Background: There are no reports on the prevalence and social acceptance of food allergies (FAs) and FAinduced symptoms in nursery schools in Japan.

Purpose: The purpose of this study is to clarify the current status of FA among children in nurseries.

Methods: Investigations were conducted in childcare facilities nationwide through survey request forms found on the Web page or sent via post.

Result: We received responses from 15722 out of the 32210 institutions (48.8%) to whom survey request forms were sent.

The overall prevalence of FA was 4.0%, with 6.4% at age less than 1 year, 7.1% at age 1, 5.1% at age 2, 3.6% at age 3, 2.8% at age 4, 2.3% at age 5, and 0.8% at age 6. Ninety-three point four percent of the institutions responded that they catered to children with FA, whereas 3.3% of the institutions responded that they did not. The details of the meal service were as follows: 52.4% were meals without causative foods, 39.5% were alternative meals without causative foods, and 3.3% were packed lunches from home. Seven point six percent of infants had at least one FA symptom in the institutions.

Conclusion: Several nursery schools were accepting children with FA, and school lunches were also modified by removing causative food and providing alternative meals. On the other hand, several infants experience FA-induced symptoms, and it is necessary for each department to establish a system to reduce accidental ingestion and to ensure proper emergency response.

Backgrounds: Recently, patients with oral allergy syndrome (OAS) to fruits or vegetables caused by pollenfood allergy syndrome (PFAS) have increased nationwide. We examined effectiveness of SCIT using birch pollen extract for PFAS.

Methods: A total of 19 patients (9 male and 10 female) underwent SCIT with birch pollen extract from August 2011 to August 2016. Rush schedule was used for the initial updosing for SCIT in a hospital setting. In maintenance phase, SCIT was administered every 4-8 weeks on an outpatient basis. According to the situation of sensitization, patients underwent SCIT with other extracts at the same time. Oral food challenge (OFC) with fruits and vegetables was performed at baseline and after rush phase. We also investigated about OAS symptoms in maintenance phase.

Results: SCIT was remarkably effective in five patients for OAS symptoms just after rush phase, and effective in nine patients. And it was not effective in two patients, and not determined in three patients, but it was confirmed to be effective in four out of these five patients in maintenance phase. There were relapse of OAS symptoms in three patients, then SCIT was remarkably effective or effective in 15 patients (79%) in maintenance phase. No patients dropped off the SCIT protocol.

Conclusions: Generally, PFAS can't be expected to remit naturally. SCIT with birch pollen extract effectively reduces OAS symptoms, and it can be expected as a radical therapy for PFAS.

We treated a 13-year-old girl who developed dyspnea after ingestion of okonomiyaki, a Japanese savory pancake prepared from takoyaki flour mix that was opened several months ago and had been stored at ambient temperature. She was found to be sensitized to mite antigen, and microscopic examination of the flour specimen revealed contamination with mites. Therefore, she was diagnosed with oral mite anaphylaxis (OMA). For a more definitive diagnosis, we performed the basophil activation test (BAT) not only in this patient but also in a healthy woman who was not sensitized to mite (control), using the mite-contaminated flour and unopened takoyaki flour mix as antigens. The objective was to rule out the possibility of non-specific basophil activation induced by takoyaki flour mix. A strong activation of the patient's basophils was observed on stimulation with mite-contaminated flour, whereas no reaction was observed on stimulation with flour from the unopened pack. In the healthy control, no reaction was observed on stimulation with either of the flour samples. We demonstrate that BAT may be a useful substitute to the oral food challenge test for the auxiliary diagnosis of OMA.