Scientific Study

Background: For adults, prevalence estimates of food sensitization (FS) and food allergy (FA) have been obtained in a standardized manner across Europe. For children, such estimates are lacking. Objectives: To determine prevalence of self-reported FA, FS, probable FA (symptoms plus IgE-sensitization), and challenge-confirmed FA in European school-age children. Methods: Data on self-reported FA were collected through a screening questionnaire sent to a random sample of the general population of 7- to 10-year-old children in eight European centres in phase I of the EuroPrevall study. Data on FS and probable FA were obtained in phase II, comprising an extensive questionnaire on reactions to 24 commonly implicated foods, and serology testing. Food challenge was performed in phase III. Results: Prevalence (95%-CI) of self-reported FA ranged from 6.5% (5.4-7.6) in Athens to 24.6% (22.8-26.5) in Lodz; prevalence of FS from 11.0% (9.7-12.3) in Reykjavik to 28.7% (26.9-30.6) in Zurich; and prevalence of probable FA from 1.9% (0.8-3.5) in Reykjavik to 5.6% (3.6-8.1) in Lodz. In all centres, the majority of food-sensitized subjects had primary (non-cross-reactive) FS. However, FS due to PR-10 cross-reactivity was also common in Central-Northern Europe. Probable FA to milk and egg occurred frequently throughout Europe; to fish and shrimp mainly in the Mediterranean and Reykjavik. Peach, kiwi and peanut were prominent sources of plant FA in most countries, along with notably hazelnut, apple, carrot and celery in Central-Northern Europe, and lentils and walnut in the Mediterranean. Conclusion: There are large geograhical differences in prevalence of FS and FA in school-age children across Europe. Both primary and cross-reactive FS and FA occur frequently.