Hotter Days, Stronger Reactions: The Climate-Allergy Connection

Background: Over the past decade, there has been a notable rise in allergic reactions involving both natural rubber latex (NRL) and specific plant-derived foods in Maryland, Washington, D.C., and Northern Virginia. This condition, known as latex-fruit syndrome (LFS), is characterized by immunologic cross-reactivity between latex proteins and structurally similar proteins found in certain fruits such as banana, avocado, and kiwi. A key mechanism involves plant chitinase enzymes that can trigger hypersensitivity in susceptible individuals. This study investigates regional trends in LFS from 2014 to 2023 and explores possible environmental influences. Methodology: We conducted a retrospective cohort study using electronic health records between 2014 and 2023. Patients were identified based on International Classification of Diseases, 10th revision (ICD-10) codes indicating latex or latex-fruit allergies. Data analysis focused on temporal trends and co-allergy patterns, including associations with shellfish allergy. Results: The number of documented latex and latex-fruit allergy cases rose from 9,405 in 2014 to 50,220 in 2023, a 5.34-fold increase. Allergic reactions to cross-reactive fruits increased 8.38-fold. Co-sensitization to fruit and shellfish rose 6.67-fold, with the most pronounced surge, 10.27-fold, observed in individuals diagnosed with both latex and latex-fruit allergies. Conclusions: This regional surge in LFS suggests a growing public health concern, potentially linked to increased exposure to plant-derived allergens, such as chitinases. Environmental factors such as climate change and agricultural shifts may play a role. Continued surveillance and further research are warranted to inform public health strategies and clinical management of food-related allergic disorders.