Emergency Epinephrine Used 38 Times in Chicago Public Schools

More than half of students had no previous allergic reactions, according to report in the American Journal of Preventive Medicine

Ann Arbor, MI, October 22, 2014

The Chicago Public School (CPS) system used emergency epinephrine in 38 cases during the 2012-2013 school year and more than half of these cases were for first-time events. Anaphylaxis, an allergic reaction characterized by trouble breathing, wheezing, and throat closure, can occur within minutes or seconds and can sometimes result in death. Therefore, it is critically important that school systems have epinephrine auto-injectors (EAIs) available for general use, as reported in the current issue of the American Journal of Preventive Medicine.

Food allergies can trigger anaphylaxis and approximately 8% of children nationally are affected by food allergies. "Currently, there is no treatment or cure for food allergy," said corresponding author of the report, Ruchi Gupta, MD, MPH, Center for Community Health, Feinberg School of Medicine, Northwestern University, Chicago IL. "Timely administration of an EAI is a child's first and primary line of defense in the event of anaphylaxis resulting from allergic reaction."

The authors reviewed all 38 EAI events and found:

  • The majority of those receiving an EAI were students (92%)
  • More than half didn't know they had an allergy (55%)
  • Twenty-one of the EAIs (55%) given were to treat food-induced allergic reactions
  • Among food-induced reactions, peanut was the most common (18%) followed by fin fish (13%)
  • The trigger of more than a third of all reactions was unknown
  • Elementary schools had the most cases of EAIs administered (63%)
  • School nurses administered the medication the majority of the time (76%)

Nearly 37% of the events occurred in Chicago's North-Northwest side, while more than 26% occurred on the city's far South Side. This is significant because nearly half (47%) of the CPS students with physician-documented food allergy resided on the North-Northwest Side, and only 8% lived on the far South Side. This underscores the need for access to EAIs citywide, as children on the Far South Side may not have access to food-allergy diagnosis and could experience their first allergic reaction at school.

The Chicago Public School (CPS) system is the third largest school district in the United States with more than 600 schools providing education to approximately 400,000 children. In response to national and local legislation, CPS placed EAIs in all schools. This is the first large, urban school district in the U.S. to develop and implement the District-Issued Emergency Epinephrine Initiative.

"At CPS, it is our goal to prevent any health-related barriers to learning, which is why we have worked with all of our schools to address this critical issue by equipping them with tools and guidance that they need to keep students safe and healthy," said Stephanie A. Whyte, MD, study coauthor and chief health officer of CPS.


Notes for editors
"Emergency Epinephrine Use for Food Allergy Reactions in Chicago Public Schools," by Lilliana DeSantiago-Cardenas, MSW, Victoria Rivkina, MPH, Stephanie A. Whyte, MD, MBA, Blair C. Harvey-Gintoft, MSW, Bryan J. Bunning, BA(c), and Ruchi S. Gupta, MD, MPH. It is published in the American Journal of Preventive Medicine, online ahead of Volume 48, Issue 2 (February 2015), DOI: http://dx.doi.org/10.1016/j.amepre.2014.09.005.

Full text of the article is available to credentialed journalists upon request; contact Angela J. Beck at +1 734 764 8775 or ajpmmedia@elsevier.com. Journalists wishing to interview the authors should contact Erin White at +1 847 491 4888 or ewhite@northwestern.edu.

About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine (www.ajpmonline.org) is the official journal of The American College of Preventive Medicine (www.acpm.org) and the Association for Prevention Teaching and Research (http://www.aptrweb.org/). It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.The American Journal of Preventive Medicine, with an Impact Factor of 4.281, is ranked 10th in Public, Environmental, and Occupational Health titles and 17th in General & Internal Medicine titles according to the 2013 Journal Citation Reports® published by Thomson Reuters, 2014.

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