Anaphylaxis in children

Anaphylaxis is increasing over the two last decades, especially in young children and due to food-induced reactions. Anaphylaxis deaths remain rare in children. Food (mainly peanut, milks and nuts) is the main anaphylaxis trigger in children, before drug and insect venom. In infants, the recognition of anaphylaxis may be difficult and physicians may be aware of nonspecific symptoms (wobbly appearance, lethargy, hoarse voice or cry.). Risk factors for more severe (even fatal) or recurrent anaphylaxis reactions are well-known or highly suspected: previous episode of anaphylaxis, history of asthma or atopy, allergy to specific foods (peanuts, milks, tree nuts or soy.), multiple food allergy, adolescence, risk-taking behavior. In France, guidelines for the prescription of adrenaline auto-injector in emergency kit and for the conditions of establishment of personalized care project in allergic children at school have been recently updated. A personalized care project was introduced into national law in 2003 and updated in 2021 (PAI-RS April the 14th 2021) to harmonize emergency action plan at a national level. Since 2019, all high schools must have a provision of spare adrenaline auto-injectors and school staff training on food allergy and anaphylaxis should be encouraged. (C) 2021 Elsevier Masson SAS. All rights reserved.