Purpose of review: The observed increase in incidence of allergic disease in many regions over the past 3 decades has intensified interest in understanding the epidemiology of severe allergic reactions. We discuss the issues in collecting and interpreting these data, and highlight current deficiencies in the current methods of data gathering. Recent findings: Anaphylaxis, as measured by hospital admission rates, is not uncommon and has increased in the UK, USA, Canada and Australia over the last 10-20 years. All large datasets are hampered by a large proportion of uncoded “unspecified” causes of anaphylaxis. Fatal anaphylaxis remains a rare event, but appears to be increasing for medication in Australia Canada and the USA. The rate of fatal food anaphylaxis is stable in the UK and USA, but has increased in Australia. The age-distribution for fatal food anaphylaxis is different to other causes, with data suggesting an age-related predisposition to fatal outcomes in teenagers and adults to the fourth decade of life. Summary: The increasing rates of food and medication allergy (the latter exacerbated by an ageing population) has significant implications for future fatality trends. An improved ability to accurately gather and analyse population level anaphylaxis data in a harmonised fashion is required, so as to ultimately minimise risk and improve management.
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