Methods: 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.
Results: 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.
Conclusions: 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.