Anaphylaxis is a life-threatening reaction characterized by the acute onset of symptoms involving different organ systems and requiring immediate medical intervention. The incidence of fatal food anaphylaxis is 0.03 to 0.3 million/people/year. Most fatal food-induced anaphylaxis occurs in the second and third decades of life. The identified risk factors include the delayed use of epinephrine, the presence of asthma, the use of recreational drugs (alcohol, nicotine, cannabis, etc.), and an upright position. In the United Kingdom (UK) and Canada, the reported leading causal foods are peanuts and tree nuts. In Italy, milk seems to be the most common cause of fatal anaphylaxis in children < 18 years. Fatal food anaphylaxis in Italian children and adolescents almost always occurs outside and is characterized by cardiorespiratory arrest; auto-injectable adrenaline intramuscular was available in few cases. Mortality from food anaphylaxis, especially in children, is a very rare event with stable incidence, but its risk deeply impacts the quality of life of patients with food allergy and their families. Prevention of fatal food anaphylaxis must involve patients and their families, as well as the general public, public authorities, and patients’ associations.

中文翻译：

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成人和儿童致命的食物过敏反应

过敏反应是一种危及生命的反应，其特征是涉及不同器官系统的症状急性发作，需要立即医疗干预。致命性食物过敏反应的发生率为 0.03 至 30 万人/人/年。大多数致命的食物引起的过敏反应发生在生命的第二个和第三个十年。已确定的危险因素包括延迟使用肾上腺素、存在哮喘、使用娱乐性药物（酒精、尼古丁、大麻等）和直立姿势。在英国和加拿大，据报道，主要的致病食物是花生和坚果。在意大利，牛奶似乎是 18 岁以下儿童致命过敏反应的最常见原因。意大利儿童和青少年致命的食物过敏反应几乎总是发生在室外，其特点是心肺骤停；在少数情况下可以使用自动肌内注射肾上腺素。食物过敏引起的死亡，尤其是儿童，是一种非常罕见的事件，发病率稳定，但其风险深刻影响食物过敏患者及其家人的生活质量。预防致命的食物过敏反应必须让患者及其家人以及公众、公共当局和患者协会参与。