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ALLERGY EPIDEMIC: A 21st century disease?

Dr Dilly Murphy helps us understand the key facts and how to deal with the problems of living with allergies

As allergy sufferers, it is important to remember that your children are not abnormal and they are not alone. Current statistics reveal that the numbers affected by allergies have trebled over the last 20 years with over 25,000 now in danger of fatal or near–fatal reactions to peanut allergies.

Experts continue to debate whether this is due to the immune system over–reacting to allergens; because we have been brought up in a sanitised environment; abstaining from eating certain foods during a child’s early years; or that globalisation has introduced us to foods that we didn’t have in our diet 20 years ago.

Some researchers believe that a tendency to develop allergies is primarily inherited, noting that a child with one parent with allergies has nearly 50% chance of developing allergies. Whilst, for a child with 2 allergy–suffering parents, the likelihood increases to 70%.

Allergies on the increase

Whatever the cause the facts show that in the population:

  • One in three suffers from an allergy.
  • Over 5 million are asthma sufferers.
  • Over 15 million suffer from hayfever.
  • 40,000 children born each year have a nut allergy.
  • Hospital admissions for anaphylaxis have risen fivefold since 1990.
  • Between 1990 and 2003, 49,000 people were admitted to hospital with severe allergic reactions.
  • Eight foods account for 90% of allergic reactions – peanuts, tree nuts (including walnuts, almonds, cashews, pistachios and pecans), fish, shellfish, eggs, milk, wheat and soy.

What happens during an allergic reaction?

Allergies occur when your immune system is hypersensitive or over–reactive. Antibodies produced by the immune system mistake an allergen as an ‘invader’ and attack it.

Common allergy symptoms include localized itching, skin rash, swelling, sneezing, runny nose, tearing, earache, sore throat, gastrointestinal symptoms like diarrhoea. Red bumps on the skin may appear in food allergies, drug allergies and allergic reaction to insect stings. Gastrointestinal symptoms are most common with food, food preservatives and food additives.

On rare occasions a sudden allergic reaction triggers a whole body response. This is called anaphylaxis. Wheezing or rapid breathing and constriction of the airways may be present in anaphylaxis. Cool, moist and pale skin alongside rapid pulse and low blood pressure could be signs of related shock.

Where can I get help?

There are currently some 90 alergy clinics, but only a handful of centres that specialise in allergies in London.

If you suspect your child has an allergy, talk to your GP first – he or she can advise if tests may be necessary and refer you to a specialist.

Allergy specialists will undertake various tests including:

  • Scratch test – small amounts of suspected allergens are placed on the skin surface and development of a bump or rash indicates an allergic response. They can also be injected under the skin.
  • Patch test – adhesive patches are applied with allergens to the skin to see if they trigger an allergic reaction.
  • Challenge test – suspected foods or medications are eliminated over a period of time and then small amounts are reintroduced to see if they trigger an allergic reaction.
  • Immunotherapy – allergy shots or under the tongue pills in a series of increasing doses to desensitise the allergy sufferer.

Treatment often requires a combination of approaches with the goal of allergen avoidance, control or relief of the symptoms or desensitisation.

Adrenalin (in Epipen injections) is prescribed for people who suffer with severe food allergies, wasp and bee stings, latex allergy and drugs.

How do I tell school about my child’s allergies?

Your child’s allergy will need to be managed effectively at school:

  • Discuss your child’s allergy with the headteacher and class teacher.
  • Supply an up–to–date photo along with an individualised management plan describing how to manage your child’s condition, medication and your contact details.
  • Check that staff are trained in the use of Epipens and know where to source them. Make sure your child knows who to ask if they feel any symptoms.
  • Discuss school meals as they will usually be able to provide suitable alternatives. Encourage a good rapport between your child and the catering staff so they get to know each other.
  • Keep an open communication channel with your teacher so that you can work together in recognising potential triggers and symptoms.

What do I do if my child has a severe allergic reaction?

  • Assess your child’s condition, note symptoms and any changes in symptoms. Get them to talk about how they feel.
  • Decide if the reaction appears to be mild, moderate or severe. If mild or moderate, give our child the prescribed antihistamine.
  • Monitor continuously to make sure the symptoms do not progress to a secondary phase reaction (after the initial reaction has been treated).
  • If there are symptoms of anaphylaxis, or difficult breathing, or your child feels faint or floppy, call an ambulance and administer the adrenaline Epipen into the muscle on his upper, outer thigh.
  • Keep the child calm and sitting still in a position that is comfortable for him. Do not move him. When the ambulance arrives provide all possible information including medications, stating times given.


British Society for Allergy & Clinical Immunology includes details of NHS allergy clinics and useful links

Allergy UK, a national medical allergy charity provides research, support and information including a template Management Plan

NHS Choices website  provides fact sheets on living with allergies.