Prevalence of fish and shellfish allergy: a systematic review

Moonesinghe, Harriet, MacKenzie, Heather, Venter, Carina, Kilburn, Sally, Turner, Paul J., Weir, Kellyn and Dean, Taraneh (2016) Prevalence of fish and shellfish allergy: a systematic review. Annals of Allergy, Asthma & Immunology, 117 (3), 264-272.e4. (doi:10.1016/j.anai.2016.07.015).

Abstract

Rationale: Accurate information on prevalence of food allergy allows a more evidence-based approach to planning of allergy services. Additionally reporting on the totality of evidence relating to specific food allergy can establish geographical variation which may exist.Methods: Searches were conducted using two databases; Web of Science and PubMed. Initially 985 studies were identified; 902 were excluded at title/abstract screen, 17 at full text screen and a further 7 during data extraction. 59 studies were included in the review. Results: Thirty-four studies reported the prevalence of fish/shellfish allergies in Europe. Prevalence rates based on self-reported allergy were presented in 22 studies, sensitisation rates were assessed in 8 studies using skin prick tests and 5 studies reported on serum IgE, sensitisation plus clinical history was obtained in 4 studies and 7 studies based prevalence data on food challenges. Depending on the assessment criteria prevalence ranged between 0% - 7%.Twenty-seven studies looked at the prevalence of fish/shellfish allergy across the rest of the world. Self-reported allergy was presented in 16 studies, 10 studies combined clinical history and clinician diagnosis, 7 studies measured sensitisation rates with a further 3 studies reporting a convincing clinical history plus sensitisation. Only 2 studies used food challenges to confirm suspected allergy. Depending on the assessment criteria prevalence ranged between 0% - 24.5%.Conclusions: Very few studies have established the prevalence of fish/shellfish allergy using the gold standard challenge criteria. Where this is used the worldwide prevalence rates of fish allergy ranges between 0%-1% and 0.2%-0.9% for shellfish allergy.

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Contributors

Author: Heather MacKenzie

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