MONDAY, Sept. 21, 2020 — Among Canadian children, the risk for anaphylaxis induced by unknown nuts and peanuts is increased during Halloween and Easter, according to a study published online Sept. 21 in CMAJ, the journal of the Canadian Medical Association.

Mélanie Leung, from Montreal Children’s Hospital, and colleagues collected data on confirmed pediatric cases of anaphylaxis presenting to emergency departments in four Canadian provinces. The authors calculated the mean number of cases per day and the incidence rate ratio of anaphylaxis induced by unknown nuts, peanuts, and tree nuts presenting during each of six holidays versus the rest of the year. Data were included for 1,390 pediatric cases of anaphylaxis between 2011 and 2020.

The researchers observed higher rates of anaphylaxis to unknown nuts (incidence rate ratios [95 percent confidence intervals], 1.66 [1.13 to 2.43] and 1.71 [1.21 to 2.42]) and peanuts (incidence rate ratios [95 percent confidence intervals], 1.86 [1.12 to 3.11] and 1.57 [0.94 to 2.63]) during Halloween and Easter, respectively, compared with the rest of the year. During Christmas, Diwali, Chinese New Year, or Eid al-Adha, there was no increased risk for peanut- or tree nut-induced anaphylaxis. Compared with younger children, children aged 6 years or older had an increased likelihood of anaphylaxis induced by unknown nuts, peanuts, and tree nuts.

“Educational programs and strategies increasing vigilance among families of children with peanut or tree nut allergy and among people interacting with them are required in order to render holidays safer for all Canadian children,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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