We were puzzled by the review article on anaphylaxis by Neugut et al1 recently published in the ARCHIVES. The authors estimated that anaphylaxis to foods, drugs, latex, and insect stings may affect 1.2% to 15.0% of the US population. Risks and rates of idiopathic, exercise-induced, and other causes of anaphylaxis were not included in this estimate. They point out numerous limitations in their analysis, primarily stemming from variations in the definition of anaphylaxis and the lack of studies performed on unselected populations. Although we recognize these limitations, we were most surprised by their apparent underestimate of the impact of food-induced anaphylaxis. In the abstract, the rate of food-induced anaphylaxis was reported as 0.0004% and the minimal population at risk was reported as 1099 compared with minimal estimates of 1.9 million for penicillin, 1.36 million for insect stings, and 22 000 for radiocontrast media.
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