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TOPLINE
Food allergy diagnoses among active-duty US service members rose from about 1.8% in 2017 to 2.4% in 2024, yet severe outcomes remained rare. Over 8 years, seven medical evacuations were recorded during deployments, and 3.35% of food allergy-related emergency department (ED) visits at home duty stations required inpatient care.
METHODOLOGY
- Researchers conducted a retrospective analysis of deidentified aggregate Defense Medical Surveillance System data between 2017 and 2024 on active-duty US service members to assess food allergy incidence, prevalence, and operational outcomes.
- The study sample included all active-duty members of the Army, Navy, Marine Corps, Air Force, and Space Force; the annual total numbers ranged from 1,406,059 to 1,480,894 across the study period.
- Cases were identified using standard diagnostic codes for food anaphylaxis, food allergy, or other adverse food reactions not elsewhere classified.
- Measures included annual incidence per 100,000 person-years and lifetime prevalence of food allergy; outpatient, ED, and inpatient encounters at home duty stations where food allergy was the primary diagnosis; and medical encounters occurring during deployment and medical evacuations.
TAKEAWAY
- Food allergy prevalence among active-duty members rose from about 1.8% in 2017 to 2.4% in 2024. The incidence rate was the lowest in 2020 at 323.6 per 100,000 person-years and the highest in 2024 at 483.6 per 100,000 person-years.
- At home duty stations from 2017 to 2024, food allergy accounted for 34,810 outpatient visits, 4275 ED visits, and 143 hospitalizations. Of the ED visits, 3.35% required inpatient care.
- Medical evacuations were rare during deployment: seven evacuations occurred in 8 years. Food allergy encounters occurring during deployment totaled 843, an average of 105.4 per year. In 2024, 0.003% of members with food allergy required evacuation.
- In 2024, prevalence rates were higher among women (4.5%), Black service members (3.8%), and service members with atopic conditions, including 8.8% of those with asthma. They were lower than the overall prevalence of food allergy of 2.4% in the Marine Corps (1.2%), pilots or aircrew (1.9%), and combat, infantry or artillery roles (1.5%).
IN PRACTICE
"These results illuminate how uncommon FA [food allergy]-related emergencies are in deployment, and suggest that the current accession policy warrants reassessment and possible revision to allow more individuals with FA to participate in military service," the authors wrote.
SOURCE
Krista M. Shaw, MD, with the Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, San Antonio, Texas, was the corresponding author of the study, which was published online on October 29 in The Journal of Allergy and Clinical Immunology: In Practice.
LIMITATIONS
Cases were identified solely using diagnostic codes, without performing a chart review, raising the possibility of miscoding or misclassification. Individual-level data — such as reaction history, serum immunoglobulin E levels, skin testing results, and oral food challenge results — were unavailable. The study also included only active-duty personnel who had already passed initial accession, introducing potential selection bias.
DISCLOSURES
The authors reported no funding sources and no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
