Experts agree that allergies are major public health issue in Australia and national action is needed.
The world's first Allergy Summit took place in Sydney on August 8th. There were 60 invited participants including consumers and a wide range of medical specialists and key organisations from across Australia. This Summit was convened in partnership by the Australasian Society of Clinical Immunology Allergy (ASCIA) and Allergy & Anaphylaxis Australia (A&AA).
The scope of discussions included the impact of allergic diseases, their cost, the need for improved access to care, standards of care, education and training, research and policy, with a focus on possible solutions.
"The Allergy Summit was a great step forward, bringing together key representatives from a large number of backgrounds to work together to identify goals and strategies to address a major chronic disease affecting a large proportion of the Australian population." says Dr Melanie Wong, a leading specialist Allergy and Immunology physician and President-Elect of ASCIA.
"The Allergy Summit was the beginning of a new phase in the management of allergic diseases in Australia," said Dr Wong.
"The aim of the National Allergy Strategy will be to improve access to appropriate healthcare services and improve the quality of life of people with allergic diseases and those who care for them," says Associate Professor Richard Loh, President of ASCIA.
"We all agreed on the need for a National Allergy Strategy," says Maria Said, President of A&AA.
The National Allergy Strategy will be developed over the next six months and further funding will be sought to hold an implementation meeting in April 2015.
Allergy experts claim allergies are a much bigger and more serious problem than governments realise and national action is needed. A national Allergy Summit is taking place in Sydney on Friday, August 8, 2014.
“Allergic diseases have a significant impact on daily life including hospital admissions, lost work days, missed school and poorer quality of life - estimated at $30 billion a year.” says Dr Richard Loh, a leading specialist Allergy and Immunology physician and President of the Australasian Society of Clinical Immunology and Allergy (ASCIA), convenors of the forthcoming national Allergy Summit in Sydney on August 8th. “A collaborative approach between state and federal governments and key stakeholder organisations can greatly improve care and quality of life for patients” said Dr Loh.
“We urgently need a National Allergy Strategy,” says Maria Said, President of Allergy & Anaphylaxis Australia, who are working in partnership with ASCIA to convene the Allergy Summit. “Allergic diseases are commonly perceived as trivial. But they’re not. Conditions like allergic rhinitis (also commonly known as hay fever), asthma, eczema, allergies to foods, insects or drugs and occupational allergies cause a huge burden to individuals and the economy and people do die from anaphylaxis (severe allergic reactions) to insects, drugs and foods.”
“The fact is that many patients with allergic diseases are not receiving optimal treatment and progression of some allergic diseases can be prevented,” says Prof Loh. “For instance if allergic rhinitis (hay fever) is recognised and treated, expensive conditions like asthma, chronic rhinosinusitis and sleep apnoea can be significantly helped and even prevented. Allergic conditions also disproportionately affect children, which can significantly impact on their education and sometimes because of severity, threaten their lives.
In line with ASCIA's commitment to optimise continuing professional development (CPD) points that health professionals earn by completing ASCIA e-training courses, in 2014 the following 4 courses have been approved by the Royal Australasian College of General Practitioners (RACGP) QI & CPD Program as a single 6 hour Active Learning Module (ALM) titled ASCIA Allergy and Anaphylaxis e-training for Health Professionals ALM:
1. ASCIA anaphylaxis e-training for health professionals
2. ASCIA food allergy e-training for health professionals
3. ASCIA allergic rhinitis e-training for health professionals
4. ASCIA allergen immunotherapy e-training for health professionals
This Active Learning Module has been approved by the RACGP QI&CPD Program. Total points: 40 (Category 1). Therefore, we expect that this ALM will be popular, particularly as it has the flexibility to be completed in multiple sessions.
As of May 2014, the ASCIA allergy and anaphylaxis e-training for health professionals will be available at no charge from the ASCIA website: https://alm.ascia.org.au
ASCIA e-training courses provide a standardised and consistent approach to recognition, management and referral of appropriate patients with allergic disease. The courses are easily accessible, available at no charge and allow for flexible completion.
ASCIA is supporting World Allergy Week with the release of three new resources for patients at risk of anaphylaxis. World Allergy Week is 7-13 April 2014.
Anaphylaxis is a potentially life-threatening allergic reaction that requires urgent medical treatment. It is therefore essential to know how to recognise and respond to an anaphylaxis emergency as well as implement appropriate risk minimisation strategies to prevent exposure to known allergens.
Recent Australian data indicates that 1 in 10 children will have food allergy by the age of one year (1).
While the cause of the growing epidemic remains unknown, food allergy related anaphylaxis is more common than ever.
Whilst it is essential for health professionals to know how to treat anaphylaxis in an emergency and also provide appropriate ongoing management of patients at risk of anaphylaxis, it is also vital that patients are educated about how to manage their severe allergy.
Food allergy is common in early childhood. Avoidance of known allergic triggers is the mainstay of management, as potential future treatments such as food allergen immunotherapy remains in the realm of ongoing research at this time.
Since accidental exposure can occur despite best efforts, management of children with severe allergies, who are at risk of anaphylaxis, requires development of a broad management plan in schools and childcare including:
- age appropriate education of allergic individuals and their peers
- staff training in the recognition and management of allergic reactions
- development of strategies to reduce the risk of accidental exposure including individual health care plans
- an emergency response plan for when exposure does occur.
ASCIA guidelines for prevention of anaphylaxis in schools, pre-schools and childcare were recently published in the Journal of Paediatrics and Child Health and are available from the ASCIA website: www.allergy.org.au/health-professionals/papers/prevent-anaphylaxis-in-schools-childcare
Blanket food bans are not recommended by ASCIA, although restricting some important food allergens (such as nuts) may have a place in reducing the risk of accidental exposure in very young children who are too young to be relied upon to avoid contact with potential allergic triggers themselves, either by ingestion or cross contamination of equipment like toys or play services.
Including new asthma and anaphylaxis information
Many individuals with severe allergies, who are at risk of anaphylaxis, also have asthma and sometimes it can be difficult to differentiate between anaphylaxis and asthma symptoms.
To help address this issue the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak medical society for immunology and allergy in Australia and New Zealand, has recently included a new “Asthma and Anaphylaxis” module into its updated versions of ASCIA anaphylaxis e-training for schools, childcare services and the community.
ASCIA anaphylaxis e-training courses for schools, childcare services and community have been developed to provide ready access to high quality, consistent, reliable and evidence based anaphylaxis education throughout Australia and New Zealand.
The updated ASCIA anaphylaxis e-training courses include the following important changes:
- New asthma and anaphylaxis module – which provides clear guidance on how to respond in an emergency situation regarding anaphylaxis and asthma, as it is sometimes difficult to differentiate between the two conditions.
- Updated ASCIA Action Plans – which provide guidance on how to manage mild or moderate allergic reactions and anaphylaxis, including when and how to give the adrenaline autoinjector. For these reasons, ASCIA Action Plans should always be kept with the adrenaline autoinjector.
- Updated information about adrenaline autoinjectors.
- Amendments to terminology to ensure consistency with revised ASCIA Action plans and other ASCIA education resources.
The updated ASCIA Action Plans include the following important changes:
- Revised wording regarding CPR – by stating “Commence CPR at any time if person is unresponsive and not breathing normally”, which is consistent with the Australian Resuscitation Council (ARC) wording.
- Revised wording regarding asthma – by stating “If uncertain whether it is asthma or anaphylaxis, give adrenaline autoinjector first, then asthma reliever medication.” and inclusion of a tick box in the personal (red and green) versions to indicate if the person has asthma.
- Space to include a larger photo of the individual in the personal (red and green) versions.
The updated ASCIA Action Plans can be freely downloaded from the ASCIA website by doctors, patients or their care-givers from:
It is important to note that:
- ASCIA Action Plans are medical documents and therefore must be completed and signed by the individual’s medical practitioner (GP or specialist).
- Parents of children with food allergy/anaphylaxis are encouraged to visit their GP yearly to renew ASCIA Action Plans for the new school year, to be re-trained in the use of their adrenaline autoinjector device (if prescribed), and check if any new problems have arisen that might suggest the need for availability of an adrenaline autoinjector (e.g. new regular asthma, new or more serious allergic reaction).
Allergy and other immune diseases are amongst the fastest growing chronic and complex health conditions in Australasia – affecting one in four children and adults in Australia and New Zealand.
The Australasian Society of Clinical Immunology and Allergy (ASCIA) said the rapid rise has resulted in an urgent need for new research to understand the reasons for the increasing prevalence and to help find potential new treatments and cures.
Today in Perth, ASCIA will launch the Allergy and Immunology Foundation of Australasia (AIFA) to fund high quality education and research projects into disorders of the human immune system in Australia and New Zealand.
Two important new anaphylaxis resources are now available on the ASCIA website:
1. ASCIA Guidelines for prevention of anaphylaxis in schools, preschools and childcare
2. Translations of Fact Sheet for Parents of Children at Risk of Anaphylaxis
ASCIA Guidelines for prevention of anaphylaxis in schools, preschools and childcare
These Guidelines provide strategies to minimise the risk of accidental allergen exposure in schools, preschools and childcare services and replace the previous version that was published in 2004.
They have recently been published in the Journal of Paediatrics and Child Health (JPCH) 49 (2013) 342-345 http://onlinelibrary.wiley.com/doi/10.1111/jpc.12166/abstract and the PDF has also been posted on the ASCIA website with permission from Wiley Publishing and the JPCH:
Translations of Fact Sheet for Parents of Children at Risk of Anaphylaxis in NSW
Fact sheets for parents of children diagnosed to be at risk of anaphylaxis in, including translations into other languages are now available on the ASCIA website in the anaphylaxis resources section:
The Australasian Society of Clinical Immunology and Allergy (ASCIA) has released the ASCIA Allergy and Immune Diseases in Australia (AIDA) Report with the aim of these conditions being recognised as one of the 7 most important and prioritised chronic disease groups and a National Health Priority Area in Australia.
ASCIA President, Clinical Associate Professor Richard Loh states "Allergy and immune diseases are among the fastest growing chronic conditions in Australia. Almost 1 in 5 Australians has an allergic disease and this is increasing."
"Allergic diseases impact significantly on the quality of life of those who have the condition as well as those who care for them. Whether you are managing persistent allergic rhinitis or life threatening anaphylaxis, these conditions impact on every day of your life. Increased awareness of these conditions and improved access to patient care is vital as these conditions continue to increase in prevalence and impact on our community", said Maria Said, President of Allergy & Anaphylaxis Australia.
"Whilst the increasing prevalence of allergic disease, particularly the increase in food allergy prevalence, has been reported widely in the media, immunodeficiency diseases are serious, potentially life-threatening conditions that are also increasing in number and complexity", said A/Prof Loh.
"1 in 20 Australians are affected by autoimmune diseases, many of which impact tremendously on their quality of life", he said.
ASCIA seeks recognition of allergy and immune diseases as a prioritised chronic disease group and a National Health Priority Area to assist in raising awareness nation-wide as well as a national approach to improving the prevention and management of these conditions.
Food Allergy - A Rising Global Health Problem:
This week the World Allergy Organization (WAO) has announced the 3rd annual World Allergy Week (8-14 April 2013) with the theme of Food Allergy - A Rising Global Health Problem.
Food allergy is rising in prevalence in both developed and developing countries, especially in children, so there is a need for enhanced education and patient care services worldwide. During World Allergy Week 2013, the Australasian Society of Clinical Immunology and Allergy (ASCIA), a member of WAO would like to highlight the issue of Food Allergy and Quality of Life.
Food allergy is common in Australia, and predominantly affects young children. In the most accurate estimate of food allergy in Australia performed thus far (1), the HealthNuts study based in Melbourne, Victoria, demonstrated food challenge proven incidence of food allergy at age 12 months to be much higher than previously suspected; food allergy overall (10%); peanut allergy (3%); raw egg (8.8%) and sesame seed (0.8%). Estimates of food allergy in older children are 3-5%. An estimated 1.3% of Australian adults have food allergy (2).
Food allergy and anaphylaxis are conditions where the threat of reaction is ongoing but when another reaction will occur is unpredictable. Nor is it easy to predict if reactions will worsen or become life-threatening (anaphylaxis) as 1/3 of patients with anaphylaxis have food-induced anaphylaxis with first known exposure and 80% of fatal anaphylaxis cases have had previous milder reactions without dangerous features.
Current death rates appear to be relatively low (3), although this may increase with time as current young children with peanut/ tree nut allergy age. Concentrating on death rates alone, however, underestimates the ongoing impact on quality of life experienced by patients and their carers on a daily basis (4-6).
- Jan 23 2013 - ASCIA anaphylaxis e-training for first aid (community) is now available
- Dec 21 2012 - ASCIA President's message
- Dec 6 2012 - ASCIA Action Plan for Anaphylaxis Updated 2013 versions now available
- Oct 8 2012 - ASCIA allergic rhinitis and immunotherapy e-training courses for health professionals are now available