Food Allergy Awareness Week (previously known as Allergy Awareness Week)
12-18th May 2014
Our goal is to raise awareness about food allergies, anaphylaxis (a life threatening
reaction) and all the problems families face when living with food allergies.
Food allergy is now a common condition in childhood and affects up to one in ten
children under the age of 5 years¹. It is a complex and stressful condition to manage
and yet little understood by others.
What is a food allergy?
A food allergy is an over-response of the immune system to a food protein, causing it
to trigger an allergic reaction. Mild to moderate symptoms can include hives, itching,
swelling, sneezing, red & watery eyes, vomiting, diarrhea and nausea. In some cases,
it can cause potentially life-threatening symptoms, called anaphylaxis, either by
breathing difficulties and/or a sudden drop in blood pressure.
In New Zealand children, the most common allergies are to cow’s milk and egg,
followed by peanuts, tree nuts, wheat and soy. Kiwifruit, sesame, fish and shellfish
are also common. The majority of children will lose their milk, egg, wheat and soy
allergies by age five to seven years². But allergies to peanuts, tree nuts, fish and shell
fish are generally prolonged, which is why these four allergies are the most common
amongst adolescents and adults. However globally more than 120 foods have been
identified as causing food allergies³.
Increase of food allergies
Reasons for the increase in prevalence of food allergy are not known. There is a
genetic component, with children of parents with allergies at higher risk, but it is
generally acknowledged that environmental factors associated with a westernised
life-style are driving this epidemic. Factors being investigated include ‘the hygiene
hypothesis’; lifestyle changes leading to lack of Vitamin D; dietary changes;
pollutants; and the effect of stress on the immune system. For more information
click green arrow below.
Whatever the causes, the increase in prevalence and complexity has mainly
impacted on young children and their families. While we have no data as yet on
prevalence in New Zealand,




global studies show food allergy as the leading cause of anaphylaxis in
children³;
a seven-fold increase in hospitalizations for anaphylaxis in children in the last
10 years³.
A pilot study in which Allergy New Zealand was involved, found high rates of
adverse reactions to food in young New Zealand children across all ethnic
groups4
most children with food allergy have eczema², and will go on to develop
other allergies including environmental allergies causing asthma and/or
allergic rhinitis (hayfever)³.
Anaphylaxis
The incidence of anaphylaxis, which is a severe and life-threatening allergic reaction,
is known to be increasing particularly in children, and is associated with the increase
in prevalence of food allergy. EAACI (the European Academy of Allergy and Clinical
Immunology) state that “the problem is more common than epidemiological studies
appear to show, among other reasons because it has an acute and unexpected
onset, can vary in severity and also can be spontaneously cured”5. They also state
that food allergy is the most common trigger of anaphylaxis in the community,
followed by medicines and insect stings.
Diagnosis and Management
A paper written by New Zealand paediatricians and published in the New Zealand
Medical Journal in 2013², provides guidance on the diagnosis and management of
IgE-mediated food allergy in children. Specialist referral is recommended in any child
with:







Definite or possible anaphylaxis
Allergy to cows’ milk or multiple food allergies, where expert advice is
needed
Where there is uncertainty about the diagnosis or interpretation of
results
Food sensitisation on ssIgE/SPT, where supervised challenge may be
necessary to clarify whether there is clinical allergy
Allergy to foods such as peanut and nut where the risk of severe allergic
reactions is higher
Children with asthma and FA, with asthma a risk factor for severe food
allergic reaction on accidental exposure
Children whose FA persists beyond 5 years of age.
However Allergy New Zealand’s CEO, Mark Dixon, notes “education, training and
support for health professionals including primary care practitioners, is very limited,
and there are few allergy specialists in New Zealand. The result is often significant
delays in referral and diagnosis, making it hard for individuals and families to
manage effectively on a day to day basis.”
Delays in diagnosis and risk management, and/or follow-up of food allergic children
can exacerbate health conditions such as eczema and asthma, as well as increase
stress and anxiety, limit social interaction and so on. A case study published in 2013
illustrated how such delays can also put children at risk of severe reactions and even
death6.
Treatment
Although there is no cure yet for food allergy, research in the last decade has
increased exponentially and researchers are getting closer to developing treatments
based on changing the way the immune system responds to allergens through
desensitisation - this works much the same way as ‘allergy shots’ work for hay fever.
But until these come into fruition, avoiding the allergenic food is the only treatment.
Patients and caregivers also have to learn how to treat allergic reactions and
particularly be aware of what to do in the case of anaphylaxis.
However in saying this, in Allergy New Zealand’s experience, most families are
plunged into food allergy with no prior experience of what it is or is involved, and
many find the challenges daunting. Food allergy has been described as a hidden
disability, and studies indicate a reduced quality of life including long-term effects on
health as well as psychological and social well-being. The direct and indirect costs are
also significant including medical costs and special foods, as well as lost income and
reduced education attainment due to the amount of lost time from work and
school7.
PHARMAC
A critical issue for many at risk of anaphylaxis, as well as their families and
communities, is the lack of funding for adrenaline auto-injectors. Anyone diagnosed
at risk of anaphylaxis from food or insect venom (bee and wasp) is prescribed an
auto-injector and recommended to have with them at all times.
However in spite of repeated approaches to Pharmac over the past decade, the
Government’s pharmaceutical funding body continues to decline funding. The
reason given is essentially that it is not cost effective. “In many ways the measures
families and their communities take to minimize the risk of anaphylaxis for children
works against them where Pharmac’s funding model is concerned” says Mark. “It
doesn’t take into account the costs they are incurring and the stress associated with
the uncertainty of anaphylaxis and the need to always be on your guard. Autoinjectors are a bit like seat belts, you never know when you are going to need them,
so the recommendation is to have them with you always.”
Petition
Allergy New Zealand has vowed to continue the campaign for funding and fully
supports the petition created by Wellington mum, Helen Richardson. The petition
has attracted more than 9000 signatures (online and hard copy) and Helen is
planning to take her campaign to the House of Representatives.
“Is is estimated 1 in 10 children born in New Zealand will develop food allergies and
many of these children will have multiple food allergies. A significant number of
these children will experience an anaphylactic episode triggered by a food allergen
and will be prescribed an adrenaline auto-injector. This is a critical life saving
treatment but many kiwis cannot afford to fill or renew prescriptions for this
treatment and my campaign is about ensuring this inequity is address as a matter of
public health policy,” says Helen.
Be aware, Show You Care*
About Allergy New Zealand
Allergy New Zealand is a national charity dedicated to providing reliable information,
education and support so you can manage your or your child's allergy and live an
active and healthy lifestyle.
We also represent their interests particularly to government, policy makers and the
media, provide information and guidance to the health, education and food sectors,
and support research.
www.allergy.org.nz
Contact
Allergy New Zealand
Karina Yanez, Communications Manager
comms@allergy.org.nz
021 0842 2680
1. Osborne et al. Prevalence of challenge-proven IgE-mediated food allergy using population-based sampling and
pre-determined challenge-criteria in infants. Journal of Allergy & Clin Immunol, 2011.
2. Sinclair et al. IgE_mediated food allergy – diagnosis and management in New Zealand children. NZMJ 2013
3.EAACI: Food Allergy & Anaphylaxis Public Declaration. FAAM 2013 (www.eaaci.org)
4. Crooks et al. Adverse reactions to food in New Zealand children age 0-5 years. NZMJ 2010
5.EAACI. Up to 22% of European children have an allergy, with serious reaction to food on the rise. April 2014
(www.eaaci.org)
6.JanSinclair. Fatal food allergy and opportunities for risk minimization. NZMJ, May 2013.
7. Gupta et al. The economic impact of childhood food allergy in the United States.
8. *Used with permission from Allergy & Anaphylaxis Australia 2014