Latex-fruit syndrome is an allergic condition in which individuals allergic to natural rubber latex also react to certain fruits, such as kiwi, avocado, banana, papaya, and chestnut. This cross-reactivity occurs due to shared allergenic proteins between latex and these fruits. Affected individuals may experience symptoms like oral allergy syndrome, hives (urticaria), swelling (angioedema), or, in rare cases, anaphylaxis.
Recent studies have shown a direct link between rising temperature patterns and latex-fruit allergies. As temperatures have risen, reported cases of latex-fruit allergies have also increased. In fact, the decrease in temperature in 2018 was followed by a slow decrease in latex-fruit allergy cases until 2020. However, as temperatures rose again after 2020, latex-fruit allergy cases also surged, reinforcing the link between climate patterns and allergy trends.
Latex-fruit syndrome is an IgE-mediated allergy in which individuals sensitive to latex may also react to fruits that contain structurally similar proteins. Symptoms ranged from skin reactions to anaphylaxis, rarely. Approximately 4.2% of individuals, particularly those in healthcare professions, are affected, although rates have declined with reduced latex exposure. Cross-reactivity can occur without direct latex contact, and strict avoidance remains the primary treatment.
It is thought that allergic reactions associated with latex-fruit syndrome occur through cross-reactivity and direct sensitization. This is reinforced by the finding that Hev B latex allergens, especially hevein (a member of Hev B 6), form complexes with plant defense proteins such as Class I chitinases. A major allergenic component, hevein (part of Hev B 6), plays a central role in allergic responses involving both plant-derived and insect-related chitinases.
Latex sensitivity is typically associated with plant-like foods, however, it may also be relevant for other reasons related not just to the plant which produce latex, but potentially to agricultural practices such as the use of a productive-agent ethylene oxide with inherent toxicity itself as an agent to promote the maturation of fruits. Interestingly, ethylene oxide was shown to induce the expression of Class I chitinases, and this may also explain the increasing instances of latex-fruit syndrome.
A retrospective cohort study was conducted utilizing electronic health record data from 2014 to 2023. Patients with latex or latex-fruit allergies were identified using ICD-10 codes for further analysis. The study focused on examining temporal trends and co-allergy relationships, with particular attention to associations with shellfish allergy.
Across the period between 2014 and 2023, documented cases of latex and latex-fruit allergies rose from 9,405 to 50,220- a 5.34-fold increase. Allergies to cross-reactive fruits rose by 8.38-fold, and co-sensitization to both fruit and shellfish increased 6.67-fold. The most dramatic increase, 10.27-fold, was observed in individuals diagnosed with both latex and latex-fruit allergies.
Data across Maryland, D.C., and Northern Virginia have shown an increase in latex and latex-fruit allergy rates in the past ten years. This increase raises concerns about public health and an urgent need for improved surveillance, research, and prevention strategies. One factor associated with this increase is climate change, and specifically, rising temperatures in the region.
The warmer climate has impacted plant biology, and increased chitinase production, which are powerful allergens that will increase allergy risks. The message highlights the importance of integrated approaches to public health and the environment to mitigate the rising allergy burden resulting from climate change.
Read more about latex allergy and related fruit sensitivities on medtigo’s condition resource.
Reference: Sen A, Zinabu S, Bisrat M, et al. Hotter Days, Stronger Reactions: The Climate-Allergy Connection. medtigo J Med. 2025;3(2):e30623224. doi:10.63096/medtigo30623224
