10 Things You Might Not Know Have Peanuts

Have a read of this link, perhaps you are aware of more

Care pathways for children with allergies

The journal Archives of Disease in Childhood has recently published a supplement containing a series of articles focused on developing care pathways for children with allergies. The articles represent an attempt by the Royal College of Paediatrics and Child Health (RCPCH) Science and Research Department to develop national care pathways for children, as requested by the UK Department of Health.

The articles each focus on a different condition:

Anaphylaxis
Asthma and/or rhinitis
Drug allergies
Eczema
Food allergy
Latex allergies
Urticaria, angioedema, or mastocytosis
Venom allergies

Each article presents a pathway algorithm and a set of competences that are required to deliver high-quality care. They are intended as “a guide for training and development of services to facilitate improvements in delivery as close to the patient's home as possible.” The authors note that the pathways should be implemented by a multidisciplinary team, at a local level, and with an eye to establishing connections between primary, secondary, and tertiary care.


Care Pathways

Allergies, Asthma and Winter Holidays

For sensible advice on managing your food allergies over the coming holidays see tips on the AAAAI websites, as well as other charities such as the UK Anaphylaxis Campaign

Causes of ant sting anaphylaxis

This study determined the Australian native ant species associated with ant sting anaphylaxis, geographical distribution of allergic reactions, and feasibility of diagnostic venom-specific IgE (sIgE) testing. 376 participants reported 735 systemic reactions. Of 299 participants for whom a cause was determined, 265 had reacted clinically to Myrmecia species and 34 to green-head ant (Rhytidoponera metallica). Of those with reactions to Myrmecia species, 176 reacted to jack jumper ant (Myrmecia pilosula species complex), 18 to other jumper ants (15 to Myrmecia nigrocincta, three to Myrmecia ludlowi) and 56 to a variety of bulldog ants, with some participants reacting to more than one type of bulldog ant. Variable serological cross-reactivity between bulldog ant species was observed, and sera from patients with bulldog ant allergy were all positive to one or more venoms extracted from Myrmecia forficata, Myrmecia pyriformis and Myrmecia nigriceps. Therefore 4 main groups of Australian ants cause anaphylaxis. Ser um sIgE testing enhances the accuracy of diagnosis and is a prerequisite for administering species-specific venom immunotherapy.

Brown SG, van EP, Wiese MD, Mullins RJ, Solley GO, Puy R, Taylor RW, Heddle RJ.
Causes of ant sting anaphylaxis in Australia: the Australian Ant Venom Allergy Study.
Med J Aust 2011 Jul 18;195(2):69-73

Spice allergy. A review

Spice allergy seems to be rare, reportedly affecting between 4 and 13 of 10,000 adults and occurring more often in women because of cosmetic use. No figures were available on children.

Most spice allergens are degraded by digestion; therefore, IgE sensitization is mostly through inhalation of cross-reacting pollens, particularly mugwort and birch. The symptoms are more likely to be respiratory when exposure is by inhalation and cutaneous if by contact. Studies on skin testing and specific IgE assays are limited and showed low reliability.

The diagnosis primarily depends on a good history taking and confirmation with oral challenge. The common use of spice blends makes identifying the particular offending component difficult, particularly because their components are inconsistent.

Chen JL, Bahna SL.
Spice allergy.
Ann Allergy Asthma Immunol 2011 Sep;107(3):191-199

Allergy Food Labelling

The current legislation on general food labelling dates back to 1978 and nutrition labelling rules were adopted in 1990. Consumer demands and marketing practices have changed significantly since then. EU consumers want to be better informed when purchasing food and to have labels that are simple, legible, understandable and not misleading. PLease see link below for updated that will hopefully assist food allergic patients and their families in making informed decisions on the food they buy within the EU


Questions and Answers on the Food Information regulation

The Prevalence, Severity, and Distribution of Childhood Food Allergy in the US

Pediatrics. 2011 Jun 20. The Prevalence, Severity, and Distribution of Childhood Food Allergy in the United States.
Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, Holl JL.

Objective: The goal of this study was to better estimate the prevalence and severity of childhood food allergy in the United States. Methods: A randomized, cross-sectional survey was administered electronically to a representative sample of US households with children from June 2009 to February 2010. Eligible participants included adults (aged 18 years or older) able to complete the survey in Spanish or English who resided in a household with at least 1 child younger than 18 years. Data were adjusted using both base and poststratification weights to account for potential biases from sampling design and nonresponse. Data were analyzed as weighted proportions to estimate prevalence and severity of food allergy. Multiple logistic regression models were constructed to identify characteristics significantly associated with outcomes. Results: Data were collected for 40 104 children; incomplete responses for 1624 children were excluded, which yielded a final sample of 38 480. Food allergy prevalence was 8.0% (95% confidence interval [CI]: 7.6-8.3). Among children with food allergy, 38.7% had a history of severe reactions, and 30.4% had multiple food allergies. Prevalence according to allergen among food-allergic children was highest for peanut (25.2% [95% CI: 23.3-27.1]), followed by milk (21.1% [95% CI: 19.4-22.8]) and shellfish (17.2% [95% CI: 15.6-18.9]). Odds of food allergy were significantly associated with race, age, income, and geographic region. Disparities in food allergy diagnosis according to race and income were observed. Conclusions: Findings suggest that the prevalence and severity of childhood food allergy is greater than previously reported. Data suggest that disparities exist in the clinical diagnosis of disease.