Living with allergy

Most children grow out of their allergy, but some must learn to lead their lives by coping with it. Here’s how . . .

Allergy is related to the immune system. Normally, the immune system fights harmful things, such as disease. But an allergic person’s body believes that, just like a disease, a particular food or other substance poses a danger. Unfortunately, this well-meaning reaction by the immune system can often do a lot of harm.

Allergic reactions vary in severity. Mild or moderate symptoms may include itching or swelling in the mouth, hives anywhere on the body, generalised flushing of the skin or nausea and vomiting. A severe allergic reaction is anaphylaxis – the extreme end of the allergic spectrum – and is potentially life-threatening if not treated quickly with adrenaline. The whole body is affected, often within minutes of exposure to the allergen, but sometimes after hours. Serious symptoms include a severe drop in blood pressure (where you go weak and floppy), severe asthma, or a closing of the throat.

Symptoms and treatment

Symptoms of severe allergic reaction (anaphylaxis):

• Generalised flushing of the skin
• Nettle rash (hives) anywhere on the body
• Swelling of throat and mouth
• Difficulty in swallowing or speaking
• Alterations in heart rate
• Severe asthma
• Abdominal pain, nausea and vomiting
• Sudden feeling of weakness (drop in blood pressure)
• Collapse and unconsciousness

Symptoms usually occur after seconds or minutes, and may progress rapidly. Occasionally, they will begin a few hours after contact with the allergenic food or substance.

A person would not necessarily experience all of these symptoms.

Treatment

Adrenaline (also known as epinephrine) is the front-line treatment for anaphylaxis. During anaphylaxis, blood vessels leak, bronchial tissues swell and blood pressure drops, causing choking and collapse. Adrenaline acts quickly to constrict blood vessels, relax smooth muscles in the lungs to improve breathing, stimulate the heartbeat and help to stop swelling around the face and lips.

If your child has an anaphylactic reaction, an injection of adrenaline could save his or her life. It is vital that he or she carries an adrenaline injection kit at all times, and that family, friends and school staff are briefed about when and how it should be used. If the child is too young to carry their own adrenaline. It is important to ensure that it is near to hand at all times. You can get adrenaline injection kits from your GP on prescription.

What can cause anaphylaxis?

Peanuts and tree nuts (hazelnuts, almonds, walnuts, and so on) are the most common cause of severe reactions and have received much publicity for that reason. Some people also react to wheat, fish, shellfish, eggs, milk, sesame, soya and a wide range of other foods, including some fruits. In the UK, for example, kiwi fruit allergy among children is becoming common. There are also many non-food causes of anaphylaxis, such as insect stings, latex and drugs.

Peanuts and tree nuts are the most common cause of severe allergic reactions

Incidence and statistics

Acute, severe allergy is thought to affect around one million people. The prevalence of food allergy is at its highest in young children (about one in 17 children). In most cases the allergy is mild. Around 80-90% of children outgrow their sensitivity by the age of five. Children are very likely to outgrow an allergy to milk, eggs, soy or wheat. Allergies to peanuts, tree nuts, shellfish or fish are less frequently outgrown.

Peanut and nut allergy

The prevalence of peanut allergy in children has tripled in the last decade, according to the findings of a study published in the Journal of Allergy and Clinical Immunology in November 2002. The researchers, who tested a large population of pre-school children in the Isle of Wight over a 10-year period, concluded that more than one in 70 children across the UK is allergic to peanuts. The figure they had arrived at a decade before was one in 200 children.

Egg allergy

Egg allergy is common in childhood and most cases are mild. Approximately 1% of young children suffer from an egg allergy, that is around 35,000 children aged four and under. A significant number – perhaps a third – suffer moderate to severe symptoms. In a few cases, egg allergy persists into adulthood, but most children outgrow it by the age of five.

Milk allergy

Cow’s milk allergy is common in infants and most cases are mild. In a small but significant number of cases, symptoms can be life threatening. Milk allergy rarely develops after one year of age and the onset is usually related to the introduction of cow’s milk-based infant formula. The prevalence of true milk allergy – as opposed to intolerance – is estimated to be as high as 2% in children under a year old.

Fortunately, the remission rate is very good, with 45-55% outgrowing their allergy by one year, 60-75% by age two, and 85-90% by age three. However, cow’s milk allergy may occasionally be life-long. In this group, symptoms may be severe.

Management of a s evere allergy

Severe allergies present quite a challenge to both parents and schools. Many schools and pre-schools are finding that cases of peanut allergy, milk allergy, egg allergy and other allergies are on the increase. The good news is that even the most extreme form of allergy – anaphylaxis – is manageable in schools. But what staff and parents need is accurate, reliable information. Schools are encouraged to devise an individual management plan for each allergic child. For more information, visit www.allergyinschools.org.uk

Adrenaline injections are a life saver in cases of severe reaction

If your child has a severe food allergy, it is important to explain to them that some foods can be particularly risky and to teach them to take extra care with these foods while away from home. For example, highrisk foods for people with nut allergy include curries, desserts, biscuits, some breads, and some sauces. Prepare safe versions of these foods at home so your child has the opportunity to have them in a safe environment. This teaches the child that he or she isn’t being denied foods, but is simply avoiding risky situations.

Teach your child what symptoms to expect, with words appropriate for their age. For example, a toddler may only need to know, “nuts will make you very poorly”. A 12-year-old should know in more detail the symptoms that may occur. However, be careful not to be so graphic that your child develops a fear of eating. Instead, stress the importance of avoiding high-risk foods and getting help quickly if a reaction occurs.

As children grow, they need to be able to:

• Tell friends, teachers, waiters, and so on, about their allergy
• Know and understand their symptoms
• Have knowledge of the risks and how to manage them
• Handle peer pressure
• Handle social situations
• Have a good understanding of food labels and how to interpret them
• Know about ingredients and cooking
• Know what to do should they have a reaction and establish emergency protocols

The Anaphylaxis Campaign

The Anaphylaxis Campaign is a registered charity that provides information and guidance to people affected by potentially life-threatening allergies. One of the charity’s main aims is to create a safe environment for people with allergies by educating the food industry, schools, pre-schools, colleges, health professionals and focusing on medical facts, food labelling, risk reduction, new treatments, latest research and many other allergyrelated subjects.

Events held by The Anaphylaxis Campaign throughout the UK

The Anaphylaxis Campaign Workshop Programme

Youth workshops are held across the UK for food-allergic youngsters aged 11-18. The aim is for them to learn how to assess and manage the risks associated with food allergy through interactive sessions including discussion and role-play. The emphasis is on fun, and the youngsters gain great benefit from meeting others who face the same challenges.

Workshops are also held for parents of food-allergic children of any age, covering topics such as school issues, eating away from home and holidays abroad.

Family Fun Days

The Anaphylaxis Campaign holds Family Fun Days so members have a chance to get together in an informal setting and share tips and experiences on living with allergy.

These events are open to all the family and feature games and competitions to help children up to the age of 11 understand their allergy better.

Support Groups

Support groups are run by members of the Anaphylaxis Campaign to enable other members to share experiences of living with severe allergy. Many of the groups meet regularly and children are often welcomed.

For further information please contact:
The Anaphylaxis Campaign
PO Box 275
Farnborough
Hants
GU14 6SX
Helpline: 01252 542029
Website: www.anaphylaxis.org.uk
Website: www.allergyinschools.org.uk

 

 

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