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Insects and medication cause most anaphylaxis

Insect stings and bites are the most common cause of anaphylaxis, closely followed by medicines, the largest-ever population-based study has found.

The analysis of eight million patient-years of information from the UK General Practice Research Database also concluded that anaphylactic reactions to vaccines are rare.

Some 675 cases of anaphylaxis were identified, giving an incidence of 8.4 cases per 100,000 patient-years. Insect sting or bite accounted for 32 per cent and medicines for 30 per cent, with penicillin or NSAIDs the most frequent causes. Food allergies caused 22 per cent of cases, with more than half due to nuts.

But only 24 cases of anaphylactic reaction to vaccines were found. The most common cause was DTP. 'Acute severe allergic reactions to vaccines are rare and seldom life-threatening,' concluded the US researchers in a report in Archives of Internal Medicine (February 9).

Only 10 per cent of cases had hypotension and shock requiring urgent treatment – but 70 per cent were either hospitalised or seen at A&E. There was one death in 675 cases.

Dr Apelles Econs, a clinical allergist and a GP in Weybridge, Surrey, said: 'Lives are at stake. It's not an over-

reaction to arrange emergency referral.'

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