1. food and drink
2. food allergies

News facts
SPRING 2012
INSIDE THIS ISSUE:
Presidents Report
2
Allergic rhinitis & immunotherapy
3
Andrenaline autoinjector for general use 5
Is it Allergic Rhinitis?
10
NEW GS1 GoScan app 14
Pathways in Food Allergies
15
Dr Ruhno Awards
17
Manage your Asthma
18
Food Recalls
24
Contacts
28
Understanding
and managing
your hay fever
Allergy & Anaphylaxis Australia
1300 728 000
www.allergyfacts.org.au
Allergy & Anaphylaxis Australia is supported by
funding from the Australian Government.
PUBLISHED BY
Allergy & Anaphylaxis Australia Copyright 2012
ACKNOWLEDGEMENTS
Allergy & Anaphylaxis Australia gratefully
acknowledges the support of ASCIA, Alphapharm
Pty Ltd, Link Pharmaceuticals, Clayton Utz,
Food Allergy & Anaphylaxis Network.
G
UNSUN
O
HER
ES
It’s time to
recognise our
unsung Allergy
Aware Heroes
DISCLAIMER
Allergy & Anaphylaxis Australia and its members and
associates make no representation and give no warranty
as to the accuracy of the information contained within this
publication and do not accept any responsibility for any
errors or inaccuracies in or omissions from the information
contained therein (whether negligent or otherwise) and
Allergy & Anaphylaxis Australia, its members and associates
shall not be held liable for any loss or damage however arising
as a result of any person acting in reliance or refraining from
acting in reliance on any information contained therein. No
reader should rely solely on the information contained in this
publication as it does not purport to be comprehensive or
to render specific advice. This disclaimer does not purport
to exclude any warranties implied by law which may not be
lawfully excluded.
ACN 159 809 051
New children’s
story book
YOUR TRUSTED CHARITY FOR ALLERGY SUPPORT
SPRING 2012
President’s Report
Hi everyone,
labelling and precautionary statements in London. The
It has now been a couple of months since we adopted
Australian Food Allergen Bureau chairperson, Kirsten
our new name of Allergy & Anaphylaxis Australia. Thanks
Grinter presented on the work done on the precautionary
to all our members for the support and encouragement
labelling including the VITAL process. See more at www.
you have given us throughout this transition process. I am
allergenbureau.net. The international team of experts who
proud to say that all feedback on our name reflecting the
first met in Australia through the Allergen Bureau in 2010
broad scope of our work has been positive. That said, the
also presented. It was heartening to see more than 80
changes we are making to website, logo, resources etc
scientists, legislators, clinicians, dietitians, food industry
continue. This is a huge task and we thank you for your
and of course consumer representatives discussing safer
patience during this time.
food choices for those with food allergy worldwide. Huge
Allergy & Anaphylaxis Australia is your trusted charity for
thanks to ILSI for the opportunity to partake.
allergy support. The ever increasing prevalence of allergy
Last and not least, I attended the annual Food Allergy
in Australia is a sharp reminder of how strong an advocate
and Anaphylaxis Alliance (FAAA) meeting in Washington
we need to be for all Australians who live with allergic
DC. We had a record 18 countries from around the
disease/s. Back in the 80s and 90s, if you said you had an
world represented; all at different stages of food allergy
allergy to something, be it a grass, mould or even a food,
management. Alarmingly, some still without access to
people often thought you just wanted to be trendy; a new
adrenaline autoinjectors in their country. Our aim is to
age person with ‘sensitivities’! Far have we come since
work together to progress food allergy management
that time but we still have much more to do in increasing
internationally. This year, we had the Global Food
awareness of all allergies Australia-wide.
Protection Institute develop an interactive workshop with
September was a busy month for our executive team.
the Food Allergy and Anaphylaxis Network for day 1 of the
Geraldine Batty and I attended the ASCIA scientific
three day meeting.
meeting in Wellington, New Zealand. Our stand at the
exhibition attracted many health professionals with an
The FAAA is A&AA’s support group. It is with these people
interest in the work we do to support allergic individuals
and from these people that we learn and share. The FAAA
and those caring for them. It was great to see the ever
has been a strong support for A&AA to grow to be the
increasing number of allergy nurses drop by and discuss
organisation it is today. We are grateful to Anne Munoz
their challenges or victories with us.
Furlong, founder of FAAN who brought her vision to life
Geraldine and I attended many a presentation on a variety
through the FAAA in 2000. This was A&AA’s 12th year
of subject areas. We experienced wet wrapping in a
of involvement in the Alliance and it is important that we
workshop on eczema and listened intently to presenters
acknowledge the support we have received to progress
talking about allergic rhinitis, allergic conjunctivitis, asthma
allergy management in Australia.
and other allergic conditions. We thank ASCIA for the
This newsletter is a little late due to our ever growing
opportunity to partake in this yearly information filled
struggle to keep up with our workload. Thank you for
meeting.
understanding!
I also attended another two international meetings in
Until next time, stay well
September. The first was a European International Life
Sciences Institute (ILSI www.ilsi.eu) workshop on food
Maria
2
SPRING 2012
ASCIA allergic rhinitis and
immunotherapy e-training
The ASCIA allergic rhinitis and immunotherapy courses aim
ASCIA Patient Information – Is it Allergic Rhinitis?
to provide accurate, consistent and evidence based education
www.allergy.org.au/images/stories/aer/infobulletins/pdf/
for primary care practitioners on how to effectively manage
AER_Is_it_Allergic_Rhinitis.pdf see page 10
allergic rhinitis, when to refer patients to specialists and
ASCIA Treatment Plan for Subcutaneous Immunotherapy
how to safely administer ongoing (maintenance) allergen
(for Specialist to provide to GP)
immunotherapy (sometimes referred to as desensitisation),
www.allergy.org.au/patients/allergy-treatment/scit-
one of the treatment options for some patients with
treatment-plan
moderate or severe allergic rhinitis.
The ASCIA allergic rhinitis and immunotherapy e-training
These courses and resources have undergone extensive
courses are closely related as clinical immunology/allergy
review by ASCIA members and representatives from other
specialists may recommend immunotherapy for some
medical organisations to ensure the highest quality evidence
patients with allergic rhinitis.
based resources have been developed.
Allergic rhinitis course overview
To maximise utilisation of the resources, ASCIA allergic
1 Overview of allergic rhinitis.
rhinitis and immunotherapy e-training courses are available
2. Clinical assessment.
free of charge from the ASCIA website www.allergy.org.au/
3. Aeroallergen minimisation.
health-professionals/healthprofessionals- e-training n
4. Pharmacotherapy and other treatment options.
5. Final assessment.
FOOD ALLERGY
AWARENESS WEEK
Immunotherapy course overview
1. Overview of immunotherapy.
2. Diagnosing aeroallergen and insect venom allergy.
Mark your
2013 diary
3. When to consider referral for immunotherapy.
4. Safe administration of subcutaneous immunotherapy
(SCIT).
5. Safe administration of sublingual immunotherapy (SLIT).
6. Final assessment.
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These courses have been developed in parallel with the
following supporting resources that are also
available free from the ASCIA website:
ASCIA Treatment Plan for Allergic Rhinitis (for completion
by Specialist, GP or Paediatrician)
www.allergy.org.au/patients/allergic-rhinitis-hay-fever-andsinusitis/allergic-rhinitis-treatment-plan see page 12
3
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SPRING 2012
Living with Allergies
Many of us live life with an allergy......or multiple allergies.
doctor. Allergy management needs to become a way of life.
It might be to pollen, mould, cockroach excrement, house
When my son was aged 2 years he had food allergy, asthma,
dust mite, a single food or multiple foods, dogs and cats or
eczema and allergic rhinitis. He was under the care of a great
some other trigger. No matter the trigger, allergy affects our
GP who put him on an antihistamine daily, asthma puffers,
quality of life. Many allergic conditions cannot be ‘cured’ so
nose spray, numerous skin creams and more. He was sleep
we need to learn to manage our allergy in the best way we
can. Avoidance of the trigger sounds easy but in reality this
deprived and so was I! I felt like I’d failed as a mum because I
can be challenging. Some need only take medication when
couldn’t keep his eczema under control. I’d think I was on top
needed but for many it means also taking daily medication
of it, ease off on that ‘steroid’ cream and let him play in the
to help prevent exacerbation of symptoms. Chronic allergy
sand pit only to watch the eczema worsen before my eyes.
can be debilitating. It can affect our sleep, school and work
I hated the fact he was on antihistamines everyday so I’d stop
performance and our mood and tolerance.
it for a few days and then watch his symptoms increase, sleep
Eczema, allergic rhinitis (hay fever), allergic conjunctivitis,
deteriorate and mood crash. It took me a while to accept he
allergic asthma, food and insect allergy, to name a few, are
really needed to have all this medication every day as his
often chronic and people need to manage them on a daily
basis. Acute episodes of allergic rhinitis leave us feeling like
doctors advised. I had to ‘cream him’ several times a day,
the there is no space in our head to think whilst the ongoing
sometimes as he screamed, restrain him whilst I gave him his
discomfort, treatment and even pain of eczema can leave
puffers through a spacer two or three times a day. I’d wrap
parents feeling like they are failing their children.
him like a burns victim to sleep and would put his Thomas the
The reality is there is no quick fix for allergy. We’d like our
Tank pyjamas on to help both me and him feel like we were
doctors to give us a medication (nasal spray, cream, asthma
very normal.
puffer or even a shot) and tell us we will be fixed in a week.
The truth at that time was that I felt that I’d failed my child.
Some people resort to alternate therapies thinking western
He was taking more medications than his great grandmother
medicine might have missed something but after many
who was almost 92! We saw an allergist when he was three and
dollars spent, they find nothing works.
I confessed I was not always compliant with medication. Once
Those of us who are not one of the lucky ones that just
he was looking better, I’d stop the nasal spray and the daily
outgrow an allergy need to accept whatever allergy we
have is our lot in life. We need to learn to live life WITH our
antihistamine. I’d let him have a bubble bath with his siblings
allergy/s. We need to get ourselves properly diagnosed by a
because I wanted my child to be like my other children. What
medical doctor and then follow a plan of treatment which
was normal in my mind, was a dose of paracetomol when
may include several avoidance measures, medications or
required and maybe a dose of antibiotics for an ear infection
treatments, carry out what we have been advised and return
not daily medications for ‘allergy’. Soon I accepted that he
to the doctor as advised or when things are not improving.
needed daily medication to help him(and the family!) have a
Trying an allergy treatment for a week and not attempting
happier life. He had allergies and he needed them controlled.
to implement avoidance measures is not part of any allergy
We couldn’t avoid all the triggers, so we had to treat daily as
management plan. Many throw their hands up in the air
saying they have tried everything but in reality, they have
well. I followed his doctor’s advice.
not ‘tried everything’ for long enough or as directed by their
Continue page 26
4
SPRING 2012
Anaphylaxis Management training,
legislation and adrenaline autoinjector
provision in the school and childcare sectors
RKS Loh1,2,3, Lamb, J, V Noble,1,2, L Sprigg1,2, Gatti, K4, S Vale1,5
on behalf of the Western Australian Anaphylaxis Project Advisory Group
1. WA Anaphylaxis Project Advisory Group
2. Child and Adolescent Health Services
3. Australasian Society of Clinical Immunology and Allergy (ASCIA)
4. WA Country Health Service
5. Anaphylaxis Australia Inc
Abstract #67
autoinjectors for general use enable staff to treat the
undiagnosed person, provides a back-up in the event of
misuse of the diagnosed person’s device and enables the
provision of a second dose of adrenaline if required.
Background: Anaphylaxis may occur in schools and child
care services, with up to 1 in 6 children reported as having
their first anaphylaxis in that setting. The Western Australian
(WA) government established an expert steering group
to implement strategies to enable effective anaphylaxis
management in schools and child care services.
BACKGROUND
Over the past ten years, anaphylaxis presentations to
Western Australia’s (WA) only tertiary pediatric hospital have
increased 7-fold. In response, the development of a statewide
strategy to manage anaphylaxis in the school and childcare
sectors was identified as a priority by the WA Government,
managed through the WA Department of Health.
Method: Staff in schools and child care services were
educated in anaphylaxis prevention, recognition and
emergency management using a standardised face-toface training package delivered by a state-wide network of
approximately 300 community health nurses. Legislative
changes were enacted to support schools and child care
services to be equipped with adrenaline autoinjectors for
general use. Institutions whose staff undertook training
received government funded adrenaline autoinjectors (1 per
300 children).
The Anaphylaxis Project Advisory Group was established
to provide anaphylaxis training and guidelines that were
accurate, comprehensive and appropriate for all schools
& childcare services across WA. Representatives on APAG
include key government and non-government agencies.
Anaphylaxis guidelines were distributed in resource kits to
all schools and childcare services across WA. EpiPens were
provided for inclusion in first aid kits on completion of faceto-face (FTF) training.
Result: Face to face anaphylaxis training has been provided to
over 80% of all schools and child care services across WA over
the past 18 months. Of the 2580 adrenaline autoinjectors
provided, 19 have been used in children (17) and staff (2)
in response to insect venom or food induced anaphylaxis.
Follow-up in these cases indicates that all devices were used
appropriately.
The government legislated to protect school and childcare
staff acting in good faith in the treatment and management
of anaphylaxis.
METHODS & RESULTS
Conclusion: Most children at risk of anaphylaxis can lead
normal, interactive lives in schools and child care services.
The development of anaphylaxis resources including training
of staff, provision of adrenaline autoinjectors and changes in
legislation have resulted in a coordinated approach to risk
minimisation for children at risk of anaphylaxis. Adrenaline
Anaphylaxis management training
Online and FTF anaphylaxis training courses were developed
in parallel and in partnership with the Australasian Society
of Clinical Immunology and Allergy (ASCIA). The ASCIA
anaphylaxis training courses contain national as well as
5
SPRING 2012
Anaphylaxis Management training,
legislation and adrenaline autoinjector
provision in the school and childcare sectors
region-specific modules, allowing the training to be nationally
One AAI was provided per 300 children. Since the initial roll-
consistent whilst accommodating regional differences.
out of AAIs commenced in July 2010, 4,400 autoinjectors.
From each major district across the state, up to three
When an AAI is used and requires replacement, the school or
Community Health Nurses (CHNs) were up-skilled to perform
childcare service completes a form providing details about
the role of Anaphylaxis Link Nurses (ALN). In turn, the ALNs
the incident and returns it to the WA Health Department
conducted a 4 hour training course to train fellow CHNs.
RESULTS
More than 220 CHNs provide FTF anaphylaxis training to
Since July 2010, 22 AAIs for general use have been used
schools and childcare services.
in schools and childcare services. Analysis of reporting forms
Training of CHNs has enabled prompt access to accurate
indicates that these have all been appropriate uses (see table
and consistent training statewide. Between January 2010 to
1).
February 2012:
Table 1
82.5% schools have received training (885 schools)
On most occasions, the responder to the anaphylaxis
72% childcare services have received training (1,301
emergency who administered the AAI was a CHN (52.4%) or
childcare services)
a staff member (47.6%). The AAI was not self-administered
by any child.
LEGISLATIVE CHANGES
Amendments to legislation were enacted to enable the
provision and use of an adrenaline autoinjector for general
use in WA schools and childcare services and to protect staff
On 18 occasions, 1 AAI was required.
acting in good faith.
However on 3
occasions, 2 of the general use devices were required, and on
Provision of adrenaline autoinjectors for general use
1 occasion, 3 devices were required.
Adrenaline autoinjectors (AAIs) for first aid kits, along with the
Further information collected by the device replacement
ASCIA Action Plan for Anaphylaxis (general), was funded by
forms included the signs/symptoms that staff identified.
the government and provided to all WA schools and childcare
The majority of children presented with respiratory
services once staff completed FTF anaphylaxis training.
symptoms (see table 2).
6
SPRING 2012
Anaphylaxis Management training,
legislation and adrenaline autoinjector
provision in the school and childcare sectors
It is important to note that both children with and without
Table 2
known anaphylaxis risk required the use of AAIs for
general use. This highlights the importance of government
commitment to implement legislative, financial and
coordination mechanisms enabling sectors and services that
provide care and education to children, to develop systems,
resources and competence to manage anaphylaxis.
When determining the effectiveness of AAIs for general
use as a strategy, a factor that may need to be considered
is whether having the devices reassures staff in schools and
childcare services.
CONCLUSION
ACKNOWLEDGEMENTS
AAIs for general use, alongside training in how to recognise and
We would like to thank the Community Health Nurses who
respond to anaphylaxis, provide the opportunity for school
provided the training and assisted with the distribution of
and childcare staff to respond to anaphylaxis emergencies
the adrenaline autoinjectors for general use. We would also
without the delay of waiting for medical assistance to arrive,
like to thank the members of the WA Anaphylaxis Project
particularly in regional areas where access to medical services
Advisory Group for their ongoing commitment to improving
may be a considerable distance away.
anaphylaxis management for WA children.n
A goodbye that’s
not really a goodbye...
Richard has served our organisation well. We have learned
so much from him and he has acknowledged that he too has
learned from us. We look forward to working with Richard
through his role in ASCIA. It is wonderful that we have a
working relationship with the peak medical allergy body
in Australia and are communicating consistent messages
through to those who need them most.
That’s how Allergy & Anaphylaxis Australia (A&AA) are
seeing Dr Richard Loh’s recent stepping down from the
A&AA Medical Advisory Board (MAB). Richard has been a
time giving, information sharing, enthusiastic member of
A&AA MAB for close on 10 years. We have been privileged to
have him part of our Board over this time of great change in
allergy management in Australia.
Thank you Richard and congratulations too!!n
Richard is now President of the Australasian Society of
Clinical Immunology and Allergy (ASCIA). We congratulate
him on this appointment and although we are sad to lose him
as a MAB member, we know that the interests of those with
allergic disease will remain at the forefront of ASCIA activities
as they have been for many, many years.
7
SPRING 2012
ASCIA anaphylaxis training
approved by ACECQA
ASCIA anaphylaxis training for childcare was recently
In addition, more than 487 children’s services in NSW and
approved by the Australian Children’s Education and Care
around 70% of childcare services in WA, have received
Quality Authority (ACECQA).
anaphylaxis training provided by NSW and WA Health
All three versions of the ASCIA anaphylaxis training for
Departments using ASCIA face to face versions for childcare.
childcare currently available have been approved:
The ASCIA e-training courses for both schools and childcare
• ASCIA anaphylaxis training for NSW childcare – available
are freely accessible from the ASCIA website.
as e-training or face to face training delivered by trained
For more information, visit the ASCIA website
nurse educators approved by the NSW Ministry of Health.
(www.allergy.org.au) n
• ASCIA anaphylaxis training for WA childcare – available
as e-training or face to face training delivered by nurse
Does your ASCIA Action Plan
match your autoinjector?
educators approved by the WA Health Department.
• ASCIA anaphylaxis e-training for Australasian childcare
– this version of e-training is suitable for use throughout
Make sure that the ASCIA Action Plan for Anaphylaxis you
Australia and New Zealand.
have matches the adrenaline autoinjector you have been
ASCIA developed anaphylaxis training for childcare in
prescribed.
response to the recognised need for accessible, consistent,
reliable
and
evidence
based
anaphylaxis
education
We continue to have to remind individuals, parents and
throughout Australia and New Zealand.
schools about checking they have updated their ASCIA Action
ASCIA is the peak professional medical society for
Plan. The original look EpiPens have now all expired and are
immunology and allergy in Australia and New Zealand. As
no longer in the market place so if you have an EpiPen, your
such, ASCIA has the benefit of:
ASCIA Action Plan for Anaphylaxis MUST have graphics of
• Providing the most up to date evidence based training
the new look device which speaks of the blue safety release
and the orange needle end. Please check your Action Plans.
resources that are available on the ASCIA website (www.
allergy.org.au);
• Drawing on the expertise of the ASCIA membership and
key stakeholder organisations to ensure that the training
resources are accurate and appropriate for the intended
target audience;
• Established relationships with stakeholder organisations
who are involved in the consultation process, including
representatives from relevant Education, Children’s
Services and Health Departments. ASCIA anaphylaxis
e-training for childcare and schools has been extremely
well received. Since its release in March 2010, there have
been more than 28,000 registrations and approximately
one third of these registrations have been from staff
working in childcare services.
8
SPRING 2012
Using
assist
with fundraising.
From time to time we get enquiries about fundraising
Not only are you able to send your personal fundraising
activities and how some of you would like to help raise some
page to your own network of family and friends, but your
much needed funds for Allergy & Anaphylaxis Australia.
page will be available to view on the website. Messages of
One way that it can be done is by making your own
encouragement can be made by sponsors/donors on your
fundraising page and you, the fundraiser, can watch your
fundraising page using the website mycause.com.au
efforts grow.
Visit their website to find out how easy it is to get started by
creating your own fundraising page. Your Fundraising Page
is the place where your friends, family and workmates can
sponsor you, they can see the donation tally and you can
keep track of your fundraising efforts.
We benefit from decreased administrative workload and
increased funds raised through online social networking
and associated events. mycause does not charge a fee per
transaction and there are no ongoing monthly hosting fees.
Charities benefit from decreased administrative workload
and increased funds raised through online social networking
and associated events.n
Thank you to Mr Hayden who recently raised $655
for Anaphylaxis Australia through taking part in an
endurance event by using www.mycause.com.au
Allergy & Anaphylaxis Australia is a registered charity with
mycause which means it is easy for you to start your own
fundraising activity. Please note at present we still appear
as Anaphylaxis Australia Inc on mycause.com.au. The legal
changes to our recent organisation name change are in its
final stages so this will be updated in the very near future.
mycause is a one-stop shop for anyone seeking to raise
funds, or donate to, a charity or cause of their choice.
Essentially, mycause.com.au brings together fundraisers,
charities and donors, uniting them with a common goal.
9
SPRING 2012
Is it Allergic Rhinitis
(Hay Fever)?
Reproduce with permission from ASCIA www.allergy.org.au
ASCIA EDUCATION RESOURCES (AER) PATIENT
Complications of allergic rhinitis may include:
INFORMATION
• Sleep disturbance
Allergic rhinitis (often known as hay fever) affects around
• Daytime tiredness
1 in 5 people in Australia and New Zealand. It can affect
• Headaches
children and adults.
• Poor concentration
Despite the name, hay fever is not caused by hay and does
• Recurrent ear infections in children
not result in fever. It is caused by the nose and/or eyes
• Recurrent sinus infections in adults
coming into contact with environmental allergen(s), such as
• Asthma which is more difficult to control
pollens, dust mite, moulds and animal hair. The person may
then experience one or more of the following symptoms:
ALLERGY TESTING
Immediate signs or symptoms
If you suffer from allergic rhinitis, particularly if it is
persistent, or affects your day-to-day function, discuss
• Runny nose
treatment options with your general practitioner. A referral
• Rubbing of the nose
to a clinical immunology/allergy specialist may be required
• Itchy nose
for further assessment including allergy testing.
• Sneezing
Further information on allergy testing is available on the
• Itchy, watery eyes
ASCIA website:
Obstructive signs or symptoms
www.allergy.org.au/patients/allergy-testing
• Congested nose
TREATMENT OPTIONS AEROALLERGEN MINIMISATION
• Snoring
If it is possible to confirm the allergen(s) causing the allergic
Whilst some of these symptoms may be similar to those
rhinitis, then minimising exposure to the allergen(s) may
caused by infection (e.g. colds and flu), allergy symptoms
reduce symptoms.
tend to persist unless treated appropriately.
Further information on allergen avoidance and minimisation
Some patients with allergic rhinitis have asthma. Better
is available on the ASCIA website: www.allergy.org.au/
control of allergic rhinitis has been shown to result in better
patients/allergy-treatment/allergen-avoidance
asthma control in both adults and children.
TREATMENT OPTIONS – MEDICATIONS
Symptoms range from mild or moderate (i.e. does not affect
Intranasal corticosteroid sprays are nasal sprays that contain
day to day function) to severe (affects day to day function).
very low dose steroids and are one of the most effective
Symptoms may occur in a particular season (usually due to
treatments for allergic rhinitis. These are safe for long
allergies to grass, weed or tree pollens) or are persistent and
term use in both children and adults. Higher strength nasal
present all year round (usually caused by allergies to house
corticosteroid sprays require a prescription from a doctor. It
dust mites, moulds or animal hairs). Allergic rhinitis (hay
is important you are instructed how to deliver these sprays
fever) is not caused by a food allergy.
properly into your nose.
10
SPRING 2012
Is it Allergic Rhinitis
(Hay Fever)?
Reproduce with permission from ASCIA www.allergy.org.au
Non-sedating antihistamines (antihistamines that do not
The Australasian Society of Clinical Immunology and Allergy
make you drowsy) are effective in relieving symptoms and
(ASCIA) is the peak professional body of Clinical Immunology
are available without prescription from your local pharmacy.
and Allergy Specialists in Australia and New Zealand.
However they are not as effective as some other medications
Website: www.allergy.org.au
for the treatment of blocked nose and/or sinuses and you
Email: [email protected]
should discuss treatment with your doctor. Non-sedating
Postal address: PO Box 450 Balgowlah NSW 2093 Australia
antihistamines are available in tablet or in the form of nasal
Disclaimer
sprays, and do not require a script.
This document has been developed and peer reviewed
Saline nasal sprays or irrigations are salt mixtures, either
by ASCIA members and is based on expert opinion and
delivered by a nasal spray or through a bottle that can be
the available published literature at the time of review.
purchased from a pharmacy without a script. They can
Information contained in this document is not intended
help to clear nasal congestion and reduce allergic rhinitis
to replace medical advice and any questions regarding a
symptoms. They are not as effective as other treatments
medical diagnosis or treatment should be directed to a
for allergic rhinitis and are usually more effective when used
medical practitioner. The development of this document is
with other treatments.
not funded by any commercial sources and is not influenced
Decongestant nasal sprays or tablets relieve a blocked feeling
by commercial organisations.n
in nose. It is very important that these are only used for a
maximum of 5 days. Longer use can result in worsening nasal
THUMBS
UP
blockage. Certain individuals should not use decongestants
(e.g. pregnancy, high blood pressure). Discuss with your
doctor or pharmacist before using these medications.
TREATMENT OPTIONS ALLERGEN SPECIFIC IMMUNOTHERAPY
This is also known as desensitisation. It involves the
administration of regular, gradually increasing amounts
of allergen extracts, by injections or by sublingual drops or
tablets (under the tongue). Treatment is usually for 3-5 years
and is typically offered for individuals > 5 years of age with
severe allergic rhinitis. The therapy reduces the severity
of symptoms and/or the need for regular medications.
Immunotherapy is long term treatment that should be
A big THANK YOU to
Campbell’s Arnott’s for their donation to assist us
with work in ongoing awareness raising.n
initiated by a clinical immunology/allergy specialist.
Further information is available from the ASCIA website
www.allergy.org.au
© ASCIA 2012
11
SPRING 2012
T R E AT M E N T p l A N F o R
www.allergy.org.au
Alle r g i c Rhi n i t i s
( H a y F e v e r)
Patient name:
Plan prepared by: Dr
Signed:
Date:
A l l E R G E N M i N i M i s AT i o N
Minimising exposure to confirmed allergen/s may assist some individuals in reducing allergic rhinitis
symptoms. Patient education resources on allergen avoidance or minimisation is available on the
ASCIA website: www.allergy.org.au/patients/allergy-treatment/allergen-avoidance
M E d i c AT i o N s
Intranasal corticosteroid spray:
1 or
2 times/day/nostril for
Additional instructions:
weeks or
months or
1. Prime the spray device according to manufacturer’s instructions
(for the first time or after a period of non-use).
continuous
CORRECT
2. Shake the bottle before each use.
INCORRECT
3. Blow nose before spraying if blocked by mucus.
4. Tilt head slightly forward and gently insert nozzle into nostril.
Use right hand for left nostril (and left hand for right nostril).
5. Aim the nozzle away from the middle of the nose and direct
nozzle into the nasal passage (not upwards towards tip of nose,
but in line with the roof of the mouth).
6. Avoid sniffing hard during or after spraying.
Note: Onset of benefit may take days, so this treatment must be used regularly. It does not have to be stopped every few weeks. If significant
pain or bleeding occurs contact your doctor.
Oral non-sedating antihistamine:
or
as needed
Additional instructions:
Dose
Intranasal antihistamine sprays:
Additional instructions:
mL/mg
1 or
1 or
2 times/day
2 times/day or
as needed
Saline nasal
spray or
irrigation
times/day or
Use 10 minutes prior if used in conjunction with intranasal corticosteroid spray
as needed
Decongestant:
nasal spray or
tablet. Dose
times/day for up to 5 days (not more than 1 course/month)
mL/mg
Other medications:
Note: If allergen immunotherapy has been initiated by a clinical immunology/allergy specialist, it is important to follow the treatment as prescribed.
Contact your GP if you have any questions or concerns.
© ASCIA 2012. This treatment plan was developed by ASCIA as a medical document to be completed and signed by a medical practitioner. Further information is
available on the ASCIA website: www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis
12
POLLEN FORECAST
SPRING 2012
FIND OUT THE 4-DAY POLLEN FORECAST FOR YOUR LOCATION BY VISITING
www.weatherzone.com.au/pollen-index/
FIND OUT THE POLLEN SEASONS BY VISITING THE POLLEN CALENDAR
Here you can click on a plant name to find out information about the plant and what times of
the year the plant is usually flowering all over Australia.
www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/guide-to-commonallergenic-pollen
13
SPRING 2012
Exclusive Invitation:
Try the GS1 GoScan app to win an iPhone
Australia how they can make it even better for you and your
family’s needs. Plus, your feedback puts you in a draw to win a
new Apple device. GS1 Australia will provide participants with
details of how to win.
This month GS1 Australia is launching a targeted consumer
release of the GS1 GoScan iPhone app that includes
identification of food allergens in packaged foods. And you
can be one of the first to try it out.
Because this is a pre-launch version of the app, you might
notice that some products are not found when scanned.
Don’t be discouraged – we are working to have many
thousand more products by the time of the official launch in
March 2013.
If you would like to take part, all you need to do is visit
www.goscan.com.au to register. For more updates, check
out GS1 GoScan on Facebook and follow @GS1GoScan on
Twitter.n
SIMPLY REGISTER TO TAKE
PART IN AN EXCLUSIVE
RELEASE OF THE APP.
GS1 GoScan is a groundbreaking new iPhone app that delivers
the information you need to make the right product choice
for your dietary and lifestyle requirements – at home, in the
shops or on the go. GS1 GoScan allows you to access detailed,
authorised product information directly from brand owners
and manufacturers.
The GS1 GoScan app was developed by the not-for-profit
organisation GS1 Australia, in association with Allergy
& Anaphylaxis Australia, Australian Food and Grocery
Council, Coeliac Australia, Allergen Bureau plus major food
manufacturers and supermarkets.
The aim of this app is to make it easier for you to access
product information including allergen content, to enable
better, healthier product choices.
GS1 Australia is working hard to get the GS1 GoScan app
ready for its launch to the iTunes store in early 2013, and they
need your help to make it the best it can be. Simply register
at www.goscan.com.au, to take part in an exclusive release
of the app.
Once you’ve installed the app, give it a try in any of the three
major supermarkets (Coles, Woolworths and IGA) and tell GS1
14
SPRING 2012
Developmental Pathways
in Food Allergy
By Audrey Dunn Galvin Ph.D., Reg. Psychol. Ps.S.I.
In order to gain a truly meaningful picture of the impact of
profound effects on emotional and social aspects of a
a disease on a patient’s everyday life, health professionals
child’s everyday life than having a food-allergic reaction.
must understand the patient perspective. The term used to
Children were also found to be generally anxious according
measure these perspectives is called health related quality
to parents, even in situations where food was not involved.
of life (HRQL). How a patient may perceive their quality
Findings in the EuroPrevall birth cohort study demonstrate
of life may depend on many factors, such as age, gender,
that the impact of a diagnosis of food allergy begins
context, and culture. Therefore, patients with the same
early and can be detected over the course of one year.
clinical criteria often have dramatically different responses.
Researchers in Iceland, U.K., Germany, Spain, Netherlands,
To give an example, two patients with the same prognosis
and Italy administered a questionnaire before the infant was
following an operation for a heart bypass can have two very
diagnosed with food allergy by food challenge, and again 12
different perspectives on how their lives have changed.
months later. A similar pattern of responses across countries
For one, it may be an opportunity, for another, it may be
shows that even at this very young age, it appears that
perceived as a catastrophic event that changes how they
children are reluctant or afraid to try new foods, and have a
see themselves, how they interact with others, and how
lack of variety in their diets. Children’s ability to participate
they perceive the overall quality of their everyday lives. In
fully in social events is also adversely impacted. We found
turn, this can impact how well they follow medical advice for
similar results using the same questionnaire in the U.S.,
their future health. It has become increasingly important,
Singapore, and Japan.
therefore, for researchers and healthcare professionals
While health related quality of life instruments such as
to understand how the perceptions, experience, and
these questionnaires capture the impact of food allergy, the
impact of a chronic disease might influence a patient’s
manner in which food allergy is experienced and managed
interpretation and response to it, so that we can respond
every day must also be evaluated.
more appropriately.
Experience and coping in any chronic disease is an intricate
Although a growing number of families must live and cope
pattern of facts and feelings interwoven into a child’s
with food allergy on a daily basis, it is only in recent years
developmental pathway from birth to adulthood. Patient
that the social and emotional impact of food allergy has
and parental perceptions of risk may seem irrational to some
been researched in depth. The EuroPrevall project gave
clinicians, but have their own logic and validity from the
great advances to research in this area, and several disease-
perspective of those living and coping with food allergy. In
specific measures were developed to assess quality of life
order to create a developmental framework, we interviewed
in children and teens, including a series of food allergy
120 children/teenagers aged 6-18 years in 15 age-appropriate
quality of life questionnaires. When the questionnaires were
focus groups. Parents were also interviewed. Our findings
completed and analyzed, we found a strong impact of food
indicated that experience and coping in food allergy is
allergy on the quality of life in children’s everyday lives.
complex and dynamic, and involves a series of factors such
as age, gender, and the type of disease.
Although the life-threatening nature of anaphylaxis makes
prevention the cornerstone of therapy, it also impacts the
Because they were diagnosed when infants, young children
quality of life of food-allergic patients. In the initial focus
feel that they are the same as other children, and parents
groups conducted, parents suggested that the anxiety
help them to feel normal and protected in their everyday
associated with the risk of a potential reaction has more
lives. As children become more aware of the rules and see
15
SPRING 2012
Developmental Pathways
in Food Allergy
By Audrey Dunn Galvin Ph.D., Reg. Psychol. Ps.S.I.
them as restrictive, together with a growing awareness
Transition points are a source of stress and uncertainty,
of difference and uncertainty, the search for normality
particularly for parents of food allergic children. The start
becomes stronger, and children evolve strategies in order to
of elementary school is a new anxiety trigger, because
cope. By adolescence, these coping strategies become more
the parent must hand over responsibility and control to a
defined, and in some cases more rigid, and an expanding
third party. As children grow and become more aware of
social world further drives their search for normality.
differences, and as their social world expands, parents worry
that children may take risks in order to “fit in” with other
Subsequently, we also analyzed data from focus groups and
children. Going to secondary school is a transition point that
interviews held in Australia, the U.K., Italy, Singapore, and
tests parents’ resources, increases their uncertainty, and
the U.S. The themes that emerged from other countries
intensifies their anxiety. Since parents can transmit these
were strikingly similar to our previous research including the
feelings to their child, allaying parental anxiety reduces the
impact of living with uncertainty, with difference, with rules
child’s and creates a positive feedback loop, which ultimately
and the coping strategies used.
benefits both.
“Living with uncertainty” is a central theme when living
Middle childhood is an important transition point when
with food allergy. Allergic reactions are unpredictable –
children begin to gain autonomy and self-belief in their
sometimes they are mild, sometimes severe, and sometimes
ability to control events in their lives. We find increased
they happen when least expected, even if the individual is
levels of anxiety or risk-taking behavior follows this point,
vigilant. This is not only because of the uncertain nature
resulting from the negative impact of attempting to cope
of reactions in food allergy, but also because of confusion
every day with challenges that are above and beyond those
and lack of transparency and specificity in food labeling;
faced by most children in this age group, who do not have
inconsistency around guidelines for use and prescription
food allergy.
of epinephrine; and lack of awareness and understanding
Adolescence is yet another important transition point
among some schools, restaurants, and the general public.
with increased stresses related to age-specific challenges,
Children and teens can respond to these conditions by
in addition to the burden of food allergy. Parents also
experiencing a loss of control over their condition, and,
experience high levels of stress and anxiety due to constant
therefore, in some cases, becoming very anxious and
vigilance and feelings of guilt. Some of this worry is
avoidant in their emotions and behaviors, or in contrast,
maladaptive (e.g., overprotection), preventing normal social
becoming frustrated, or angry, and taking risks with their
development, and therefore may have a long-term impact
safety.
on health related quality of life and positive coping ability.
Trust in safety of food labeling and confusion about
Greater support and clear information is important at the
thresholds (how much allergen is required to cause a reaction,
time of diagnosis and at the different transition points along
and how severe this reaction might be) is a significant source
the developmental pathway. Specifically, parents have
of uncertainty and stress for children, teens, and parents. In
suggested that greater emphasis is needed on the social
many cases, teens and young adults felt reading ingredient
and emotional aspects of food allergy, on knowing what to
labels was pointless and frustrating, and therefore took
expect, and on enhancing self-management skills that both
deliberate risks. This attitude was often formed during the
children and their families can draw on, and that generalize
middle childhood years.
to both everyday and non-typical situations.
16
SPRING 2012
Developmental Pathways
in Food Allergy
By Audrey Dunn Galvin Ph.D., Reg. Psychol. Ps.S.I.
To address and attempt to alleviate food allergy related
a family member/s who go out of their way to ensure a
stressors, research suggests that reducing uncertainty
family celebration has a menu that was put together with
should be a major goal for health professionals working with
food allergy in mind, a school, day care or preschool with
children, teens and families.
proactive and supportive staff, a baby sitter, your partner
or someone in your workplace. Think of those who have
Audrey DunnGalvin, Ph.D. is a registered psychologist and
demonstrated consistency in understanding your needs and
a biostatistician in the department of Paediatrics and Child
the responsibilities of caring for/supporting someone living
Health at Cork University Hospital in Cork, Ireland.n
with the risk of anaphylaxis.
Please include in your thinking those people who at
Dr John Ruhno
and Be a M.A.T.E
annual awards
sometime during the last year have made that contribution
that meant an improvement in your quality of life. It may
have been on a one off special occasion or ongoing support
during the year.
Because there is such a wide range of support extended to
those with potentially severe allergic reactions, nominate
someone or an organisation that best represents what
We are pleased to announce that nominations are being
accepted for the 2012 Dr John Ruhno and Be a MATE
Awards. The Be a MATE award is to be awarded to a school
or a childcare service whereas the Dr John Ruhno Award can
be awarded to any member/organisation in the Australian
community.
These awards were established to recognise the outstanding
contributions and significant support of members of our
‘Allergy Aware’ community in the past 12 months.
When living with severe allergy and the risk of anaphylaxis
it is important to let others know about your allergy and
how to assist you with management and of course in an
emergency. It takes time for those not familiar with allergy
and anaphylaxis to understand and find ways in which they
can support children and adults at risk of anaphylaxis. We
hear reports of people not understanding and people not
respecting management strategies so now is your chance to
acknowledge those who have helped you, those who have
shown you compassion and understanding and provided you
with support; those who have made allergy management
easier. Let these people set an example for others to follow.
We hope you will nominate a person/people or an institution
that have made a difference in your life e.g. a friend who
really understands and is ready to help you at anytime,
you’ve come to value and expect from being allergy aware.
The nominees may have set an example by leading the
way in:
• promoting respect for those living with the risk of
anaphylaxis
• implementing manageable allergen minimisation
strategies
• demonstrating quality care and knowledge
• understanding the needs of those living with severe
allergy
• communicating on behalf of those who live with the risk
of anaphylaxis
• encouraging open communication on food allergy needs
• improving the quality of life of those with severe allergy
Send your entry via email or mail in about 500 words why
you feel your nominee is worthy of the award. Remember
the Dr John Ruhno Award is for an individual/workplace and
the BE a MATE award is for schools or childcare. n
Entries to [email protected] or
Allergy & Anaphylaxis Australia
Awards, PO Box 3182 Asquith NSW 2077
Entries close 31st December 2012.
17
SPRING 2012
Manage your asthma –
ask your doctor about an Asthma Plan.
For many years, Allergy & Anaphylaxis Australia has reminded
reaction or an asthma attack, GIVE Adrenaline autoinjector
individuals, parents, carers, schools etc of the importance
first, followed by asthma reliever medication, call an
of following instructions on the ASCIA Action Plan when it
ambulance, continue asthma first aid and keep following the
comes to first aid management of allergic reactions to food
ASCIA Action Plan for Anaphylaxis. Lay person flat, do not
or insects.
stand or walk. If breathing is difficult allow to sit.
Many individuals who have allergies (children and adults) also
Nathional Asthma Council Australia is the place to visit
have asthma. It is important to keep asthma well controlled at
for valuable information about asthma once you have
all times. According to the National Asthma Council Australia,
discussed management at length with your doctor. Visit
“Quick action may help prevent an asthma attack from
www.nationalasthma.org.au for asthma resources such as:
becoming an asthma emergency”.
• What is Asthma?
Remember: If someone has both a severe allergy and asthma
• How to manage your asthma.
and you are unsure whether they are having an allergic
• What to do during an attack.n
Kids’ First Aid for Asthma
First Aid for Asthma
2
3
Be calm and reassuring.
Don’t leave the person alone.
Give 4 puffs of a blue/grey reliever
(e.g. Ventolin, Asmol or Airomir)
Use a spacer, if available.
Use the person’s own inhaler if possible.
If not, use first aid kit inhaler or borrow one.
Wait 4 minutes.
Wait 4 minutes.
If the person still cannot breathe normally, give
4 more puffs.
CALL AN AMBULANCE IMMEDIATELY
(DIAL 000)
Say that someone is having an asthma attack.
If the person still cannot breathe
normally, give 1 more dose.
Keep giving reliever while waiting
for the ambulance:
Give 4 puffs every 4 minutes until the ambulance arrives.
For Bricanyl, give 1 dose every 4 minutes
Sit the child upright.
Stay calm and reassure the child.
Don’t leave the child alone.
Give 4 separate puffs of a reliever inhaler –
blue/grey puffer (e.g. Ventolin, Asmol or Airomir)
Use a spacer, if available.
Give one puff at a time with 4–6 breaths after each puff.
Use the child’s own reliever inhaler if available.
If not, use first aid kit reliever inhaler or borrow one.
4
Give 2 separate doses of a
Bricanyl inhaler
If a puffer is not available, you can
use Bricanyl for children aged
6 years and over, even if the child
does not normally use this.
wait 4 minutes.
wait 4 minutes.
If the child still cannot breathe normally, give
Give one puff at a time (Use a spacer, if available).
4 more puffs.
If the child still cannot breathe
normally, give 1 more dose.
Give 4 separate puffs every 4 minutes until the ambulance arrives.
If child still cannot breathe normally,
call an aMBUlance
iMMeDiately (Dial 000)
Say that a child is having an
asthma attack.
Keep giving reliever
Give one dose every 4 minutes
until the ambulance arrives.
witH SPaceR
witHoUt SPaceR
BRicanyl
Use spacer if available*
Kids over 7 if no spacer
For children 6 and over only
• assemble spacer (attach mask if under 4)
• Remove puffer cap and shake well
• Insert puffer upright into spacer
• Place mouthpiece between child’s teeth
and seal lips around it OR
place mask over child’s mouth
and nose forming a good seal
• Press once firmly on puffer to fire
one puff into spacer
• child takes 4–6 breaths in and out
of spacer
• Repeat 1 puff at a time until 4 puffs
taken – remember to shake the puffer
before each puff
• Replace cap
• Remove cap and shake well
• Get child to breathe out away
from puffer
• Place mouthpiece between child’s
teeth and seal lips around it
• Ask child to take slow deep breath
• Press once firmly on puffer while
child breathes in
• Get child to hold breath for at least
4 seconds, then breathe out slowly
away from puffer
• Repeat 1 puff at a time until 4 puffs
taken – remember to shake the puffer
before each puff
• Replace cap
• Unscrew cover and remove
If the child still cannot breathe normally,
If the person still cannot breathe
normally, CALL AN AMBULANCE
IMMEDIATELY (DIAL 000) Say that
someone is having an asthma attack.
Keep giving reliever.
Children: 4 puffs each time is a safe dose.
Adults: For a severe attack you can give up to 6–8 puffs every 4 minutes
HOW
TO USE
INHALER
2
3
Give 2 separate doses of a
Bricanyl or Symbicort inhaler
If a puffer is not available, you can use
Symbicort (people over 12) or Bricanyl, even
if the person does not normally use these.
Give 1 puff at a time with 4 breaths after each puff
If the person still cannot breathe normally,
4
1
Sit the person comfortably upright.
call an aMBUlance iMMeDiately
(Dial 000)
Say that a child is having an asthma attack.
Keep giving reliever.
For Symbicort, give 1 dose every 4 minutes
(up to 3 more doses)
WITH SPACER
WITHOUT SPACER
BRICANYL OR SYMBICORT
• Assemble spacer
• Remove puffer cap and shake well
• Insert puffer upright into spacer
• Place mouthpiece between teeth
and seal lips around it
• Press once firmly on puffer to fire
one puff into spacer
• Take 4 breaths in and out of spacer
• Slip spacer out of mouth
• Repeat 1 puff at a time until 4 puffs
taken – remember to shake the puffer
before each puff
• Replace cap
• Remove cap and shake well
• Breathe out away from puffer
• Place mouthpiece between teeth
and seal lips around it
• Press once firmly on puffer while
breathing in slowly and deeply
• Slip puffer out of mouth
• Hold breath for 4 seconds or as
long as comfortable
• Breathe out slowly away from puffer
• Repeat 1 puff at a time until 4 puffs
taken – remember to shake the puffer
before each puff
• Replace cap
• Unscrew cover and remove
• Hold inhaler upright and twist grip
around and then back
• Breathe out away from inhaler
• Place mouthpiece between teeth
and seal lips around it
• Breathe in forcefully and deeply
• Slip inhaler out of mouth
• Breathe out slowly away from inhaler
• Repeat to take a second dose
– remember to twist the grip both
ways to reload before each dose
• Replace cover
How
to USe
inHaleR
• Hold inhaler upright and twist grip
around then back
• Get child to breathe out away
from inhaler
• Place mouthpiece between child’s
teeth and seal lips around it
• Ask child to take a big strong breath in
• Ask child to breathe out slowly
away from inhaler
• Repeat to take a second dose –
remember to twist the grip both ways
to reload before each dose
• Replace cover
*If spacer not available for child under 7, cup child’s/helper’s hands around child’s nose and mouth
to form a good seal. Fire puffer through hands into air pocket. Follow steps for WITH SPACER.
Not Sure if it’s Asthma?
CALL AMBULANCE IMMEDIATELY (DIAL 000)
Severe Allergic Reactions
CALL AMBULANCE IMMEDIATELY (DIAL 000)
If a person stays conscious and their main problem seems to be breathing,
follow the asthma first aid steps. Asthma reliever medicine is unlikely to
harm them even if they do not have asthma.
Follow the person’s Action Plan for Anaphylaxis if available. If the person
has known severe allergies and seems to be having a severe allergic
reaction, use their adrenaline autoinjector (e.g. EpiPen, Anapen) before
giving asthma reliever medicine.
For more information on asthma visit:
Asthma Foundations – www.asthmaaustralia.org.au
National Asthma Council Australia – www.nationalasthma.org.au
not Sure if it’s asthma?
call aMBUlance iMMeDiately (Dial 000)
Severe allergic Reactions
call aMBUlance iMMeDiately (Dial 000)
If the child stays conscious and their main problem seems to
be breathing, follow the asthma first aid steps. Asthma reliever
medicine is unlikely to harm them even if they do not have asthma.
Follow the child’s Action Plan for Anaphylaxis if available. If you
know that the child has severe allergies and seems to be having
a severe allergic reaction, use their adrenaline autoinjector
(e.g. EpiPen, Anapen) before giving asthma reliever medicine.
For more information on asthma visit: Asthma Foundations www.asthmaaustralia.org.au National Asthma Council Australia www.nationalasthma.org.au
if an adult is having an asthma attack, you can follow the above steps until you are able to seek medical advice.
Although all care has been taken, this chart is a general guide only which is not intended to be a substitute for individual medical advice/treatment. The National Asthma Council Australia expressly
disclaims all responsibility (including for negligence) for any loss, damage or personal injury resulting from reliance on the information contained. © National Asthma Council Australia 2011.
Although all care has been taken, this chart is a general guide only which is not intended to be a substitute for individual medical advice/treatment. The National Asthma Council Australia expressly
disclaims all responsibility (including for negligence) for any loss, damage or personal injury resulting from reliance on the information contained. © National Asthma Council Australia 2011.
18
MSC552
1
SPRING 2012
19
SPRING 2012
Write to us if you have a baby/child
with cow’s milk allergy.....share your story
Parents of young babies who develop cow’s milk allergy
often speak of their difficulty in accessing the help they
need. We want to know more about these difficulties.
Does your baby/child have cow’s milk allergy? Consider
sharing your experience with us. The information you
share will help us try to improve the current awareness and
management of cow’s milk allergy and access to special
formulas including amino acid formulas.
•What was it that first made you aware that something
was not right?
•What health professional did you see first e.g. GP,
Paediatrician, Allergy Specialist?
•Did your child have any reactions to regular cow’s milk
formula, cow’s milk through your breast milk or other
dairy foods before they were diagnosed and if so how
many?
•If your baby was on a special formula, how easy has it
been to access that formula?
•What costs were involved?
•How long was it before you saw an allergy
specialist?(months?)
•Was your child put on an amino acid formula? If so, by
whom?
•At what age was your child diagnosed? How old are they
now? Do they still have cow’s milk allergy?
•What were the three most difficult aspects of having
an infant with a cow’s milk allergy? Proper diagnosis,
management, accessing the right formula or other?
These questions are simply to provoke thought. Share
whatever information you feel comfortable sharing. Your
information may be shared anonymously with your written
permission. Please include your email address, postcode
and phone number when writing in. n
Email to [email protected] titled Cow’s
Milk Allergy or post to Allergy & Anaphylaxis Australia,
PO Box 3182 Asquith NSW 2077
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P
SPRING 2012
Letter to the editor
Dear Editor,
My husband had an anaphylactic reaction yesterday which the doctors think was to a Symbicort inhaler. He has been referred
for allergy tests and given an EpiPen®. He didn’t have the rash or wasn’t wheezy, his throat was just swollen and starting to
close up. He woke himself up snoring where his throat was closing and his lips were so swollen they split.
He still doesn’t realise how serious it was. I watched him in hospital as he kept yawning. His oxygen went down to 86%, it was
quite scary as he wasn’t panicking, just getting more sleepy. They put him on oxygen and gave him adrenaline.
He doesn’t know I have messaged you but now we have this EpiPen, he doesn’t think he needs to carry it around with him.
He said he will be careful with what he eats and leave it in the car. I said they only think it was the inhaler - most probably
was but doctors have told him to be careful with food as the other culprit was some chocolate with nuts in he ate just before,
although he has had nuts before - just not these chocolates.
He is trying to make out it didn’t happen and it will never happen again and I don’t know how to get through to him. Even the
doctor said inside of his mouth and throat were swollen and his airways.
Should he carry his pen everywhere?
I was so calm when it happened, it was this morning I realised how close it was. He wasn’t even wheezing; he was getting
drowsy and the doctors said his throat/tongue was swollen. No rash or anything which is why my husband probably isn’t
grasping it. I am trying to persuade him to get a medic alert necklace as well. Wish he wasn’t so stubborn.
Sorry for the long post, I just don’t know who else to ask.
Thanks ever so much
Julia
Dear Julia,
People are prescribed an adrenaline autoinjector (EpiPen or Anapen in Australia) if they have had a previous anaphylaxis or
if a doctor thinks someone with an allergy is at high risk of having a severe allergic reaction/anaphylaxis in the community
setting. It is important that people prescribed adrenaline pens always carry the pen and their ASCIA Action Plan for
Anaphylaxis with them ( i.e. adults should carry in a pocket, a bum bag, a backpack, handbag etc) where ever they go. The
pen and the ASCIA Plan need to be close by at all times and must not be in the car if he is not in it. (Adrenaline autoinjectors
need to be stored away from heat and direct light and therefore not in a car). Your husband’s adrenaline autoinjector must
always be easily accessible to him and those he is with. This is very important even for people who know what they are
allergic to because by definition unpredictable reactions are exactly that, unpredictable.
It is very important that people who have been prescribed an adrenaline pen by a GP or in an emergency department get a
referral to see an Allergy specialist as soon as possible afterwards. This is so they can receive a full workup for the cause of the
reaction, as well as to receive appropriate education about the risk of anaphylaxis and the use of the adrenaline pen.
PTO
21
SPRING 2012
Letter to the editor Cont.
Your husband’s case illustrates a few important points:
• The cause of a reaction is not always clear. Was it the inhaler or the nuts? This is important because adults may develop
allergies to foods even if they were previously able to tolerate the food.
• Therefore it is very important to try and get a correct diagnosis through an Allergy Specialist. If your husband has developed
a nut allergy the risk of another reaction is higher than if it was the inhaler because he is more likely to accidentally (or
purposefully) eat nuts again than he is to accidentally use his asthma inhaler!
• Many people at risk of anaphylaxis are reluctant to carry their adrenaline pens. Just remember – If you knew when you were
going to need the pen you would never need it because you would avoid the reaction in the first place.
• Presumably he has asthma and therefore needs an inhaler. People with asthma are more at risk of anaphylaxis if they also
have food, medication or drug allergies. So it is very important that he receive the correct advice about what to do if he can’t
use his inhaler because it turns out to have been the cause after all.
Please call our office to discuss further. It is important your husband is reviewed by an allergy specialist sooner rather than
later. It is difficult to be told you have a diagnosis of severe allergy and may be at risk of anaphylaxis in childhood but being
diagnosed in teen years or adulthood also poses similar challenges.
Name has been changed for privacy reasons.n
22
SPRING 2012
23
SPRING 2012
Food Alerts
ALMOND ALERT
Food Product: Confectionery
Brand Name: Kanga Kandy Choc Winter Mix
Best before date: 17 May 2013
APN/EAN/TUN Number: 9332864001116
Pack Description: clear bag with red and
yellow label, 400g
Country of Origin: Australia
Distribution: VIC
Reason for Recall: Undeclared Almonds
Company Responsible: Peter Magee Pty Ltd
(trading as Vic State Distributors)
FOR RECALL INFORMATION: 03 5335 9844
MILK ALERT
Food Product: Fish and fish products
Brand Name: I & J Crispy Battered Flathead
in Beer Batter
Best before date: All Best before dates up to and
including 15/9/2013.
APN/EAN/TUN Number: 9310139458933
Pack Description: Cardboard box, 300g, 6 fillets per
pack(frozen product)
Country of Origin: Thailand
Distribution: National
Reason for Recall: Undeclared milk in vegetable
shortening ingredient in product. Information not
provided to Simplot.
Company Responsible: Simplot Australia Pty Ltd
FOR RECALL INFORMATION: 1800 061 279
EGG ALERT
Food Product: Mixed and/or processed food
Brand Name: Olive Branch Smoked Salmon Dairy Free
(dip and/or spread)
Best before date: Ist November 2012
APN/EAN/TUN Number: 9322515006225
Pack Description: Plastic tub 200g
Country of Origin: Australia
Distribution: NSW, QLD, SA, VIC
Reason for Recall: Undeclared egg
Company Responsible: Quality Food World Pty Ltd
FOR RECALL INFORMATION: 1300 765 459
24
SPRING 2012
Food Alerts
EGG ALERT
Food Product: Mixed and/or processed food
Brand Name: Olive Branch Smoked Salmon Dairy Free
(dip and/or spread)
Best before date: All best before dates up to and
including Ist November 2012
APN/EAN/TUN Number: 9322515006225
Pack Description: Plastic tub 200g
Country of Origin: Australia
Distribution: NSW, QLD, SA, VIC, ACT
Reason for Recall: Undeclared egg
Company Responsible: Quality Food World Pty Ltd
FOR RECALL INFORMATION: 1300 765 459
PEANUT & ALMOND ALERT
A recall was issued for Kanga Kandy Choc Winter Mix
last week when it was found to contain undeclared
almond (after a customer complaint).
Anaphylaxis Australia has now been notified and
advised that this product also contains undeclared
peanut.
Food Product: Confectionery
Brand Name: Kanga Kandy Choc Winter Mix
Best before date: 17 May 2013
APN/EAN/TUN Number: 9332864001116
Pack Description: clear bag with red and yellow label,
400g
Country of Origin: Australia
Distribution: VIC
Reason for Recall: Undeclared Almonds and PEANUT
Company Responsible: Peter Magee Pty Ltd (trading
as Vic State Distributors)
FOR RECALL INFORMATION: 03 5335 9844
SULPHITE ALERT
Food Product: Beverage -wine
Brand Name: McGuigan Black label 20th Anniversary
Reserve 2011 Shiraz Cabernet Sauvignon
Best before date: NIL
APN/EAN/TUN Number: L 12175 ; 764253951013
Pack Description: Glass bottle with black printed
label, 750ml
Country of Origin: Australia
Distribution: QLD, NSW, ACT, VIC, SA, WA
Reason for Recall: Undeclared sulphur dioxide 220
Company Responsible: Australian Vintage Limited.
FOR RECALL INFORMATION: 02 8345 6377
25
SPRING 2012
Always Read
Ingredient List
Cadbury in Australia are importing a Freddo Biscuit from
Europe where the chocolate backing on the biscuit contains
hazelnut paste.
Always read the ingredient list of every product you purchase
every time. Just because the wrapping or the product looks
like something safe you have eaten before, products and
ingredients change – DON’T BE CAUGHT OUT! n
Note that this is a biscuit product and while it uses the same
generic shape as the Freddo Frog chocolate piece made here
in Australia the product will be sold in the biscuit aisle.
The Freddo Biscuit will clearly display an “allergen flash” on
front of pack and “hazelnut” will be bolded in the ingredients
list.
There is no change to the Freddo Frog chocolate products.
These have always been free of any nut inclusions.
Living with Allergies cont.
I studied nursing in the 80’s and learned very little about
make it. Being under the care of a doctor who understands
allergy. I didn’t even understand my own allergic rhinitis at
allergy, and not just buying over the counter medications
that time and did not have it properly managed until years
for allergy symptoms over and over is most likely to lead to
after my child was diagnosed. In the 90’s, many in the
better management and improved quality of life. Ongoing
community saw allergy as just a trendy term people put on a
symptom. Many did not take it seriously. And then......if you
care helps doctors assess your allergic status and therefore
spoke of a food that might threaten life, you almost had the
consider treatment options which include, preventative
word ‘fruitcake’ written across your forehead. We have come
medications, referral to an allergy specialist and possible
a long way.
discussion on immunotherapy which decreases some allergic
The message I can share from my journey thus far is that we
sensitivities such as house dust mite, grass pollen, bee or
need to take the advice of doctors who understand allergy and
wasp sting.
take long term medication if we need it. Taking a prescribed
nasal spray, rubbing in a daily moisturiser or taking a daily
Own your allergy just like a person with diabetes or epilepsy
antihistamine when we are free or almost free of symptoms
owns their condition and learns to live with it. Manage it as
is the right thing to do if that is what your doctor has advised.
best you can within the scientific limitations we currently
If you have moderate to severe allergy that is difficult to
have. Many allergies cannot be cured but signs and symptoms
manage ask for a referral to see an allergist.
can be better managed and quality of life improved.n
Accept there is no quick fix. Allergy is complex yet treatment
Maria Said
although sometimes onerous need not be as complex as we
26
SPRING 2012
New childrens’ book
recently launched
Marty loved to party. At every party, Marty was the first to
arrive and the last to leave.
That was before Marty found out that peanuts make him
sick. Really sick. Parties aren’t so much fun for Marty now
that he keeps ending up in hospital. How can Marty and his
friends make their parties safe and fun for everybody?
Marty’s Nut-Free Party by Katrina Roe was released on
September 1 and includes informative Notes for Parents
and Carers by Dr Elizabeth Pickford from RPA Allergy Clinic.
It is important to make sure children with food allergies
are not left out of social occasions. Katrina Roe hopes her
book will teach allergic children, their friends and families
to negotiate the minefield that is living with a food allergy,
especially at party time.
ORDER FORM
Name:
Address:
“For young children, birthday parties are the highlight of
Suburb:
Pcode:
their year,” Katrina said. “But for children with food allergies,
Marty’s Nut Free Party
parties can be difficult. Young children are messy eaters.
P&H for 1 book P&H for 2 or more books Little hands dip in and out of bowls of food. Faces, fingers
and clothes get covered in sticky treats. The potential for
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Phone:
QTY
Add $8.00
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Sub Total
TOTAL:
Prices are inclusive of GST cross-contamination is enormous!”
Marty’s Nut-Free Party focuses less on the pragmatic side of
METHOD OF PAYMENT
peanut allergy and more on the social issues it raises. This
Please tick which method:
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book is relevant for all children with food allergies, not just
those who are peanut allergic. It will be a useful resource
to teach the allergic child’s extended family, friends and
shows allergic children that with a bit of care, they can still
have as much fun as everyone else.
Members Master Card
Name on card:
teachers how to take good care of them. With gorgeous
illustrations by Leigh Hedstrom, Marty Nut-Free Party
Visa Expiry date:
/
TOTAL AMOUNT:
*CCV
*Visa & MasterCard: This number is printed on your cards in the
signature area of the back of the card.
(It is the last 3 digits AFTER the credit card number in the signature
area of the card).
Signature:
$15.95
Please make cheque/money orders payable to:
Anaphylaxis Australia Incorporated
Non members $19.95
PO Box 3182 , Asquith, NSW, 2077
Office phone (02) 9482 5988 or fax (02) 9482 4113
Order your copy now using this order form or visit our online
store www.allergyfacts.org.au
ACN 159 809 051
27
SPRING 2012
Allergy & Anaphylaxis Australia
Contacts & Medical Advisory Board
WA
Jodie Bellchambers
0414 379 010
TAS
Call 1300 728 000, leave a message
and we will get back to you within 48 hours.
Caroline Osborne
(03) 6432 3223
[email protected]
VIC
Sally Voukelatos
(03) 9572 1735
0425 703 123
MEDICAL ADVISORY BOARD
FOR MEMBER SUPPORT
INFORMATION
Dr Brynn Wainstein NSW
Dr Raymond Mullins ACT
Dr Michael Gold SA
Dr Jane Peake QLD
Dr Mimi Tang VIC
LEGAL ADVISORS
Clayton Utz
SA
Pooja Newman
[email protected]
(08) 83420876
FAAA MEDICAL
ADVISORY BOARD
Dr Michael Gold
Dr Raymond Mullins
Allergy & Anaphylaxis Australia
Committee 2011-2012
NATIONAL PRESIDENT
ASSISTANT SECRETARY
COMMITTEE MEMBER
Maria Said NSW
Loretta Buchhorn NSW
Debby Yang NSW
VICE PRESIDENT
PUBLIC OFFICER
COMMITTEE MEMBER
Sandra Vale WA
Geraldine Batty NSW
Annelise Kirkham QLD
NATIONAL TREASURER
Geraldine Batty NSW
NATIONAL SECRETARY
RESEARCH OFFICER
Stephen Batty NSW
COMMITTEE MEMBER
Leith Pawsey VIC
Virginia McNally NSW
1300 728 000
Allergy & Anaphylaxis Australia
PO Box 3182
Asquith NSW 2077
Office Admin: (02) 9482 5988
Fax: (02) 9482 4113
[email protected]
ACN 159 809 051
www.allergyfacts.org.au
28