August 4, 2017:
Food allergy occurs in around 1 in 20 children and in about 2 in 100 adults. The severity of allergic reactions can be unpredictable, ranging from mild through to severe allergic reactions (anaphylaxis). While extremely uncommon, deaths due to food allergy have occurred in Australia and New Zealand. Management of food allergy requires accurate diagnosis to allow careful allergen avoidance, together with an ASCIA Action Plan for treatment of allergic reactions. Skin prick tests and blood tests for allergen specific IgE are commonly used to help in the diagnosis of food allergy. However these tests do not always provide a definite answer about whether or not someone is allergic to a food. The “gold standard” test to diagnose food allergy is a food allergen challenge, sometimes called an oral food challenge.
Food allergen challenges conducted under the guidance of allergy specialists are an essential part of clinical practice, with more than 8,000 challenges performed in Australia last year. In patients at risk of anaphylaxis, food allergen challenges are performed in a controlled environment under the supervision of medical and nursing staff experienced in treating anaphylaxis.
Until now there had never been a death from a medically supervised food challenge reported anywhere in the world. Tragically, we have seen a recent report of the death of a child in the US after a food allergen challenge. This tragic event may understandably raise concerns and questions about how and why food allergen challenges are performed. While we do not know the details surrounding this tragedy, it is appropriate to provide the community with information about food allergen challenges in Australia and New Zealand.
While acknowledging this terrible tragedy, food allergen challenges remain a generally safe and essential part of allergy practice in carefully selected patients after consultation with an allergy specialist. If you are considering a food allergen challenge for you or your child and have any concerns, you should discuss these with your allergy specialist who can provide you with personalised information based on your individual circumstances.
For information about food allergen challenges, including the benefits, risks and precautions, go to www.allergy.org.au/patients/food-allergy/food-allergy-challenges-faqs
The following information is also available free of charge from the ASCIA website:
- General information about food allergy and dietary avoidance for food allergens (diet sheets) www.allergy.org.au/patients/food-allergy
- ASCIA anaphylaxis e-training for first aid (community) www.allergy.org.au/patients/anaphylaxis-e-training-first-aid-community