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Should peanut allergy screening be introduced for all Irish children?

Article  in  Clinical and Translational Allergy · March 2015

DOI: 10.1186/2045-7022-5-S3-P13

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5 authors, including:

Maeve Kelleher Audrey Dunn Galvin

Imperial College London University College Cork
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Deirdre M Murray Jonathan Hourihane

University College Cork University College Cork
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 Kelleher et al. Clinical and Translational Allergy 2015, 5(Suppl 3):P13
http://www.ctajournal.com/content/5/S3/P13

POSTER PRESENTATION Open Access

Should peanut allergy screening be introduced

for all Irish children?
Maeve Kelleher*, Claire Culliane, Audrey Dunn Galvin, Deirdre Murray, Jonathan O.B. Hourihane, BASELINE Team
From Food Allergy and Anaphylaxis Meeting 2014
Dublin, Ireland. 9-11 October 2014

Rationale The mode of presentation of these 24 Peanut Allergic

There has been an incremental increase in peanut
allergy worldwide in recent decades. Unlike other major
food allergens, peanut allergic children are unlikely to
acquire tolerance in childhood. Peanut and treenuts are
the most common foods implicated in food induced
anaphylaxis. We use the data gathered from a large
unselected Irish birth cohort study to assess whether
screening for Peanut Allergy should be implemented in
Irish children.
children was examined. 11 infants were confirmed peanut
allergic prior to 2 years through screening when present-
ing with other food allergies. At 2 years 26% (11/42) of
children with previously confirmed food allergy, were
peanut allergic. Six infants reported an adverse reaction
to peanut between 1-2 years and all 6 were confirmed
peanut allergic. Just 7 infants or 0.5% (7/1373) of the
remainder of the asymptomatic population were con-
firmed peanut allergic.

Methods
2137 infants were enrolled on the BASELINE study
from July 2008 to October 2012. From birth to 2 years
children had 5 study appointments. Screening questions
for food allergy were asked at each visit. Skin prick test-
ing (SPT) to peanut was performed in infants who had
symptoms suggestive of peanut allergy or in infants with
known Egg or Cow’s milk allergy. At 2 years screening
for food allergy and sensitisation was offered to all parti-
cipants by SPT to a panel of common food allergens
including peanut. A SPT >3mm was deemed positive.
Infants with peanut positive SPT not regularly and safely
ingesting peanut had Oral Food Challenge (OFC) to dif-
ferentiate Peanut Allergy from asymptomatic food
sensitisation.
Results
Of all 2137 infants enrolled from on to the study from
Conclusion
The prevalence of Peanut allergy in Irish 2 year olds is
1.69%. One third of children with peanut positive testing
at two years can safely tolerate peanut. It is incumbent to
avoid peanut testing on asymptomatic children unless
prompt access to OFC is available to differentiate between
Peanut sensitization and peanut allergy. This study would
suggest targeted screening of infants presenting with early
onset Cow’s Milk or Egg allergy would be the most appro-
priate use of peanut allergy screening resources.
Published: 30 March 2015
doi:10.1186/2045-7022-5-S3-P13
Cite this article as: Kelleher et al.: Should peanut allergy screening be
introduced for all Irish children? Clinical and Translational Allergy 2015
5(Suppl 3):P13.

July 2008 to October 2012, 1537 attended at 2 years.

1421 infants had a full food panel SPT undertaken.
Peanut sensitisation rate was 2.68% (38/1421) and of
these children 63% (24/38) had proven peanut allergy.
Peanut allergy prevalence at 2 years was 1.69% (24/1421).

Department of Pediatrics and Child Health, University College Cork, Cork,

Ireland
© 2015 Kelleher et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://
creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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