More than one in five anaphylactic reactions occur in students with no known allergies

A new study to be presented at the American Academy of Pediatrics (AAP) National Conference & Exhibition in Washington DC, surveyed schools participating in the EPIPEN4SCHOOLS program, which has provided free epinephrine auto-injectors to more than 59,000 public and private kindergarten, elementary, middle and high schools in the United States. The devices are used for emergency treatment of anaphylaxis, a severe allergic reaction that can occur quickly and without warning.

Among the 6,019 schools responding to the survey, a total of 919 anaphylactic events were reported. The majority (75 percent) of individuals were treated with epinephrine auto-injectors, while 18 percent were treated with antihistamines. Nearly 22 percent of the time, the individuals had no known allergies. The most commonly reported triggers included food, accounting for 62 percent of cases, and insect stings (10 percent). Triggers could not be identified in 20 percent of the cases.

The findings highlight the unpredictable nature of anaphylaxis and the significant number of people who experience it for the first time in schools, the study's authors said.

"There's always a first time for a reaction--it can be at home, it can be in school, it can be in a restaurant, it can be on the soccer field," said lead author Martha V. White, MD, research director at the Institute for Asthma & Allergy in Montgomery County, Maryland. "But the bottom line is that many students experiencing anaphylaxis in school had no prior known allergies and would not have had medication there or at home," she said, emphasizing the need for greater access to epinephrine auto-injectors in schools and other public places.

The study was funded by Mylan Specialty, which distributes epinephrine auto-injectors.