Information updates

ASCIA has developed new resources to support newborn screening for Severe Combined Immune Deficiency (SCID), which is now available throughout Australia and New Zealand:

• Newborn Screening for Severe Combined Immune Deficiency (SCID) and BCG Vaccination - Position Statement for health professionals https://www.allergy.org.au/hp/papers/immunodeficiency-nbs-scid-bcg

• Newborn Screening for Severe Combined Immune Deficiency (SCID) Frequently Asked Questions (FAQ) for patients and carershttps://www.allergy.org.au/patients/immunodeficiencies/nbs-scid

The FAQ includes answers to the following questioins:

Q 1. Why are SCID newborn screening tests performed in Australia and New Zealand?

Q 2. How are SCID newborn screening tests performed?

Q 3. When are further tests needed?

Advocacy for SCID newborn screening in Australia has been ongoing from ASCIA and patient.carer support organisations for several years, and is one of the goals for the ASCIA Immunodeficiency Strategy. 

ASCIA Adrenaline Injectors Frequently Asked Questions (FAQ) has been updated to provide more information about PBS and Pharmac listings of adrenaline injectors in Australia and New Zealand. The updated FAQ is available on the ASCIA website https://www.allergy.org.au/hp/anaphylaxis/adrenaline-injectors-faqs

The updated information is shown below in blue..

Q 1: What adrenaline injectors are available in Australia and New Zealand?

ASCIA recommends the use of adrenaline (epinephrine) as the first line emergency/first aid treatment for severe allergic reactions (anaphylaxis) using either of the following two brands of adrenaline injector devices:

• EpiPen^® - Available in Australia (PBS* listed since 2003) and New Zealand (Pharmac** listed since 2023).
• Anapen^® - Available in Australia (PBS listed since 2021).

*Australian Government Pharmaceutical Benefits Scheme (PBS)

• assessed to be at significant risk of anaphylaxis by a clinical immunology/allergy specialist, respiratory physician or a paediatrician, or by a GP in consultation with one of these specialists; or
• after treatment with adrenaline for anaphylaxis when they are discharged from a hospital or emergency department.

A doctor (including a GP) or nurse practitioner can provide follow-up PBS authority prescriptions for replacement of devices just prior to expiry, or devices used for treatment of anaphylaxis.

**New Zealand Government Pharmaceutical Management Agency (Pharmac)

The initial Pharmac authority prescription for up to two adrenaline injector devices can be provided to patients:

• assessed to be at significant risk of anaphylaxis by a relevant practitioner; or
• who have experienced a previous anaphylactic reaction which has resulted in presentation to a hospital or emergency department.

Additional prescriptions are limited to replacement of devices just prior to expiry, or devices used for treatment of anaphylaxis. 

AREXVY (GSK) is a vaccine for respiratory syncytial virus (RSV) which has been approved in Australia by the TGA for individuals 60 years and older for the prevention of lower respiratory tract disease caused by RSV. GSK is working to ensure national distribution of the vaccine across Australia. The vaccine will be administered by healthcare professionals in various locations, such as clinics, general practices, and health centres. AREXVY will soon be made available nationally, on private prescription.

AREXVY is the first RSV vaccine to be approved by the TGA, and is a recombinant subunit vaccine that does not contain any live virus., 

RSV is a common and contagious respiratory virus that can cause cold- and flu-like symptoms in adults. RSV infections typically peak during autumn and winter in temperate climates in Australia, alongside other respiratory viruses, however, RSV can be caught at any point throughout the year.

RSV is often considered as an illness that mainly affects children, and in some cases, RSV may be a mild infection. However RSV can also cause serious illness and in rare cases, even death, in older adults. Older adults with certain chronic medical conditions, including asthma, diabetes, chronic obstructive pulmonary disease (COPD) and congestive heart failure have a greater risk of being hospitalised from RSV compared with those without these conditions.

Symptoms of RSV in adults are often similar to other acute respiratory infections, like colds or influenza, and can include a blocked nose, cough, fatigue, fever, sore throat, runny nose, body aches and headache. Cases of RSV were only officially counted in Australia from 2021, so there are still gaps in fully understanding how common the disease is and what impact it has on the Australian population.

Here is a link to the GSK media release for further information.

Each month more than 6,000 subscribers (ASCIA members and community) are informed about allergy and immunology updates via monthly ASCIA e-newsletters.

The  format has been updated in 2024 to improve access and the user experience. 

To subscribe and access the community version of the ASCIA e-newsletter go to https://www.allergy.org.au/about-ascia/updates/archive/listing

On 17 March 2022, the National Blood Authority (NBA) engaged HealthConsult to develop a Report about uptake of subcutaneous immunoglobulin (SCIg).  The final report  "Evaluate and Develop Options to Improve Access to Subcutaneous Immunoglobulin (SCIg)" is now available on the NBA website https://blood.gov.au/Ig-program and the direct link to the report is Final Report (nba.gov.au).

Options recommended for implementation include :

• Option 1: Establish position statement(s) on when SCIg should be considered for initiation of Ig treatment.
• Option 3: Develop a national statement on the benefits of SCIg to improve education and awareness

Note - The ASCIA website includes a SCIg Position Statement and other information about the benefits of SCIg.

Background information

Eligibility for patient access to publicly funded Immunoglobulin (Ig) is administered by the NBA through the National Immunoglobulin Governance Program (‘the Program’). The supply of Ig products such as Intravenous Ig (IVIg) and SCIg is managed by the NBA and funded under the National Blood Agreement, at no cost to patients. Widespread evidence exists of SCIg supporting patient-centred quality of life benefits as well as cost savings for health systems compared to IVIg.

A survey of patients and carers conducted for this project showed that 95.2% of patients who have tried SCIg and IVIg believe that SCIg is the better treatment option. However, SCIg usage in Australia (as a proportion of eligible Ig patients) is around 16%, compared to around 25% in countries such as the United Kingdom, Canada, France, and Italy.Therefore, opportunities exist to optimise the uptake of SCIg in Australia and increase access for patients, health services and the health system to SCIg (where appropriate).

The scope of HealthConsult’s engagement included:

• Identifying barriers to the optimal uptake of SCIg because of the current service model.
• Developing options to optimise access to SCIg. The identified options aim to develop a service model that is adaptable to changing conditions in a clinical setting and promotes sustainability in the National SCIg Program to support eligible patients.

Healthcare workers are invited to participate in a short survey (~5 minutes) on reporting cases of edible insect food allergy after consumption of insect-based food products such as crickets, mealworms. green ants and witchetty grubs (native to Australia). This survey is being conducted by researchers from James Cook University and the University of Sydney who are affiliated with ASCIA, Centre for Food and Allergy Research (CFAR), and the National Allergy Centre of Excellence (NACE). 

The survey link is  https://jcu.syd1.qualtrics.com/jfe/form/SV_20rS7COSt5qfs8K  and the closing date is 9 February 2024.

The purpose of this survey is to:

• Identify case reports of food allergy to edible insect-based food products and supplements that are gaining popularity as a novel and sustainable source of protein, and are currently being sold as an alternative source of proteins for human consumption in mainstream grocery stores.
• Determine the prevalence of edible insect consumption in the population and the incidence of allergic hypersensitivity upon the ingestion of or exposure to edible insect food products.

Why is collecting this information important?

• Edible insect-based food products and protein supplements are increasingly introduced as an alternative sustainable novel food source to address the global need to feed the growing population.
• However, food safety is of major concern due to the high similarity of conserved proteins with shellfish and house dust mites. Case reports of clinical cross-reactivity have been documented in America, Asia and Europe which identifies that edible insects can be harmful to those suffering from shellfish allergy.
• Currently, there is little research and evidence on the prevalence of edible insect food allergy in Australia. The prevalence and incidence of edible insect food allergy in Australia will provide evidence of the significance of this type of food allergy among the Australian population and initiate research to improve diagnostic accuracy and develop management protocols for the affected Australian population.

This survey will take approximately 5 minutes to complete with the option to save and return to it within 14 days. Each question in the survey requires a response. Please use one questionnaire for each patient/client.

Participation in the survey is voluntary and your responses will be securely stored by Qualtrics and only accessed by approved researchers from James Cook University, University of Sydney and employees of ASCIA. Any identifiable information received will not be stored with your responses. If you have any questions about the survey, please contact Shay Karnaneedi (Food Allergy Researcher at James Cook University) at: This email address is being protected from spambots. You need JavaScript enabled to view it.

There is currently a call for submissions to a Senate Inquiry for the potential impacts of Red Imported Fire Ants (RIFA) on the health of Australians, as well as costs. - see https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Rural_and_Regional_Affairs_and_Transport/FireAnts). 

The call for submissions was due to close on 1 December 2023, but this has now been extended to 29 January 2024.

RIFA have the potential to have a devastating environmental and health impact if they are allowed to spread across Australia. RIFA are very aggressive, and commonly cause sensitisation in those who are stung.  Their stings can cause large local allergic reactions and anaphylaxis. They have largely been contained to outbreaks in Queensland, but they were reported to have recently crossed into New South Wales.

In reponse to the Inquiry, the National Allergy Centre of Excellence NACE has lodged a detailed submission and an ASCIA submission has also been lodged on 1 December 2023, which can be viewed at https://www.allergy.org.au/ascia-submissions. 

The National Allergy Council has updated the Best Practice Guidelines for anaphylaxis prevention and management in schools and children’s education/care services, which are now available on the re-designed Allergy Aware website – www.allergyaware.org.au

The key changes to the Best Practice Guidelines include:

• An allergy aware approach as a separate, first recommendation.
• Clearer recommendations related to allergy documentation by schools and camps. A camp section has also been added to the Allergy Aware website.
• Clearer information about reporting allergic reactions in schools.
• Updated links to specific sections in the implementation guide and supporting materials included at the end of the document.
• QR codes added to the resource table in the Appendix.
• A cleaner design with some fun elements. This same approach has been taken with the Allergy Aware website.

In addition to updating the Best Practice Guidelines, two new parent guides have been created:

• What does it mean to be an allergy aware school or children’s education/care service? 
• How can families support allergy aware schools or children’s education/care services? 

To order hard copies of the Best Practice Guidelines complete the form available at https://www.allergyaware.org.au/best-practice-guidelines-order-form before 31 January 2024. Printed copies will be mailed in late February/early March 2024.