• Article

EpiPen4Schools survey Characteristics of anaphylaxis and common triggers

The purpose of this study was to describe the characteristics of anaphylactic events and EAI use in children and adults in US schools.

This exploratory, cross-sectional, web-based survey of schools participating in the EpiPen4Schools program captured characteristics of anaphylactic events and EAI use during the 2013-2014 school year.

A total of 5683 schools responded to questions on the occurrence of anaphylactic events. A total of 919 anaphylactic events were reported by 11% of schools (607/5683). Most schools (89%, n=5076) reported no anaphylactic events, and 10% (n=543) reported 1 to 2 anaphylactic events. Most anaphylactic events occurred in students, 89% (n=757), 22% (n=187) of which occurred in those with no known allergies. In 9% (n=75), allergy status was unknown. Of the 919 events, triggers were reported for 847 events (92%); most triggers, 62% (n=529), were listed as food, 10% (n=81) were listed as insect stings, 7% (n=56) as environmental/medication/health-related factors, and 1% (n=9) as latex. Approximately 20% of events (n=172) had an unknown trigger. Although food allergy triggers were predominant throughout the year, prevalence of certain triggers varied seasonally. Insect stings were relatively less frequent during winter, 4% (n=5/143), vs fall, 13% (n=31/243), and spring, 10% (n=26/268) months, whereas unknown triggers reached a high of nearly 27% (n=71/268) during spring.

More than 1 in 10 schools reported an anaphylactic event in a single school year, many of which were associated with unknown triggers. These data indicate the unpredictable nature of anaphylaxis and the importance of anaphylaxis training for staff.


White, MV., Goss, D., Hollis, K., Millar, K., Silvia, E., Siegel, P., ... Hogue, S. (2015). EpiPen4Schools survey: Characteristics of anaphylaxis and common triggers. Journal of Allergy and Clinical Immunology, 135(2, Suppl), AB212. DOI: 10.1016/j.jaci.2014.12.1626