VERY-LOW FREQUENCY OF LATEX AND FRUIT ALLERGY IN PATIENTS WITH SPINA-BIFIDA FROM VENEZUELA - INFLUENCE OF SOCIOECONOMIC-FACTORS

Background: The prevalence of latex allergy appears to be substantiall y higher in certain high risk groups, particularly in children with sp ina bifida. The source of this increase is presently unknown and may b e due either to increased infantile exposure or to an intrinsic predil ection for atopy in this condition. Objective: We attempted to ascerta in the prevalence of latex and tropical fruit allergy in children of l ower socioeconomic strata with spina bifida from Caracas, Venezuela, w ho have limited operative and other medical exposure to latex. Methods : Ninety-three unselected patients with spina bifida from clinic and h ospital populations were prick tested with commercial (Stallergenes-Pa steur) latex extract and crude glove (Baxter-Trifler, 1/5 wt/vol) late x extract as well as with standardized mite and cockroach, 1/10 wt/vol , extracts (Hollister-Stier). An array of tropical fruits were also in cluded in the battery of skin test materials, using the prick by prick method. Careful family and personal history for allergy as well as an y reactions to rubber products were noted, placing emphasis on intraop erative anaphylaxis, number of operations and use of bladder catheters . Results: Only four patients of the 93 skin tested (4.3%) were positi ve to latex. Atopy was not a predisposing factor for latex allergy and neither was the number of surgical interventions. No fruit allergy wa s found in this population and three of the four skin test-positive pa tients had facial angioedema when exposed to balloons. Conclusions: Th e very low incidence of latex allergy found in our patients with spina bifida could very well be due to a low level of rubber exposure as be st exemplified in the use of nonlatex bladder catheters, frequently wa shed and resterilized surgeon's gloves, and low number of operations p er patient. The fact that atopy was no more prevalent in children with spina bifida than in the general population in Venezuela strongly sup ports exposure level as the major factor determining latex sensitizati on.