Report: Up to 1 in 10 Americans May Suffer From Food Allergies

/PRNewswire/ -- A review published Wednesday in the Journal of the American Medical Association (JAMA) and reported in the New York Times underscores the need for additional research on the prevalence, diagnosis, and treatment of food allergy. One of the most important points suggested by the JAMA study as well as a New York Times article on the subject is that as many as 1 in 10 people may have food allergy.

A May 11 New York Times article regarding JAMA's review states that "true incidence of food allergies is only about 8 percent for children and less than 5 percent for adults."

Between 2 and less than 10 percent of the population has food allergy, according to the JAMA review, "Diagnosing and Managing Common Food Allergies." This figure clearly illustrates the need to increase government commitment to research, testing, and education of a growing problem.

"The systematic review of the food allergy literature published in JAMA is helpful in crystallizing the fact that food allergy is common, affecting millions of Americans, but also points out that we need much more research to better understand the exact prevalence, and how to prevent, more easily diagnose, and treat this life-changing medical problem," said Scott H. Sicherer, M.D., professor of pediatrics, clinician, and clinical researcher at Jaffe Food Allergy Institute, Mount Sinai School of Medicine in New York.

The Centers for Disease Control and Prevention has reported an 18 percent increase in food allergy among children from 1997-2007 and a 3.5-fold increase in hospital admissions related to food allergy among children between the period from 1998-2000 to 2004-2006. The CDC also estimates about 4 percent of U.S. children under the age of 18 have a food allergy.

However, despite these statistics, just $26 million was appropriated last year for research on food allergy, a potentially life-threatening medical condition. The National Institutes of Health last year allocated $175 million for autism funding, which is estimated to affect 1 in 100 children.

JAMA's review was conducted in conjunction with the National Institute of Allergy and Infectious Diseases, which is drafting national Guidelines to the Diagnosis and Management of Food Allergies. The Food Allergy & Anaphylaxis Network (FAAN) and The Food Allergy Initiative (FAI), which have long focused on the need for clinical studies dedicated to food allergy, applaud the government for undertaking these guidelines.

The New York Times article also states that many people who think they have a food allergy actually do not. There is no dispute that many individuals are misdiagnosed with food allergies. Better diagnostic tools are needed. The gold standard for food allergy diagnosis, a double-blinded, placebo-controlled food challenge, is not typically used by allergists because they are not being fully reimbursed for this time-consuming, expensive and potentially dangerous procedure. Funding of this procedure should be addressed by insurance companies.

While improved data on prevalence is necessary, the potential severity of a food allergy reaction is such that individuals should err on the side of caution and assume they have a food allergy and practice avoidance until they are properly diagnosed.

Researchers throughout the world are working diligently to find treatments and a cure for food allergy. FAAN and FAI call upon the federal government to help find a cure for food allergy by providing the necessary funding for quality research.

ABOUT FAAN

Founded in 1991 by Anne Munoz-Furlong, the Food Allergy & Anaphylaxis Network (FAAN) is the world leader in information about food allergy, a potentially life-threatening medical condition that afflicts approximately 12 million Americans, or one out of every 25. A nonprofit organization based in Fairfax, Va., FAAN has approximately 25,000 members in the U.S., Canada, and 58 other countries. It is dedicated to increasing public awareness of food allergy and its consequences, to educating people about the condition, and to advancing research on behalf of all those affected by it. FAAN provides information and educational resources about food allergy to patients, their families, schools, health professionals, pharmaceutical companies, the food industry, and government officials. For more information, please visit FAAN at www.foodallergy.org.

ABOUT FAI

The Food Allergy Initiative (FAI) is a national 501(c)(3) nonprofit organization that funds research seeking a cure for food allergies. FAI was founded in 1998 by concerned parents and grandparents to support basic and clinical research worldwide; public policies to make the world safer for those afflicted; and educational programs to make the hospitality industry, schools, day care centers, and camps safer. The largest private source of funding for food allergy research in the United States, FAI has contributed more than $65 million toward the fulfillment of its mission. For more information, visit www.faiusa.org, call 212-207-1974, or e-mail info@faiusa.org.

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FDA Approves XYZAL(R) For Use In Children Age Six Months And Older For The Relief Of Perennial Allergic Rhinitis And Chronic Idiopathic Urticaria

/PRNewswire/ -- UCB and sanofi-aventis U.S. announced today that the U.S. Food and Drug Administration (FDA) has approved XYZAL (levocetirizine dihydrochloride) for children age six months and older for the relief of symptoms of perennial allergic rhinitis (indoor allergies) and chronic idiopathic urticaria (chronic hives) and for children age two years and older for symptoms of seasonal allergic rhinitis (outdoor allergies). Until now, XYZAL , a once-daily prescription antihistamine in both tablet and liquid formulations, has been used to treat symptoms of indoor and outdoor nasal allergies, as well as chronic idiopathic urticaria in patients age six years and older.

"There are options for treating nasal allergies in young children, one of which is XYZAL . The availability of a liquid treatment with the established safety and efficacy of XYZAL provides caregivers a new treatment option that can help relieve nasal allergy symptoms in young patients once diagnosed by a physician," said Michael Blaiss, M.D., clinical professor of pediatrics and medicine at the University of Tennessee Health Science Center; past president of the American College of Allergy, Asthma, and Immunology (ACAAI) and co-editor of the Atlas of Allergic Diseases.

Nasal allergies are currently the most common chronic condition found in children, with allergic rhinitis believed to affect as many as 40 percent of U.S. children. Recognizing the symptoms and increased hereditary risk are key elements to ensuring early diagnosis and proper management. A child with one parent living with allergies has a 48 percent chance of developing allergies, while a child with two parents living with allergies has a 70 percent chance of developing allergies.

XYZAL tablets received FDA approval on May 25, 2007 and XYZAL oral solution received FDA approval on February 19, 2008.

In September 2006, UCB and sanofi-aventis U.S. entered into an agreement to launch and co-market XYZAL in the U.S. UCB and sanofi-aventis U.S. have a long history in the nasal allergy treatment arena and are committed to advancing treatment for nasal allergy sufferers and helping meet unmet medical needs for patients with chronic nasal allergy symptoms.

About Allergic Conditions

Many people suffer from the symptoms associated with common allergic conditions. The immune system of nasal allergy sufferers overreacts to something in the environment, leading to symptoms that affect their respiratory system, eyes, or skin. Experts estimate indoor and outdoor nasal allergies affect as many as 40 million people in the U.S.

Seasonal allergic rhinitis (SAR), commonly referred to as "hay fever" or "outdoor allergies," is the most common form of allergic rhinitis. By definition, SAR includes nasal allergies to seasonal pollens like grass, trees, and weeds, as well as mold. Perennial Allergic Rhinitis (PAR) is sometimes referred to as "year round" or "indoor allergies" and is characterized by allergic symptoms that last longer than four weeks. House dust mites, animal dander, and mold most commonly trigger PAR. Chronic Idiopathic Urticaria (CIU) is most commonly known as "chronic hives of unknown origin" and is defined as the occurrence of daily, or almost daily, wheals and itching for at least six weeks with no obvious causes.

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Folic Acid May Help Treat Allergies, Asthma

Folic acid, or vitamin B9, essential for red blood cell health and long known to reduce the risk of spinal birth defects, may also suppress allergic reactions and lessen the severity of allergy and asthma symptoms, according to new research from the Johns Hopkins Children's Center.

In what is believed to be the first study in humans examining the link between blood levels of folate -- the naturally occurring form of folic acid -- and allergies, the scientists say results add to mounting evidence that folate can help regulate inflammation. Recent studies, including research from Johns Hopkins, have found a link between folate levels and inflammation-mediated diseases, including heart disease. A report on the Johns Hopkins Children's findings appears online ahead of print in the Journal of Allergy & Clinical Immunology.

Cautioning that it's far too soon to recommend folic acid supplements to prevent or treat people with asthma and allergies, the researchers emphasize that more research needs to be done to confirm their results, and to establish safe doses and risks.

Reviewing the medical records of more than 8,000 people ages 2 to 85 the investigators tracked the effect of folate levels on respiratory and allergic symptoms and on levels of IgE antibodies, immune system markers that rise in response to an allergen. People with higher blood levels of folate had fewer IgE antibodies, fewer reported allergies, less wheezing and lower likelihood of asthma, researchers report.

"Our findings are a clear indication that folic acid may indeed help regulate immune response to allergens, and may reduce allergy and asthma symptoms," says lead investigator Elizabeth Matsui, M.D., M.H.S., pediatric allergist at Johns Hopkins Children's. "But we still need to figure out the exact mechanism behind it, and to do so we need studies that follow people receiving treatment with folic acid, before we even consider supplementation with folic acid to treat or prevent allergies and asthma."

The current recommendation for daily dietary intake of folic acid is 400 micrograms for healthy men and non-pregnant women. Many cereals and grain products are already fortified with folate, and folate is found naturally in green, leafy vegetables, beans and nuts.

Other findings of the study:

People with the lowest folate levels (below 8 nanograms per milliliter) had 40 percent higher risk of wheezing than people with the highest folate levels (above 18 ng/ml).
People with the lowest folate levels had a 30 percent higher risk than those with the highest folate levels of having elevated IgE antibodies, markers of allergy predisposition.
Those with the lowest folate levels had 31 percent higher risk of atopy (allergic symptoms) than people with the highest folate levels.
Those with lowest folate levels had 16 percent higher risk of having asthma than people with the highest folate levels.
Blacks and Hispanics had lower blood folate levels - 12 and 12.5 nanograms per milliliter, respectively - than whites (15 ng/ml), but the differences were not due to income and socio-economic status.

The Johns Hopkins team is planning a study comparing the effects of folic acid and placebo in people with allergies and asthma.

Asthma affects more than 7 percent of adults and children in the United States, and is the most common chronic condition among children, according to the Centers for Disease Control and Prevention. Environmental allergies are estimated to affect 25 million Americans, according to the CDC.

Co-investigator on the study: William Matsui, M.D, of the Johns Hopkins Kimmel Cancer Center.

The research was funded by the National Institutes of Health.

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CDC Study Finds 3 Million U.S. Children have Food or Digestive Allergies

The number of young people who had a food or digestive allergy increased 18 percent between 1997 and 2007, according to a new report by the Centers for Disease Control and Prevention. In 2007, approximately 3 million U.S. children and teenagers under age 18 – or nearly 4 percent of that age group – were reported to have a food or digestive allergy in the previous 12 months, compared to just over 2.3 million (3.3 percent) in 1997.

The findings are published in a new data brief, “Food Allergy Among U.S. Children: Trends in Prevalence and Hospitalizations.” The data are from the National Health Interview Survey and the National Hospital Discharge Survey, both conducted by CDC′s National Center for Health Statistics.

The report found that eight types of food account for 90 percent of all food allergies: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. Reactions to these foods by an allergic person can range from a tingling sensation around the mouth and lips, to hives and even death, depending on the severity of the reaction.

Children with food allergy are two to four times more likely to have other related conditions such as asthma and other allergies, compared to children without food allergies, the report said.
Other highlights:

* Boys and girls had similar rates of food allergy – 3.8 percent for boys and 4.1 percent for girls.
* Approximately 4.7 percent of children younger than 5 years had a reported food allergy compared to 3.7 percent of children and teens aged 5 to 17 years.
* Hispanic children had lower rates of reported food allergy (3.1 percent) than non-Hispanic white (4.1 percent) or non-Hispanic black children (4 percent.)
* In 2007, 29 percent of children with food allergy also had reported asthma compared to 12 percent of children without food allergy.
* Approximately 27 percent of children with food allergy had reported eczema or skin allergy, compared to 8 percent of children without food allergy.
* Over 30 percent of children with food allergy also had reported respiratory allergy, compared with 9 percent of children with no food allergy.
* From 2004 to 2006, there were approximately 9,537 hospital discharges per year with a diagnosis related to food allergy among children from birth to 17 years. Hospital discharges with a diagnosis related to food allergy increased significantly over time between 1998-2000 through 2004-2006.

The mechanisms by which a person develops an allergy to specific foods are largely unknown. Food allergy is more prevalent in children than adults. Most affected children will outgrow food allergies, although food allergy can be a lifelong concern.

The full report is available at www.cdc.gov/nchs.

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Cypress Pharmaceutical, Inc. receives FDA approval of Cetirizine Hydrochloride Oral Solution

(BUSINESS WIRE)--Cypress Pharmaceutical, Inc., announced yesterday that the U.S. Food and Drug Administration (FDA) has granted final approval of the company’s abbreviated new drug application (ANDA) for the prescription and over-the-counter versions of Cetirizine Hydrochloride Oral Solution, 1 mg/1 mL.

Cypress’ Cetirizine HCl Oral Solution is the AA-rated generic equivalent to McNeil Consumer Healthcare’s Zyrtec® Oral Solution. The prescription version of Cetirizine HCl Oral Solution is used for the relief of symptoms associated with perennial allergic rhinitis in children 6 to 23 months of age, and for chronic urticaria (hives) in children 6 months to 5 years of age. The over-the-counter version of Cetirizine HCl Oral Solution is an antihistamine used for the relief of sneezing, runny nose, itchy, watery eyes and itchy throat or nose due to indoor and outdoor allergies for individuals 2 years and older and for the relief of itching due to hives for individuals 6 years and older.

Cypress’ Cetirizine HCl Oral Solution will be available through all the national drug wholesalers and chain drug stores and will begin shipping immediately.

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Hopkins Experts: Most Vaccine-Allergic Children Can Still Be Safely Vaccinated

With close monitoring and a few standard precautions, nearly all children with known or suspected vaccine allergies can be safely immunized, according to a team of vaccine safety experts led by the Johns Hopkins Children’s Center. Writing in the September issue of Pediatrics, the multicenter research team offers pediatricians a step-by-step tool for quickly identifying children with allergic reactions to vaccines, and a much-needed guide, they say, to safely immunize those who are allergic.

Serious allergic reactions to vaccines are extremely rare — one or two per million vaccinations, according to some estimates — but when they happen, such episodes can be serious, even life-threatening, making it critical for pediatricians to instantly spot true allergic reactions and differentiate them from more benign nonallergic responses, investigators say. It is also crucial that pediatricians design a safe immunization plan for children with confirmed vaccine allergies. Children who have had one allergic reaction are believed to be at a higher risk for future reactions, typically more serious than the first.

“We cannot reiterate enough that the vaccines used today are extremely safe, but in a handful of children certain vaccine ingredients can trigger serious allergic reactions,” says Robert Wood, M.D., lead author on the paper and chief of pediatric Allergy and Immunology at Hopkins Children’s. “For the most part, even children with known allergies can be safely vaccinated.”

Given recent outbreaks of vaccine-preventable infections like measles, mumps and whooping cough in the United States, and measles and polio overseas, it is essential to safely vaccinate as many children as possible, investigators say.

Combing through available evidence on vaccine safety and allergies, the Hopkins-led team developed a sequence of instructions – an algorithm – that prompts physicians one step at a time on how to evaluate and immunize children with known or suspected vaccine allergies.

The guidelines are intended for doctors and parents who are uncertain about vaccine safety in children who have already had or are at high risk for having allergic reactions to vaccines.

In such cases, the Hopkins-led group advises a workup by an allergist, including skin prick testing—a prick on the skin or an injection under the skin with a small dose of vaccine or the suspected allergen from the vaccine—or blood tests that would detect the presence of characteristic antibodies that patients develop to allergens, such as antibodies to gelatin or egg proteins used in several common vaccines.

In many cases, allergic children can be vaccinated using alternative forms of a vaccine that are free of the allergen. Even if allergen-free formulations are unavailable, many children can still be vaccinated and remain under physician supervision for several hours after vaccination. Another option is testing the child to check for immunity. If blood tests show the child has already developed protective antibodies, it may be OK, at least temporarily, to withhold further doses of the vaccine, researchers write.

“Vaccines save lives, and parents should know that children who have had allergic reactions after a vaccine are likely to have developed protection against infection as a result of the vaccination,” says investigator Neal Halsey, M.D., an infectious disease specialist at Hopkins Children’s, and professor of International Health at the Johns Hopkins University Bloomberg School of Public Health.

“Most children who have had an allergic reaction after a vaccine can still be vaccinated against other diseases safely and some can receive additional doses of vaccines they might have reacted to,” Halsey adds.

Many children with known vaccine allergies who have low levels of protective antibodies and require more doses can be vaccinated safely under the guidelines. In some cases, children with known allergies can be given antiallergy medications, such as antihistamines and corticosteroids, before vaccination to help ward off or lessen the allergic reaction. For a step-by-step guide to vaccine administration in children with known or suspected vaccine allergy, see the full text of the article at http://pediatrics.aappublications.org/future/122.3.shtml.

Immunizations of children with known vaccine allergies should always be administered under medical supervision in a clinic equipped to treat life-threatening allergic reactions or in a hospital intensive-care unit. Patients can usually go home after an hour or two if they have no adverse reactions.

True allergies typically cause immediate reactions, involving the immune system as a whole that occur within a few minutes to a few hours of vaccination. By contrast, delayed reactions, which occur within days, even weeks after vaccination, are generally benign and are rarely, if ever, dangerous.

Symptoms of immediate allergic reactions include hives, swelling, wheezing, coughing, low blood pressure, vomiting, diarrhea, and can lead to full-blown anaphylaxis, a life-threatening allergic reaction.

The research was funded by the Centers for Disease Control and Prevention.

Co-investigators on the research: Melvin Berger, M.D. Ph.D., University Hospitals of Cleveland; Stephen Dreskin, M.D. Ph.D., University of Colorado; Rosanna Setse, M.D. M.P.H., Johns Hopkins University Bloomberg School of Public Health; Renata Engler, M.D., Walter Reed Army Medical Institute; Cornelia Dekker, M.D., Stanford University School of Medicine. The Clinical Immunization Safety Assessment Network, consisting of six medical research centers with expertise in immunization safety, was part of the study.

Conflict of interest disclosure for Hopkins investigators: Halsey has received research support from vaccine manufacturer Wyeth and is a consultant for vaccine manufacturers GlaxoSmithKline and Merck.

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Breathe Easy this Allergy Season

HHH note: May is Allergy & Asthma Awareness Month. According to the Asthma & Allergy Foundation of America, Atlanta ranks number 4 for America's Allergy Capitals.

(ARA) – For the millions of Americans who suffer from asthma and allergies, a dust-free home may be just what the doctor ordered. As allergy season approaches, it is a good time to put dusting on top of your cleaning checklist. Here are some tips for allergy-proofing your home from board-certified physician and author of “Allergies & Asthma for Dummies,” Dr. William E. Berger:

“House dust is one of the most prevalent – and unavoidable – allergy triggers in any home,” says Dr. Berger. “Since you can’t control the allergens outside your home, dusting is just one of the several easy steps you can take to allergy-proof the inside.”

Don’t Sleep on It

You are not the only one who loves your bed; so do dust mites. In fact, an average bed contains 2 million dust mites, which means it’s possible to breathe in significant amounts of allergens while sleeping. However, a few simple steps can be taken to ensure those mites are not sleeping in your bed.

* Cover all mattresses and pillows with zippered, dust-proof covers. Choose a material, like plastic, vinyl or fabrics, with pores too small to allow dust mites through.

* Wash bed sheets and blankets every week in hot water – at least 130 degrees F – to kill dust mites.

Don’t Sit on It

Dusting furniture alone will not eliminate dust and pet dander. Some products, such as feather dusters or dusting cloths, simply stir up dust in the air instead of eliminating the allergens within dust and pet dander.

* Use a product that contains allergen trappers. Pledge Furniture Polish removes up to 84 percent of allergens from dust mites and pet dander found in dust.

* If you have severe allergies, avoid furniture made from upholstery. Instead choose wood, plastic, vinyl or leather furniture; these materials are easier to clean than fabric.

Don’t Touch it

Certain places in the home can be a breeding ground for dust mites and pet dander. Making smart choices when picking furniture and household accessories can make a difference for allergy sufferers.

* Pet dander is more easily collected in carpeting and thick rugs. To help make allergy-proofing easier, choose bare floors over carpeting where you can use cleaning products to pick up and remove allergens from pet dander. Using a vacuum with a HEPA filter at least once a week is an alternative option.

* Allergy sufferers should avoid curtains and instead opt for shades or blinds that are easy to clean.

Go to www.pledge.com to learn more about allergen-reducing Pledge products and for more tips on reducing allergens in your home.

Courtesy of ARAcontent

Studies Highlight MRSA Evolution and Resilience

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are caused primarily by a single strain — USA300 — of an evolving bacterium that has spread with "extraordinary transmissibility" throughout the United States during the past five years, according to a new study led by National Institutes of Health (NIH) scientists. CA-MRSA, an emerging public health concern, typically causes readily treatable soft-tissue infections such as boils, but also can lead to life-threatening conditions that are difficult to treat.

The study, from the National Institute of Allergy and Infectious Diseases (NIAID) of NIH, resolves debate about the molecular evolution of CA-MRSA in the United States. The findings rule out the previously held possibility that multiple strains of USA300, the most troublesome type of CA-MRSA in the United States, emerged randomly with similar characteristics. The study also offers a hypothesis for the origin of previous S. aureus outbreaks, such as those caused by penicillin-resistant strains in the 1950s and 1960s.

A second study led by the same NIAID scientists takes the issue of the evolution of MRSA a step further, revealing new information about how MRSA bacteria in general, including the USA300 group, elude the human immune system.

The first study, which appears online this week in the Proceedings of the National Academy of Sciences, found that the USA300 group of CA-MRSA strains, collectively called the epidemic strain, comprises nearly identical clones that have emerged from a single bacterial strain. It is the first time scientists have used comparative genome sequencing to reveal the origins of epidemic CA-MRSA. Frank R. DeLeo, Ph.D., at NIAID's Rocky Mountain Laboratories (RML) in Hamilton, Mont., led the research.

"Scientists are pressing ahead quickly to learn more about how some MRSA strains evade the immune system and spread rapidly," says NIAID Director Anthony S. Fauci, M.D. "The information presented in these two studies adds important new insights to that expanding knowledge base."

To understand how CA-MRSA is evolving in complexity and spreading geographically, Dr. DeLeo's group sequenced the genomes of 10 patient samples of the USA300 bacterium recovered from individuals treated at different U.S. locations between 2002 and 2005. They then compared these genomes to each other and to a baseline USA300 strain used in earlier studies. Eight of the 10 USA300 patient samples were found to have nearly indistinguishable genomes, indicating they originated from a common strain. The remaining two bacteria were related to the other eight, but more distantly.

Interestingly, of the eight nearly indistinguishable USA300 patient samples, two caused far fewer deaths in laboratory mice than the others, highlighting an emerging view that tiny genetic changes among evolving strains can profoundly affect disease severity and the potential for drug resistance to develop.

"The USA300 group of strains appears to have extraordinary transmissibility and fitness," says Dr. DeLeo. "We anticipate that new USA300 derivatives will emerge within the next several years and that these strains will have a wide range of disease-causing potential." Ultimately, Dr. DeLeo and his colleagues hope that the work will lead to the development of new diagnostic tests that can quickly identify specific strains of MRSA.

Fred C. Tenover, Ph.D., of the Centers for Disease Control and Prevention in Atlanta (CDC) contributed the 10 USA300 clinical isolates from CDC's Active Bacterial Core Surveillance system. Other study collaborators included Barry N. Kreiswirth, Ph.D., of the International Center for Public Health (ICPH) in Newark, N.J., and James M. Musser, M.D., Ph.D., of The Methodist Hospital Research Institute in Houston.

The second report, which involved scientists from RML, ICPH and Vanderbilt University Medical Center in Nashville, was recently published online in the Journal of Immunology. This study provides scientists with new details about the complex mechanisms MRSA uses to avoid destruction by neutrophils, human white blood cells that ingest and destroy microbes. When exposed to hydrogen peroxide, hypochlorous acid (the active component of household bleach) or antimicrobial proteins — all killer chemicals released by neutrophils — MRSA senses danger, escapes harm and turns the tables on the white blood cells, destroying them. Work is continuing in Dr. DeLeo's lab to understand how the bacterium senses and survives attacks by neutrophils.

NIAID is a component of the National Institutes of Health. NIAID supports basic and applied research to prevent, diagnose and treat infectious diseases such as HIV/AIDS and other sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. NIAID also supports research on basic immunology, transplantation and immune-related disorders, including autoimmune diseases, asthma and allergies.