This article is more than 5 years old. Information may no longer be current.

Sesame allergy may affect more than 1 million Americans

At least 1 million children and adults in the U.S. are likely affected by a current IgE-mediated sesame allergy, according to findings recently published in JAMA Network Open.

“Better understanding the U.S. population-level effect of sesame allergy is critical, owing to the fact that the U.S. Food and Drug Administration mandates the labeling of only eight allergenic foods and/or food groups: peanut, milk, shellfish, tree nuts, egg, soy, fin fish and wheat,” Christopher M. Warren, PhD, of the Center for Food Allergy and Asthma Research at the Northwestern University Feinberg School of Medicine and Ann & Robert H Lurie Children’s Hospital of Chicago, and colleagues wrote.

“The decision to not include sesame in labeling laws was made when the aforementioned eight allergens were believed to be responsible for 90% of food allergies,” they added.

Researchers reviewed survey responses of 78,851 individuals (40,453 adults) from 51,819 U.S. households to provide current estimates of the prevalence, severity, distribution and clinical characteristics of sesame allergy in the United States.

Warren and colleagues found that IgE-mediated sesame allergy likely affected at least 1 million U.S. children and adults, with an estimated 0.49% of the population indicating a current sesame allergy, 0.34% reporting “convincing IgE-mediated sesame reaction symptoms” of a current sesame allergy or a current physician diagnosis of sesame allergy and 0.23% having a “convincing” sesame allergy.

In addition, certain atopic conditions were more likely in patients with sesame allergy than patients without the condition, including: asthma (27.2% vs. 12.2%), medication allergy (18.8% vs. 11.3%), eczema (13.7% vs. 6.5%), latex allergy (8.6% vs. 2%), insect sting allergy (7% vs. 3.5%), food protein–induced enterocolitis (4.4% vs. 0.3%) and eosinophilic esophagitis (3.6% vs. 0.2%).

 

At least 1 million children and adults in the U.S. are likely affected by a current IgE-mediated sesame allergy, according to findings recently published in JAMA Network Open.

Source:Adobe

“We believe these data, which demonstrate a substantial and likely growing burden of sesame allergy in the United States, provide valuable context to physicians, policy makers, and other key stakeholders in their efforts to evaluate and reduce the public health burden of sesame allergy,” researchers wrote.

In October 2018, 2 years after Warren and colleagues completed gathering data for their study, the FDA requested information regarding the prevalence of sesame allergies in the United States to determine whether the product should be mandatorily declared as an allergen on food labels. The agency has not released its decision yet.

Jennifer L. P. Protudjer, PhD and Elissa M. Abrams, MD, FRCPC, both of the department of pediatrics and child health at the University of Manitoba, Winnipeg in Canada, discussed some of Warren et al’s “concerning” findings in a related editorial.

"One-half of children and one-third of adults with sesame allergy reported that they did not have a physician diagnosis of their allergy. However, severe reactions involving multiple systems were reported by one-third of the population with convincing sesame allergy. This raises concern that patients with sesame allergy may not be identified by traditional screening questions or have limited access to health care professionals,” they wrote.

Earlier this year, a report indicated the prevalence of overall food allergy and the number of patients who erroneously self-report a food allergy is rising. Subsequently, Healio Primary Care provided ways that primary care physicians can test for food allergy.

Patients of all ages should undergo a respiratory, ear/nose/throat and dermatologic history, according to Tania Elliott, MD, of NYU Langone Health and Kanao Otsu, MD, of National Jewish Health in Denver. If the patient is a child, a breastfeeding, weight and diet history should also be taken. Based on the patients’ responses, blood tests and food challenges can also be used to confirm or deny the existence of food allergy in patients, Elliott and Otsu added. – by Janel Miller

Disclosures: Warren reports receiving grants from the NIH during the conduct of the study. Protudjer reports being on the steering committee for the National Food Allergy Action Plan. Please see the study and previous Healio coverage for all other authors’ relevant financial disclosures.