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: 

www.allergy.org.au/health-professionals/papers/prevent-anaphylaxis-in-schools-childcare

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:

www.allergy.org.au/health-professionals/anaphylaxis-resources

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).

The Australasian Society of Clinical Immunology and Allergy (ASCIA) has developed ASCIA anaphylaxis training for first aid (community) in response to the recognised need for quality anaphylaxis training for the general community. This course provides ready access to high quality, consistent, reliable and evidence based anaphylaxis education throughout Australia and New Zealand. 

It has been released this week and is now available free of charge from the ASCIA website: www.allergy.org.au/patients/anaphylaxis-e-training-first-aid-community 

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.

ASCIA anaphylaxis e-training for first aid (community) has been designed to be undertaken by the broader community such as parents, friends, carers, patients, workplace or student colleagues, and club members.

The ASCIA President, Clinical Associate Professor Richard Loh states "It is important to increase awareness of anaphylaxis in the broader community. This course has therefore been developed to help patients, parents, carers and other community members manage life-threatening allergic reactions by educating people about how to identify and respond to anaphylaxis."

As we enter the Christmas and New Year holiday period it is timely to reflect on the vast achievements of the Australasian Society of Clinical Immunology and Allergy (ASCIA) over the past year, particularly in education, as well as the continuing collegiality of ASCIA members, as demonstrated so well at ASCIA 2012 in Wellington, New Zealand.

November and December 2012 have been particularly busy months for ASCIA education projects, and the following documents have recently been added to the ASCIA website anaphylaxis resources section www.allergy.org.au/health-professionals/anaphylaxis-resources :

• Revised ASCIA Action Plans for Anaphylaxis and Allergic Reactions (2013 versions)
• New ASCIA anaphylaxis parent fact sheets – NSW, WA and Australasian versions
• New ASCIA anaphylaxis and food allergy health professional information papers

Other new or updated ASCIA website information includes:

• Updated ASCIA dietary avoidance for food allergy patient information sheets www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy 
• ASCIA 2013 Annual Scientific Meeting – www.ascia2013.com.au

Updated versions of the ASCIA Action Plan for Allergic Reactions and ASCIA Action Plans for Anaphylaxis have been released by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak medical society for allergy and clinical immunology in Australia and New Zealand. 

The 2013 versions of the following ASCIA Action Plans are now available free of charge at: www.allergy.org.au/health-professionals/anaphylaxis-resources/ascia-action-plan-for-anaphylaxis :

• ASCIA Action Plan for Anaphylaxis personal (EpiPen or Anapen versions) - provided to patients with food, insect or medication allergy who have been prescribed an adrenaline autoinjector.
• ASCIA Action Plan for Anaphylaxis general (EpiPen or Anapen versions) - used as posters or stored with adrenaline autoinjectors in first aid kits.
• ASCIA Action Plan for Allergic Reactions - provided to patients with allergies who have not been prescribed an adrenaline autoinjector.

These ASCIA Action Plans provide guidance on how to treat mild or moderate allergic reactions and severe allergic reactions known as anaphylaxis, in an emergency. They indicate when and how to give the adrenaline autoinjector (EpiPen or Anapen). Therefore, it is essential that an ASCIA Action Plan for Anaphylaxis is always kept with the adrenaline autoinjector, wherever it is located, including home, school, childcare, workplace or even if it is carried by the individual.

Allergic rhinitis (commonly known as hay fever) is the most common allergic disorder in Australia and New Zealand, in both children and adults. To address the need for evidence based education in this area, for medical practitioners working in primary care, ASCIA has developed two new free online courses:

• ASCIA allergic rhinitis e-training for health professionals
• ASCIA immunotherapy e-training for health professionals

These courses have been released this week and are now available on the ASCIA website: www.allergy.org.au/health-professionals/health-professionals-e-training 

These courses aim to provide accurate, consistent and evidence based education for primary care practitioners on how to effectively manage allergic rhinitis, when to refer patients to specialists and how to safely administer ongoing (maintenance) allergen immunotherapy (sometimes referred to as desensitisation), one of the treatment options for some patients with moderate or severe allergic rhinitis.

Based on self-reports, allergic rhinitis affects approximately 15% of Australians¹. Studies have shown that moderate to severe persistent allergic rhinitis significantly impacts quality of life2. Allergic rhinitis can affect day to day functioning including affecting the learning ability of children at school and productivity of adults at work.

Primary care practitioners play an important role in the management of allergic rhinitis. Many patients with mild to moderate allergic rhinitis can be appropriately managed by their general practitioner or paediatrician. Patients with moderate or severe allergic rhinitis may need to be referred to a clinical immunology/allergy specialist, particularly for initiation of allergen immunotherapy.

ASCIA spokesperson Dr Sam Mehr said that the waiting list to see a specialist in immunology and allergy is too long and primary care practitioners can assist by assessing patients for appropriate referral.

ASCIA anaphylaxis training for childcare has been approved by the Australian Children's Education and Care Quality Authority (ACECQA), effective from 1st September 2012.

All three versions of ASCIA anaphylaxis training for childcare currently available have been approved:

• ASCIA anaphylaxis training for NSW childcare – available as etraining or face to face training delivered by trained nurse educators approved by the NSW Health Department.
• ASCIA anaphylaxis training for WA childcare – available as etraining or face to face training delivered by trained nurse educations approved by the WA Health Department.
• ASCIA anaphylaxis etraining for Australasian childcare – this version of etraining is suitable for use throughout Australia and New Zealand.

The Australasian Society of Clinical Immunology and Allergy (ASCIA) developed ASCIA anaphylaxis training for childcare in response to the recognised need for accessible, quality, consistent, reliable and evidence based anaphylaxis education throughout Australia and New Zealand.

Hereditary Angioedema (HAE) is a very rare genetic disorder that currently affects around 100 Australians. People living with HAE suffer frequent acute, unpredictable and painful attacks of swelling (angioedema) anywhere in the body, which can be life threatening if they involve the airway or gut, and require urgent treatment in an emergency department.

The Australasian Society of Clinical Immunology and Allergy (ASCIA) has recently released a Position Paper and Action Plan for Hereditary Angioedema (HAE) and these are available on the ASCIA website: www.allergy.org.au/health-professionals/papers/hereditary-angioedema 

Recent media reports regarding an association between breastfeeding and parent-reported nut allergy may cause confusion amongst parents. The Australasian Society of Clinical Immunology and Allergy (ASCIA) would like to clarify that no changes to infant feeding or maternal diet should be made based on these reports.

ASCIA Infant Feeding Advice (available on the ASCIA website http://www.allergy.org.au/health-professionals/papers/ascia-infant-feeding-advice) remains as follows:

• Breastfeeding is recommended for at least 6 months for many reasons and is encouraged for as long as the mother and infant wish to continue.
• Excluding allergenic foods from the maternal diet is not recommended as there is no evidence that this prevents allergies.
• Introducing complementary solid foods from around 4-6 months, whilst still breastfeeding, is supported by current evidence published in peer reviewed journals affiliated with professional paediatric and allergy/immunology medical organisations. Giving one new food at a time is advised and if a food is tolerated, continue to give this as a part of a varied diet. If there is any reaction to any food, you should seek medical advice and that food should be avoided until your child is reviewed by a medical practitioner with experience in food allergy.

With recent studies reporting that ten percent of infants have a diagnosed food allergy by the age of one*, it is important that resources are now available to educate health care professionals in how to deal with the growing epidemic of food allergy.

Food allergy is estimated to affect around four to eight percent of children under the age of 5 years. In the most severe cases, food allergy can lead to potentially life threatening anaphylactic reactions.

It is vital that dietitians and other health professionals know when to suspect food allergy, and be able to provide sufficient ongoing management.

For this reason, the Australasian Society of Clinical Immunology and Allergy (ASCIA) has developed a free web-based food allergy e-training course for dietitians and other health professionals across Australia and New Zealand, which is available as of today.

ASCIA Anaphylaxis Working Party Chair, A/Prof Richard Loh, said that the waiting list to see a specialist in immunology and allergy is too long and that allied health professionals must be equipped to help bridge the gap in services.

"It's essential that health professionals such as dietitians, general practitioners and paediatricians are able to provide adequate management of patients with food allergy, particularly those at risk of anaphylaxis, before they can see a specialist" he said.