Food allergies and their associated psychosocial, economic, and physical health burdens are believed to affect approximately 10% of adults and 8% of children in the United States. The eight most common food and food group allergens-including peanuts and shellfish-are well known, with the U.S. Food and Drug Administration (FDA) mandating the labeling of these on packaged foods. Yet, there is growing recognition that other food allergens, such as sesame, may also have a substantial population-level effect. Last year, the FDA requested information on the prevalence and severity of sesame allergies as it considers mandating the labeling of sesame as an allergen. A cross-sectional study reports the current estimates of the prevalence, severity, symptoms, distribution, use of health care services, and determinants of sesame allergy in the United States.

The researchers sent a food allergy prevalence survey to a nationally representative sample of U.S. households from October 1, 2015, to September 30, 2016. Surveys were completed by 51,819 U.S. households and included data on 40,443 adults and 38,408 children. The authors conclude that an estimated 0.23% of the U.S. population has a current sesame allergy with a history of convincing immunoglobulin E-mediated symptoms (that is, at least one symptom on the stringent symptom list developed by the researchers' expert panel). An additional 0.11% of the population is estimated to have a current physician-diagnosed sesame allergy without a corresponding history of stringent reaction symptoms. Overall, a total of 0.49% of the U.S. population-more than 1.5 million children and adults-may have a current sesame allergy, indicating a higher perceived burden than previously believed.

Among people reported to have a convincing sesame allergy, 37.2% said they have had a severe reaction, as indicated by multiple organ system involvement. In addition, 62.2% of those who had a sesame allergy had a current epinephrine prescription and 64.6% had visited an ED at least once because of an allergic reaction to food.-KR