JFHC editor Penny Hosie, who has personal experience of anaphylaxis, discusses the chronic shortage of specialist allergy services across the UK, as well as a lack of knowledge at community level which is placing children's lives at risk:
Anaphylaxis. Big word, scary meaning. It signifies a sudden, severe generalised allergic reaction, characterised by itching, urticaria, angioedema, bronchospasm, severe drop in blood pressure with vascular collapse, and shock. In brief, it is a life threatening reaction to an allergy.
Parents of any child newly diagnosed with anaphylaxis will tell you that it's natural to panic as you struggle to come to terms with the prospect that life will never be the same again. "Cross-contamination" becomes a new obsession and you quickly become expert in assessing situations and environments for potential threats. Even when the risk of coming into contact with potential allergens is removed from your home, the threat of contamination from outside seems to be everywhere.
Sending your child to nursery or school is a leap of faith as hidden dangers lurk in seemingly innocuous places: cereal boxes and yoghurt pots used to make artistic "creations", in the school dinner hall, or even via friends who may have eaten or touched something your child is highly allergic to before they came to school. Parties and play dates can become fraught and eating out is often avoided as the prospect of having to grill restaurant staff over ingredients doesn't make for a relaxing visit. Food shopping becomes a logistical nightmare as you battle to make sense of the confusing, often complicated - and sometimes changing - food labels.
I am one of those parents. When my daughter was just under one year old, she was diagnosed (through a series of skin prick tests, blood tests and taking
a detailed family history), as being highly allergic (anaphylactic) to eggs, nuts, wheat, soya, all dairy and lentils. Food avoidance of these foods was deemed not only necessary, it was essential as contact with any of them would have meant her life was potentially at risk. It was a steep learning curve.
Research indicates that she is one of a growing group of children with anaphylaxis. Although food isn't the only allergy which can be life threatening, it is one of the most common. The Anaphylaxis Campaign reports that as many as one in 70 UK children may be allergic to peanuts. Other foods, such as egg, milk, fish, tree nuts and kiwifruit are also implicated. This is understandably alarming not just for the parents of these children, but for everyone caring for that child, be it grandparents, other relatives, carers, nurseries, schools, etc.
The nature of some of the allergic syndromes has changed. A generation ago potentially life-threatening acute generalised allergic reactions (especially anaphylaxis) were rare, now they are significantly more common. Also more children are affected now with previously little known food allergies, such as peanuts, tree nuts, kiwi fruit and sesame seeds. The following statistics come from the Royal College of Physician's report Allergy: The Unmet (2003) and clearly illustrate these changes.
● Asthma, allergic rhinitis and atopic eczema have increased in incidence 2-3 fold in the last 20 years.
● Anaphylaxis occurs in more than one in 3,500 of the population each year.
● Hospital admissions because of anaphylaxis have increased seven-fold over the last decade.
● Food allergy is increasingly common. Peanut allergy which can be fatal, has increased from 1:200 in 1996 to 1:70 in 2002
● Adverse drug reactions account for 5% of all hospital admissions in the UK. Up to 15% of inpatients have their hospital length of stay extended because of drug allergy. This figure does not include the majority of drug allergies which occur in primary care and remain largely undiagnosed and unreported.
● 8% of healthcare workers have developed an allergy to latex, which in some cases can lead to anaphylaxis. Yet until 1979 only 2 cases had
Allergic disease currently accounts for 6% of general practice consultations and 10% of the GP prescribing budget. The cost (in primary care excluding hospital services) to the NHS is £900 million per annum.
In order to improve allergy services across the UK, we need families affected to speak out on the services they have received and make their concerns known to both their local Healthcare providers and the Health Minister via their MPs. Many people living with allergic disease will not be getting the necessary support with long term management and organisations like the Anaphylaxis Campaign and the NASG can help when navigating the often complex pathways of the NHS.