Preventing food allergy fatalities

Arch Dis Child. 2023 Sep;108(9):698-702. doi: 10.1136/archdischild-2022-324911. Epub 2023 Jan 23.


Fatal anaphylaxis to food is thankfully rare, but every death is a potentially avoidable tragedy. Usually, there will be a coronial inquest to establish the 'how and why' for each death. Reviewing these food allergy-related deaths identifies a number of common themes and risk factors. While some are non-modifiable (such as age, gender and ethnicity), others are and include delayed epinephrine administration and communication difficulties in allergen avoidance. This review highlights the key messages in food allergy-related fatality prevention for healthcare professionals and patients alike, and where available, we explain the evidence behind such recommendations. We describe the data behind the good practice points to facilitate their adoption in routine practice without generating additional anxiety for what is a comparatively rare event. We also propose an information leaflet for patients and carers, developed with patients and endorsed by two major allergy charities, to facilitate dissemination of the recommendations in this review.

Keywords: Allergy and Immunology; Paediatric Emergency Medicine; Paediatrics.

Publication types

  • Review

MeSH terms

  • Allergens
  • Anaphylaxis* / prevention & control
  • Epinephrine / therapeutic use
  • Food
  • Food Hypersensitivity* / prevention & control
  • Humans
  • Risk Factors


  • Epinephrine
  • Allergens