Seafood-induced anaphylaxis in children presenting to Canadian emergency departments Journal Articles uri icon

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  • BACKGROUND: There is a lack of data on seafood-induced anaphylaxis in children in Canada. OBJECTIVE: To evaluate the rate, clinical features, and management of seafood-induced anaphylaxis in children presenting to emergency departments across Canada. METHODS: Children with anaphylaxis were recruited at 6 emergency departments between 2011 and 2020 as part of the Cross-Canada Anaphylaxis REgistry. A standardized form documenting symptoms, triggers, comorbidities, and management was used to collect data. RESULTS: There were 75 fish-induced and 71 shellfish-induced cases of suspected anaphylaxis, most of which were caused by salmon and shrimp, respectively. Mucocutaneous symptoms were most common, whereas respiratory symptoms were associated with patients with fish-induced reactions who have comorbid asthma (adjusted odds ratio [aOR], 1.18; 95% confidence interval [CI], 1.02-1.36). Prehospital epinephrine was underused (<35%), whereas in-hospital epinephrine was given to less than 60% of the patients. Among those with a known fish or shellfish allergy, prehospital epinephrine use was associated with known asthma (aOR 1.39 [95% CI, 1.05-1.84] and aOR 1.25 [95% CI, 1.02-1.54], respectively). Among children who were assessed by either skin test or specific immunoglobulin E, 36 patients (76.6%) with suspected fish-induced anaphylaxis and 19 patients (51.4%) with suspected shellfish-induced anaphylaxis tested positive. CONCLUSION: Prehospital epinephrine is underused in the management of seafood-induced anaphylaxis. Among children with known seafood allergy, prehospital epinephrine use is more likely if there is a known asthma comorbidity.


  • Sehayek, Daniel
  • Gold, Morgan S
  • Gabrielli, Sofianne
  • Abrams, Elissa M
  • Bretholz, Adam
  • Chan, Edmond S
  • Chu, Derek
  • Clarke, Ann E
  • Gerdts, Jennifer
  • Goldman, Ran D
  • Gravel, Jocelyn
  • Hochstadter, Elana
  • Lim, Rodrick
  • McCusker, Christine
  • Moisan, Jocelyn
  • Morris, Judy
  • O'Keefe, Andrew
  • Protudjer, Jennifer LP
  • Shand, Greg
  • Simons, Elinor
  • Upton, Julia
  • Zhang, Xun
  • Ben-Shoshan, Moshe

publication date

  • May 2022