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.