Anaphylactic Reactions on the Beach: A Cause for Concern? (original) (raw)

2009, Journal of Travel Medicine

A naphylaxis is an acute, severe reaction that results from the release of preformed and newly synthesized bioactive mediators from mast cells and basophils. 1 More than 500 fatal cases of anaphylaxis per year are estimated to occur in the United States, while more than 12 deaths are reported in Greece. 1-4 Foods, venoms, and drugs are the most common exogenous antigens, which can provoke an immunoglobulin (Ig) E-mediated reaction, whereas exercise, radiocontrast media, as well as nonsteroidal anti-infl ammatory drugs may induce clinical symptoms with a not yet completely understood mechanism. When no etiologic agent is found despite repeated evaluations, the term idiopathic anaphylaxis is used. 2 Food allergy, in particular, is often implicated in multiple allergies as well as in several reactions such as anaphylactic shock, laryngeal angioedema, and severe acute asthma. 5,6 Crete is a 1,000 km coastline island in the south of Greece. Every year almost 3 million tourists visit this island and enjoy its beaches. Some of the commonest causes of anaphylaxis, including hymenoptera bites, high-risk food, exercise, and jellyfi sh bites, are often encountered on the beach. Even though the risk of anaphylaxis in schools and other public places has been emphasized by various authors, no studies regarding the risk of anaphylactic shock on the beach have been reported so far. 3-8 We evaluate the training level of lifeguards working on the beaches of the island of Crete regarding the management of anaphylaxis. In addition, we assess the sufficiency of medical equipment that lifeguards possess to treat an anaphylactic reaction. Method of Study A prospective, randomized study was conducted in an academic tertiary referral medical center (