Prevalence data are based on different diagnostic procedures. While the prevalence of sensitization (sensitivity) can be estimated by SPT, RAST, and immunoblot, a clinical relevant sensitization (allergy) is evaluated by convincing history (anamnesis) or food challenge tests (ideally by DBPCFC).
1.1 General Population
Prevalence estimates within the author's selected populations
are listed. Those that are assigned randomly selected ("unselected") with
numbers more than 500 may be regarded as representative of the "general
populations". Inclusion criteria may involve circumstances not related
to atopic predisposition according to current knowledge.
| Country / Subjects | Allergy / Sensitivity to | References |
| Germany, Augsburg
1537 subjects between 28 and 78 years of age (study period from 1997 to 1998) |
pork 3.4% (SPT)
pork 2.0% (corresponding frequency estimates for the representative study base, n=4178) |
Böhler et al. 2001 |
1.2 Subjects with Atopic or Other Diseases
| Country / Subjects | Allergy / Sensitivity to | References |
| France
34 idiopathic nephrotic syndrome (INS) patients with or without atopic manifestations |
pork meat 26% (human basophil degranulation test) | Lagrue et al. 1986 |
| France
a) asthmatic children b) asthmatic adults |
a) pork 20% (RAST)
b) pork 8.6% (RAST) |
Sabbah 1990 |
| France
80 cases of food- related anaphylaxis (from 1993-97) |
pork kidney 1.3% (reported to CICBAA databank) | European Commission 1998 |
| France, Pierre Benite
580 patients with adverse reactions to food (study period 1984-92) |
pork 17% (RAST) | Andre et al. 1994 |
| France, Nancy and Toulouse
544 food allergic children |
pork 0.6% (food challenge) | Rance et al. 1999b |
| South Africa, Cape Town
112 children with atopic dermatitis |
pork 2.9% (reported by parents) | Steinman & Potter 1994 |
| Switzerland, Zurich
402 food allergic adults (study period 1978-87) |
beef and pork 4.5% | Wüthrich 1993 |
| Switzerland, Zurich
383 food allergic patients (study period 1990-94) |
pork 2.6% | Etesamifar & Wüthrich 1998 |
| USA, Durham, NC
113 atopic children |
pork 28% (SPT)
pork 1.8% (DBPCFC) |
Sampson & McCaskill 1985 |
| USA, Little Rock, AR
165 patients with atopic dermatitis |
pork 6.7% (SPT) from which non were DBPCFC-positive (n=7) | Burks et al. 1998 |
| USA, Memphis, TN
266 patients with anaphylaxis (age of 12-75 years, study period 1978-92) |
pork 4.5% | Kemp et al. 1995 |
1.3 Prevalence of Associated Allergies
| Country / Subjects | Sensitivity / Allergy to | References |
| France, Angers
pork-allergic patients |
cat epithelia | Drouet et al. 1994b |
| USA, New Orleans, LA
57 subjects with suspected meat allergy |
beef 73%
lamb 71% pork 58% vension 59% chicken 41% turkey 38% (grid immunoblot) |
Ayuso et al. 1999 |
| Symptoms & Case Reports | References |
| systemic reactions
anaphylaxis (1, 4*, 9*), excercise induced anaphylaxis (5), fatal reactions (10**), tachycardia (4) cutaneous symptoms
gastrointestinal symptoms
respiratory symptoms
other symptoms
* after ingestion of pork kidney (4, 9) and gut (9)
|
(1) Pavel & Comanescu 1969
(2) Bernstein et al. 1982 (3) Mylek et al. 1992 (4) Wüthrich 1996 (5) Drouet et al. 1994b (6) Valsecchi et al. 1994 (7) Kanerva 1996 (8) Asero et al. 1997 (9) Llatser et al. 1998 (10) Drouet et al. 2001 |
| Threshold for Elicitation of Symptoms
The cumulative dose of 14.1 g freeze-dried pork induced allergic symptoms in a pork allergic adult (DBPCFC) (1) |
(1) Bernstein et al. 1982 |
3 Diagnostic Features of Pork Allergy
| Parameters / Subjects | Outcome | References |
| SPT, Clinical Relevance
9 reportedly pork allergic subjects |
0% had positive SPT | Boccafogli et al. 1994 |
| Proteins / Glycoproteins | Allergen Nomenclature* | References |
| Serum Albumin [67 kDa]** | Sabbah et al. 1994a + 1994b, Asero et al. 1997 | |
| Allergens: 51, 40, and 28-30 kDa (pork meat) | Llatser et al. 1998 | |
| Allergens: 200, 90, 57, and 47 kDa (pork kidney) | Llatser et al. 1998 | |
| Allergens: 57 and 27 kDa (pork gut) | Llatser et al. 1998 |
5.1 Sensitization to Pork Allergens
| Country / Subjects | Sensitivity to | References |
| USA, New Orleans, LA
57 subjects with suspected meat allergy |
pork tropomyosin in 1 of 57
(Grid immunoblot) |
Ayuso et al. 1999 |
| Extract / Purified Allergens | Methods | References |
| Pork Protein | Extraction from raw and cooked meat with PBS (pH 7.2) overnight; followed by centrifugation, dialysis, and lyophilization | Asero et al. 1997 |
| Cross-Reacting Allergens | Subjects / Methods | References |
| Pork: (Beef)
serum albumins from pork and beef |
83% of patients sera reacted to pork serum albumin, 50% of patients had positive SPT to pork serum albumin (SDS-PAGE immunoblot inhibition, beef allergic patients with bovine serum albumin specific serum IgE) | Restani et al. 1997, 1998 |
| Pork: (Lamb)
pork kidney and gut from pork and lamb, respectively |
IgE-binding 200 and 90 kDa allergens from pork kidney inhibited by gut from pork and lamb, no inhibition by pork meat extract (SDS-PAGE inhibition, 1 patient with anaphylaxis to pork kidney and gut and tolerance to pork meat) | Llatser et al. 1998 |
| Pork: (Cat)
pork meat and cat epithelia, serum albumin |
In patients with pork / cat syndrome the common allergen is the 67-kDa albumin, while the major cat allergen Fel d 1 is characteristic in patients monosensitized to cat (RAST inhibition) | Sabbah et al. 1994b
Drouet & Sabbah 1996 |
| Treatment | Effects | References |
| Heat
raw and cooked pork |
4 IgE-binding proteins with Mr from 20 to >100 kDa in raw pork, only a 65-kDa allergen (probably serum albumin) was detected in raw and cooked pork (1 pork allergic patient, SDS-PAGE immunoblot) | Asero et al. 1997 |
| Heat
raw and cooked pork |
Positive SPT to raw meat and serum albumin; negative SPT to cooked meat in a meat allergic patient | Kanny et al. 1998 |
9.1 Pork Allergen Sources
| Reported Adverse Reactions | References |
| Pork | see 2 Symptoms of Pork Allergy |
| Breast Milk
Intestinal permeability tests showed breast-milk-induced alterations in a 1-month-old boy with gastrointestinal symptoms suggesting food allergy. Improvement of symptoms and normalization of intestinal permeability during provocation with the milk were obtained after elimination of egg and pork from the mother's diet (1) |
(1) de Boissieu et al. 1994 |
| Several Pork Products
Oral allergy syndrome after ingestion of salami, both raw and cooked ham, and bacon in a 16-year old woman; other cooked pork products such as chops and sausages were tolerated (SPT, SDS-PAGE immunoblot) (1) |
(1) Asero et al. 1997 |
| Salami
Oral allergy syndrome after ingestion of salami containing dried, uncooked pork in a 21-year old woman (open challenge with fresh food, SPT) (1) |
(1) Liccardi et al. 1996 |
| Salami
A case of anaphylaxis induced by ingestion of a salami (source of meat not specified) (1) |
(1) Pastorello et al. 2001 |
| Gelatine
Two cases of anaphylaxis induced by ingestion of gelatine (source not specified) (1) |
(1) Pumphrey & Stanworth 1996 |
| Pharmaceuticals: Aprotinin
Severe allergic reactions in a pork and beef allergic woman after ingestion of poultry sausage containing ham (1) |
(1) Wüthrich 1996 |
9.2 Pork Associated Allergen Sources
| Reported Adverse Reactions | References |
| Several Food Products
9 Adverse reactions to unexpected cow's milk allergens in a) Meatballs containing 1.1% CAS (undeclared) b) Hot dog containing 0.04% CAS (contaminated) c) Recombined ham containing 2.6% (undeclared) d) Sausage containing 1.0% CAS (undeclared) e) Sausage containing 0.06% CAS (contaminated) |
Malmheden Yman et al. 1994 |
| Sausage (Texturing Agent)
Severe reactions after ingestion of sausage containing CAS (texturing agent) (1) |
(1) Foucard et al. 1997 |
| Meat (Tenderizing Agent)
Asthma after long-term contact with papain dust in a supervisor of a meat tenderizer factory (1) |
(1) Novey et al. 1979 |
| Salami
Oral allergy syndrome after ingestion of salami in a subject with monosensitization to mite allergens (1) |
(1) Liccardi et al. 1996 |
| "Salami Worker's Lung"
Hypersensitivity pneumonitis in a woman (56 years) due to inhaled antigens from dust in a factory producing salamis; in the cultures of the material that covered the salamis Penicillium spp. was present and the suspected cause of hypersensitivity reactions (1) |
(1) Rivero et al. 1999 |
| Veterinary Drug Residues
A 64 year old woman experienced anaphylactic shocks after ingestion of pork and beef, respectively. Food allergy to animal proteins excluded. The woman was highly sensitzed to penicillin. It was concluded that food induced anaphylaxis was linked to penicillin residues in meats (1) |
(1) Kanny et al. 1994 |