Anaphylaxis fatalities and admissions in Australia

J Allergy Clin Immunol. 2009 Feb;123(2):434-42. doi: 10.1016/j.jaci.2008.10.049. Epub 2008 Dec 30.


Background: Detailed data on fatal anaphylaxis are limited, with national anaphylaxis fatality data for the United Kingdom and food-induced anaphylaxis fatality data for the United States. Time trends for anaphylaxis fatalities are not available.

Objective: We examined causes, demographics, and time trends for anaphylaxis fatalities in Australia between January 1997 and December 2005 and compared these with findings for anaphylaxis admissions.

Methods: Data on anaphylaxis deaths and hospital admissions were extracted from a national database. Death certificate codes were analyzed to determine the likely cause and associated comorbidities.

Results: There were 112 anaphylaxis fatalities in Australia over 9 years. Causes were as follows: food, 7 (6%); drugs, 22 (20%); probable drugs, 42 (38%); insect stings, 20 (18%); undetermined, 15 (13%); and other, 6 (5%). All food-induced anaphylaxis fatalities occurred between 8 and 35 years of age with female preponderance, despite the majority of food-induced anaphylaxis admissions occurring in children less than 5 years of age. Most insect sting-induced anaphylaxis deaths occurred between 35 and 84 years almost exclusively in male subjects, although bee sting-induced admissions peak between 5 and 9 years of age with a male/female ratio of 2.7. However, most drug-induced anaphylaxis deaths occurred between 55 and 85 years with equal sex distribution similar to drug-induced anaphylaxis admissions. There was no evidence of an increase in death rates for food-induced anaphylaxis, despite food-induced anaphylaxis admissions increasing approximately 350%. In contrast, drug-induced anaphylaxis deaths increased approximately 300% compared with an approximately 150% increase in drug-induced anaphylaxis admissions.

Conclusion: The demographics for anaphylaxis deaths are different to those for anaphylaxis presentations. Anaphylaxis mortality rates remain low and stable, despite increasing anaphylaxis prevalence, with the exception of drug-induced anaphylaxis deaths, which have increased.

MeSH terms

  • Adolescent
  • Adult
  • Allergens / immunology
  • Anaphylaxis / epidemiology
  • Anaphylaxis / etiology
  • Anaphylaxis / mortality*
  • Australia / epidemiology
  • Child
  • Child, Preschool
  • Drug Hypersensitivity / immunology
  • Drug Hypersensitivity / mortality*
  • Female
  • Food Hypersensitivity / immunology
  • Food Hypersensitivity / mortality*
  • Humans
  • Insect Bites and Stings / immunology
  • Insect Bites and Stings / mortality*
  • Male
  • Patient Admission / statistics & numerical data*
  • Patient Admission / trends
  • Risk Factors
  • Sex Factors
  • Young Adult


  • Allergens