Peanut and tree nut anaphylaxis in children spikes at Halloween and Easter, research on holidays and allergies finds.
Most were previously unknown allergies, according to the Canadian study, which compares Halloween, Easter, Christmas, Diwali, Chinese New Year, and Eid al-Adha.
“Identifying certain times associated with an increased risk of anaphylaxis—a serious and life-threatening allergic reaction—could help to raise community awareness, support, and vigilance,” write Melanie Leung, a fourth-year medical student at McGill University, Moshe Ben-Shoshan, a pediatric allergist and immunologist at the Montreal Children’s Hospital of the McGill University Health Centre (MUHC), and coauthors.
“This information would identify the best timing for public awareness campaigns to prevent allergic reactions.”
The study looked at 1,390 patients visiting participating pediatric emergency departments between 2011 and 2020 in four Canadian provinces: British Columbia, Ontario, Quebec, and Newfoundland and Labrador. The median age of patients was 5.4 years and 62 percent were boys.
For peanut-triggered anaphylaxis, there was an 85 percent increase in daily average cases during Halloween and a 60 percent increase during Easter compared with the rest of the year. For anaphylaxis triggered by unknown nuts, there was a 70 percent increase during Halloween and Easter compared with the rest of the year. However, the researchers did not find an increase at Christmas, Diwali, Chinese New Year, or Eid al-Adha.
“The difference in the anaphylaxis incidence among holidays may have been due to the social setting in which each holiday takes place,” Leung said. “At Halloween and Easter, children often receive candies and other treats from people who may be unaware of their allergies. The absence of such an association at Christmas may be because Christmas is a more intimate celebration among family members and close friends, who are more vigilant regarding allergen exposure.”
Canadian labeling may also be a factor, as individual packages of one-bite candies and snacks, which are exempt from labeling requirements listing ingredients, are popular at Halloween and Easter.
“Our findings suggest that educational tools to increase vigilance regarding the presence of potential allergens are required among children with food allergies, their families, and lay people interacting with children who have food allergies. Newer strategies targeting intervals associated with high anaphylaxis risk are required,” Ben-Shoshan said.