TY - JOUR T1 - Risk of peanut- and tree-nut–induced anaphylaxis during Halloween, Easter and other cultural holidays in Canadian children JF - Canadian Medical Association Journal JO - CMAJ SP - E1084 LP - E1092 DO - 10.1503/cmaj.200034 VL - 192 IS - 38 AU - Mélanie Leung AU - Ann E. Clarke AU - Sofianne Gabrielli AU - Judy Morris AU - Jocelyn Gravel AU - Rodrick Lim AU - Edmond S. Chan AU - Ran D. Goldman AU - Paul Enarson AU - Andrew O’Keefe AU - Jennifer Gerdts AU - Derek Chu AU - Julia Upton AU - Xun Zhang AU - Greg Shand AU - Moshe Ben-Shoshan Y1 - 2020/09/21 UR - http://www.cmaj.ca/content/192/38/E1084.abstract N2 - BACKGROUND: It is not established whether the risk of anaphylaxis induced by peanuts or tree nuts in children increases at specific times of the year. We aimed to evaluate the risk of peanut-and tree-nut–induced anaphylaxis during certain cultural holidays in Canadian children.METHODS: We collected data on confirmed pediatric cases of anaphylaxis presenting to emergency departments in 4 Canadian provinces as part of the Cross-Canada Anaphylaxis Registry. We assessed the mean number of cases per day and incidence rate ratio (IRR) of anaphylaxis induced by unknown nuts, peanuts and tree nuts presenting during each of 6 holidays (Halloween, Christmas, Easter, Diwali, Chinese New Year and Eid al-Adha) versus the rest of the year. We estimated IRRs and 95% confidence intervals (CIs) using Poisson regression.RESULTS: Data were collected for 1390 pediatric cases of anaphylaxis between 2011 and 2020. Their median age was 5.4 years, and 864 (62.2%) of the children were boys. During Halloween and Easter, there were higher rates of anaphylaxis to unknown nuts (IRR 1.66, 95% CI 1.13–2.43 and IRR 1.71, 95% CI 1.21–2.42, respectively) and peanuts (IRR 1.86, 95% CI 1.12–3.11 and IRR 1.57, 95% CI 0.94–2.63, respectively) compared to the rest of the year. No increased risk of peanut- or tree-nut–induced anaphylaxis was observed during Christmas, Diwali, Chinese New Year or Eid al-Adha. Anaphylaxis induced by unknown nuts, peanuts and tree nuts was more likely in children aged 6 years or older than in younger children.INTERPRETATION: We found an increased risk of anaphylaxis induced by unknown nuts and peanuts during Halloween and Easter among Canadian children. Educational tools are needed to increase awareness and vigilance in order to decrease the risk of anaphylaxis induced by peanuts and tree nuts in children during these holidays. ER -