaxis deaths.