Discussion
Subject:
Allergy Awareness Week - 1
Category:
General information
Main Topic
Maria Khoudary/sqa
22/04 15:04
What is an Allergy?
An allergy is the response of the body's immune system to a normally harmless substance,
such as pollen, food, or house dust mite. The body has an automatic reaction to what it sees
as a threat, and while in most people these substances pose no problem, in those with
allergies the immune system identifies them as a threat and produces an inappropriate
response to them. Allergies are classified into IgE mediated and non-IgE mediated allergies.
Allergies first start when cells in the immune system wrongly identify an everyday, normally
harmless, substance as an attacker. In IgE mediated allergies the immune system then begins
to produce begins to produce a class of antibodies known as IgE, specific for that particular
allergen, which will later alert the fighting cells (mast cells and basophils) within the immune
system every time that this substance is encountered. The mast cells bind with the IgE
antibodies so that they can identify the allergen next time it comes into contact with the body.
This is called sensitisation, and at this stage there are no physical symptoms of an allergy.
Mast cells are present in all the tissue that is in contact with the external environment, such as
the skin, nose, eyes, mouth, throat, stomach and gut. The next time that the same allergen is
encountered the mast cells identify it as an intruder and produce histamine and other
chemicals. It is the release of the histamine and other chemicals and their effect on the body
that cause allergic symptoms.
An allergy can therefore cause anything from a runny nose, or itchy eyes and mouth, to skin
rash and gastrointestinal symptoms such as abdominal discomfort (‘tummy ache’) and
vomiting. Severe allergies can cause breathing problems or a drop in blood pressure. Severe
allergic reactions are also known as anaphylaxis, and can be life-threatening.
In prolonged exposure to allergens the immune system also employs additional fighting cells
to attack the invading substance. These release chemical substances that cause further
discomfort to allergy sufferers and increase the severity of their symptoms.
However, the immune system can still respond to allergens without the production of the IgE
antibody. In non-IgE mediated allergies multiple cells may inappropriately react to the
presence of an allergen, and can cause many of the same symptoms as IgE mediated allergies.
Symptoms of IgE mediated allergies occur rapidly and soon after exposure to the allergen,
whereas in non-IgE mediated allergies symptoms tend to appear much later after contact with
the allergen. In these cases it can be much harder to identify which allergen is causing the
problem.
Allergy is widespread and affects approximately one in four of the population in the UK at
some time in their lives. Each year the numbers are increasing by 5%, with as many as half of
all those affected being children.
What is Causing Your Allergy?
Allergic reactions are caused by substances in the environment known as allergens. Almost
anything can be an allergen for someone. Proteins are organic substances which contain
hydrogen, oxygen and nitrogen, and form an important part of all living organisms. There are
also found in food, along with fats, carbohydrates and other substances. However, only
proteins can cause true allergic reactions.
The most common causes of allergic reactions are:
 pollen from trees and grasses
 proteins secreted from house dust mite
 moulds
 foods such as peanuts, tree nuts, milk, eggs
 pets such as cats and dogs, and other furry or hairy animals such as horses, rabbits and
guinea pigs
 insects like wasps and bees
 medicines (these may cause reactions by binding to proteins in the blood, which then
trigger the reaction)
Similar reactions can occur to some chemicals and food additives, however if they do not
involve the immune system, they are known as “adverse reactions” or “intolerances” rather
than “allergy”.
What Happens When You Have an Allergic Reaction?
When a person who is allergic to a particular allergen comes into contact with it, an allergic
reaction occurs. This begins when the allergen (for example, pollen) enters the body,
triggering an antibody response. The antibodies attach themselves to special cells, including
cells called mast cells. When the allergen comes into contact with the antibodies, these cells
respond by releasing certain substances, one of which is called histamine. These substances
cause swelling and inflammation of the surrounding tissues, which is extremely irritating and
uncomfortable.
Common symptoms associated with allergic conditions include:
 Sneezing
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Wheezing
Sinus pain
Runny nose
Coughing
Nettle rash / hives
Swelling
Itchy eyes, ears, lips throat & palate (roof of mouth)
Shortness of breath
Sickness, vomiting, & diarrhoea
Increase in nasal and airway secretions
If you are experiencing some of the symptoms mentioned above, this may indicate you have
an allergy. If you think that you have an allergy or an intolerance there are a number of ways
that you can go forward.
Our advice would be to contact your GP and ask for a referral to your nearest Allergy
Specialist. You can find out who this is from our helpline, but you will still need to be
referred by your GP.
Our Members' Nationwide Support Contact Network provides a valuable source of assistance
for people with allergy. Members also receive an information pack of useful information on
their particular allergy. Our Telephone Helpline is a source of information and immediate
support.
How to Help Your Doctor Diagnose an Allergy
The first step in management of allergic disease is identifying the cause(s) of the problem. In
some cases, this may be obvious. However, in other cases it may require detailed
investigation and medical tests. Keeping a record of your symptoms may help medical
professionals work out the allergen.
Diagnosing allergy can be difficult since the symptoms may be similar to other conditions.
For instance, many people suffer from a repeated sore throat and runny nose which they think
is a recurrent cold, when in fact they may be suffering from allergic rhinitis (hay fever).
Allergy may be responsible for other conditions such as asthma, upset stomach and skin
rashes.
If you think you may be allergic to something and do not know what it is, you should start to
keep a record of your symptoms. This will help you to find out what you may be allergic to.
Keep a diary of when your symptoms occur. In particular, the following information may
help your doctor make a diagnosis:
 Do they occur at any particular time of the day?
 Do you only get symptoms at certain times of the year?
 Do you suffer more at night time or during the day?
 Are you symptoms linked to a particular place, i.e. home or work environment?
 Do your symptoms occur when you are in the house as well as outside?
 Does exposure to animals bring on your symptoms?
 Do you think that any food or drink brings on your symptoms?
Once the offending allergen is identified, avoidance measures can be taken and the most
appropriate treatments can be commenced.
Discussion
Subject:
Allergy Awareness Week - 2
Category:
General information
Main Topic
Maria Khoudary/sqa
23/04 09:41
What is Food Intolerance (Non-IgE mediated Food
Hypersensitivity)
In food allergy, an abnormal immune system response results in the body making antibodies
to 'fight off' a food. However, some people suffer symptoms after eating certain foods even
when they are not producing antibodies against them. A variety of different mechanisms can
cause foods to affect people in this way; collectively these are known as non-IgE mediated
food hypersensitivity, or as more commonly known food intolerance.
Food intolerance is much more common than food allergy. The onset of symptoms is usually
slower and may be delayed by many hours after eating the offending food. The symptoms
may also last for several hours, even into the next day and sometimes longer. Intolerance to
several foods or a group of foods is not uncommon, and it can be much more difficult to
decide whether food intolerance is the cause of chronic illness, and which foods or substances
may be responsible.
In allergy, the patient cannot usually tolerate even a small amount of the offending food
without suffering symptoms, as it only takes a tiny amount to trigger a response from the
immune system, which makes it very easy to diagnose. Also, tests looking for IgE are easy to
perform and reliable so the diagnosis can usually be readily confirmed.
With food intolerance, some people can tolerate a reasonable amount of the food, but if they
eat too much (or too often) they get symptoms because their body cannot tolerate unlimited
amounts.
The symptoms caused by food intolerance are varied. They can include general symptoms
such as fatigue, joint pains, dark circles under the eyes, night sweats, gastrointestinal
symptoms such as diarrhoea and vomiting, bloating, irritable bowel, skin symptoms such as
rashes, eczema, and other chronic conditions.
Food intolerance can have a number of different causes:
Enzyme defects
Enzymes are required to help with the breakdown of natural substances found in certain
foods. If these enzymes are missing, or in short supply, then eating the food can cause
symptoms because part of the content of the food cannot be properly dealt with by the body.
In lactose intolerance, for example, the body lacks the enzyme (lactase) that breaks lactose
(milk sugar) down into smaller sugars ready for absorption from the gut. Lactose is too large
to be absorbed across the gut wall undigested, and its presence in the gut causes gut spasm,
pain, bloating, diarrhoea and 'failure to thrive'. Incidentally, these same symptoms can occur
in milk allergy, when the body has made antibodies to milk protein, which causes an immune
reaction when you drink milk. Hence, you cannot always distinguish allergy from intolerance
by symptoms alone without expert help.
Most foods require some enzyme activity in their digestion, and enzyme deficiencies can be
an important factor in food intolerance.
Pharmacological
Some foods contain naturally occurring chemicals that have an affect on the body, such as
caffeine in coffee, tea, and chocolate, or amines in certain cheeses. Some people seem to be
more affected than others by these natural substances in the food, causing symptoms which
would not occur in other people unless they ate far larger quantities of the food.
Toxic
A number of foods contain naturally occurring substances that can exert a toxic effect causing
symptoms of vomiting and diarrhoea. In cases such as kidney beans or chick peas that are
undercooked, there are aflotoxins, which cause these symptoms. If they are cooked fully the
toxins are not present. This can give a very confusing message to someone who seems to
tolerate a food sometimes but not others.
Histamine in foods
Some foods contain histamine naturally, and others (such as certain fish that are not fresh and
have not been stored properly) can develop a build-up of histamine in their flesh as they age.
In certain people, this histamine occurring naturally in the food can cause symptoms when
the food is eaten; typically, rashes, stomach pains, diarrhoea and vomiting and in some cases
symptoms that can mimic anaphylaxis.
Salicylates in foods
Many foods naturally contain salicylates, and our tolerance to this can vary. The vast majority
of people can eat salicylate-containing foods with no problems, but other people may suffer
symptoms if they eat too many foods, which when combined contain a large amount. These
salicylate-intolerant people will get better if they eat a diet of low and moderate salicylate
foods and avoid those with the highest levels.
Additives in foods
A wide variety of natural and artificial additives are used in colouring, preserving and
processing foods. Some people can suffer symptoms provoked by hypersensitivity to food
additives.
How is Food Intolerance recognised?
Certain features such as the pattern and type of symptoms can help to distinguish food
intolerance reactions from those that might be a result of food allergy, or some quite different
cause unrelated to food. By keeping an accurate and detailed diary of both foods eaten and
symptoms, it is possible to highlight the foods that may be causing a problem. Even if the
culprits are not clear, it gives a useful starting point on which to base exclusion and
reintroduction diets. A dietitian can help you manage these diets, which can ultimately give a
clear diagnosis.
Apart from coeliac disease and lactose intolerance there not any reliable and validated tests to
identify food intolerance. Because of this, the main tool used to diagnose food intolerance is
an exclusion diet (also called a diagnostic diet).
Symptoms are not immediate
The time relationship between eating the food and getting symptoms depends on many
factors. If the food is only eaten very occasionally, symptom onset after digestion ranges
from almost immediate to several hours. However, this is different when the food is being
consumed regularly, when each 'reaction' will run into the next, leading to the development of
chronic, almost continual, symptoms with no clear immediate reaction each time the food is
eaten. When this happens it can be more difficult to identify culprit foods but is still readily
done, and often with remarkable results.
Symptoms are usually multiple
In food allergy, the range of symptoms is usually predictable. In food intolerance, a very
much wider range of symptoms may occur and multiple symptoms are usual, and can be
general and non-specific, which can make diagnosis tricky. This highlights the need for
attention to detail and the need to record everything fully in the food and symptom diary.
Elimination followed by reintroduction
Embarking on a diet, which excludes certain foods to help find out what is causing
symptoms, is known as an exclusion diet. Certain foods are excluded for a set period of time
to see if the symptoms improve or resolve. This is followed by a reintroduction phase of the
diet so that a clear diagnosis can be obtained. The initial period of exclusion will usually be
for two weeks and up to six weeks depending on the symptoms. During this time, it is
important to replace foods with other foods of similar nutrition. A dietitian can help with this
and supervise the exclusion diet. Embarking on such diets requires a lot of dedication and
planning but the results can be life changing. Choosing the right time for you and your
family is essential – avoiding starting the diet during holidays or major celebrations is
recommended as sticking to the diet will become more difficult.
It is essential that during this exclusion phase the diet is adhered to 100% and restarted if any
mistakes are made so that the results are as accurate as possible.
Exclusion diets may avoid one food or several foods, or may start with a few foods diet
where only select foods are allowed and a list is given to be followed closely for an initial set
time period. These diets can lack essential nutrients, so it is vital they are supervised by a
dietitian.
Prolonged elimination builds tolerance
Weeks or months of elimination of the reactive food may well lead to reintroduction of the
food without reaction. This is known as tolerance, and its maintenance depends on
establishing the threshold of both frequency and quantity for that person - in other words,
eating the food occasionally may be tolerated, but reintroducing it in large quantities or on a
very regular basis (e.g. every day) might lead to symptoms recurring. This is purely
individual so working this out and not restricting the diet more than is necessary is a major
consideration.
Other factors
In a few people, underlying conditions can either cause symptoms or make food intolerances
worse. In these cases, treatment for the underlying condition should be a priority in order to
allow symptoms to improve. You should always seek advice via your GP rather than
attempting to diagnose or treat these problems yourself. Excluding other possible diagnoses
first is imperative.
Summary
Food intolerance can be caused by many factors but is treatable once the culprit foods are
identified. After excluding other possible causes a structured and supervised reintroduction
should commence.
Allergy or Intolerance?
Adverse reactions to foods are often called many different names including food
hypersensitivity, food intolerance, food allergy, and many other medical and non-medical
terms. These names add to the confusion of diagnosing and managing food related problems.
By keeping a diary of all suspected food related reactions (written records, photographs and
keeping labels of suspected pre-packed foods), this will help to identify which type of food is
causing your symptoms. Sometimes the food triggers will be obvious whilst other reactions
are very difficult to identify.
Food Allergy
True food allergy is a reaction involving the immune system where the body sees the food as
harmful and makes specific antibodies (called IgE antibodies) to ‘fight off’ the allergens
found in these foods. This results in the release of histamine and other naturally occurring
chemicals in the body. It is this release of histamine and chemicals, which produce the
symptoms we recognise as an allergic reaction.
Symptoms caused by an allergic reaction to food can range from skin reactions: which
include itching and rashes (urticaria); swelling (angioedema), gut symptoms, vomiting,
stomach ache, diarrhoea. Respiratory symptoms such as coughing, sneezing, asthma, blocked
or runny nose.
In the most severe cases symptoms may develop rapidly and can be life threatening so require
urgent medical attention. Symptoms may include swelling of the lips, tongue, or face,
shortness of breath, throat constriction and breathing difficulties. Loss of consciousness can
occur in extreme cases. This collection of symptoms is known as anaphylaxis. Normally
symptoms arise within a few minutes of eating or coming in to contact with an offending
food, although they may be delayed by up to a couple of hours. Those at risk of anaphylaxis
should have an adrenaline device available. The GP can prescribe this if it is necessary.
Thankfully true food allergy is actually quite rare, affecting approximately 2% of the adult
UK population and up to 8% of children. Should you suspect that you or your child may be
suffering from a food allergy, you should speak to your GP who will be able to help you or
may refer you for specialist advice to a hospital allergy clinic.
The foods that most commonly cause allergic reactions are peanuts, tree nuts (such as
almonds and Brazils), eggs, milk, fish, shellfish, and sesame. You should be aware that any
food can cause an allergic reaction and some foods are more likely to cause reactions in
certain ethnic groups.
Key points on food allergy
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Food allergy involves the body’s immune system and is a reaction to a specific food
or foods
Symptoms can be mild or severe and can involve the skin, gut, breathing or the whole
body circulation
Some GPs have the skills to diagnose and manage foods allergies. For the more
difficult cases or where multiple or severe food allergy exist, referral to an NHS
allergy specialist service in a hospital is recommended by NICE 2011 (the National
Institute of Clinical Excellence)
Patients with food allergy should be referred to a dietitian to help with the practical
management of their food allergy.
IgE food allergies are easy to diagnose and if the culprit foods are totally excluded it
is possible to remain completely free from any symptoms.
Reactions are often to trace amounts so complete exclusion is essential
Some people can tolerate a well-cooked version of the food but will react to the food
in its part-cooked or raw state. e.g. egg in a cake is often tolerated but the same
person will react to boiled and scrambled eggs and mayonnaise.
Food intolerance
Food intolerance is not so clear cut and is a more controversial area. Although not life
threatening, it can and often does, make the sufferer feel extremely unwell and can have a
major impact on working and social life. Ongoing symptoms can also affect the person
psychologically as they feel they will never get better.
Food intolerance reactions do not involve IgE and the mechanisms are unclear however it is
known that reactions are more likely to be delayed with the reaction occurring several hours
and sometimes up to several days after eating the offending food. The symptoms caused by
these reactions are numerous but have been associated with gut symptoms such as bloating,
diarrhoea, constipation, and IBS, and skin problems such as eczema.
Symptoms can affect different people in different ways but usually last for many hours or
days depending on the symptoms, and because it is possible to be intolerant to several
different foods at the same time it becomes very difficult to determine whether food
intolerance is the cause of chronic illness, and which foods may be responsible. Many people
with food intolerance have several symptoms. Sometimes the symptoms are vague and not
always easily diagnosed. People may complain of non-specific problems such as brain fog,
lethargy, headaches, or feeling bloated. These are often additional to bigger problems
relating to bowels and skin.
Food intolerance can be caused by several different factors; lifestyles with erratic food
intakes and poor nutritional intake or high intakes of refined foods, poor intakes of dietary
fibre or high fat diets are just a few examples.
Some people actually lack the enzymes needed to break foods down for example lactose
intolerance where the enzyme lactase is not produced in large enough amounts to break down
the lactose (milk sugars) in milk.
Others react to the chemicals that are produced naturally in foods such as caffeine,
salicylates, and histamine in foods like strawberries, chocolate, and cheese. Another possible
cause of food intolerance is to additives in foods, these can be found in the form of sulphites,
which are added to processed foods to give them a longer shelf life. They can also be found
in fruit drinks and wine. A reaction to a food that has ‘gone off’ such as salmonella
poisoning is another type of reaction to a food; such a reaction will usually affect anyone
consuming it.
Key points on food intolerance
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Usually reactions are delayed and symptoms may take several hours, even several
days to appear
Multiple symptoms can occur be many and vary from migraine to bloating, diarrhoea,
lethargy and a general feeling of poor health
Chemicals in foods such as caffeine, salicylates, Monosodium Glutamate, and
naturally occurring chemicals like histamines can also cause food intolerance
reactions
Reactions can occur after ingesting small amounts of a culprit food but are usually
triggered by larger amounts – some people report they can tolerate a food if eaten
once a week or in small daily portions but any more than this causes symptoms.
Getting a diagnosis
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Before commencing on an elimination diet you should consult your GP who may
refer you to a dietitian
To help with the diagnosis be sure to keep a food and symptoms diary.
Discussion
Subject:
Allergy Awareness Week 3- Allergy in Children
Category:
General information
Main Topic
Maria Khoudary/sqa
Yesterday 11:57
Frequently Asked Questions – in School
How common are severe food allergies among children?
Every school is likely to have at least one pupil who is severely food-allergic, and many schools will
have more. Peanut allergy is particularly common – with one in 70 children nationwide thought to
be affected.
What are the symptoms of food allergy?
For many children, the symptoms of food allergy are mild. In severe cases, symptoms may include
generalised flushing of the skin, nettle rash (hives) anywhere on the body, swelling of the throat and
mouth, severe asthma, abdominal cramps, nausea and vomiting. In very severe cases there may be
collapse and unconsciousness, although this is rare.
What is the treatment?
The treatment for a severe allergic reaction is an injection of adrenaline (also called epinephrine),
delivered into the muscle in the side of the thigh. The adrenaline injections most commonly
prescribed are the Anapen, EpiPen and Jext. These are extremely user-friendly.
How can I ensure that the allergic child’s development is not impaired?
Children who are at risk of severe allergic reactions are not ill in the usual sense. They are normal
children in every respect – except that if they come into contact with a certain food or substance,
they may become unwell. It is important that these children are allowed to develop in the normal
way and are not stigmatised or made to feel strange. All efforts should be made to ensure that the
allergic child has the opportunity to participate in all school activities.
School trips may need a little planning and preparation, together with a meeting with the parents
and/or the child to ensure they are satisfied with plans. At least one person trained in administering
adrenaline must accompany the party. From the child’s point of view, it is inadvisable for a parent to
accompany them on school trips, although in some cases this may be unavoidable.
There is no need to exclude an allergic child from cooking lessons, but care is needed with foods
that any child is allergic to. The cooking area should be cleaned thoroughly before use and recipes
thought out carefully.
Allergic children should have every opportunity to attend sports trips to other schools. Many
schools have now had to handle at least one child with food allergy or allergy to insect stings.
Ensure your P.E. Teacher is fully aware of the situation and notifies the schools to be visited that a
member of the team has an allergy when arranging the fixtures. A member of staff trained in
administering adrenaline should accompany the team. Should another school feel they are not
equipped to cater for any food-allergic child arrange for the child to take their own food.
If I have to administer adrenaline, how quickly will it work?
Signs of improvement should be seen fairly rapidly. If there is no improvement, or the symptoms
are getting worse, then a second injection may be administered after five - ten minutes.
How many injectors should an allergic pupil have at school?
The answer depends on many factors including the size of the school and the layout of the
buildings. Many allergy specialists believe every allergic child should have at least four in total – two
for home and two for school. In a particularly large school, it may be sensible to have more than
two, kept in various locations. There is no national agreement about how many injectors an allergic
child should carry, and in the end it will be up to the prescribing doctor. If the first injector is
administered promptly and correctly, and an ambulance is minutes away, then the chances of a
second being needed before the ambulance arrives will be much reduced.
Why is more than one injector recommended?
Usually one is sufficient to treat a reaction, but if the symptoms persist or get worse, and the
ambulance has not arrived, a second may be administered. The question of when to administer a
second to an individual child should be discussed with the child’s doctor. In rare cases it may be
needed after five minutes. There would also be a need to use a second injector if the first had been
wrongly administered and therefore wasted (although this is extremely unlikely if training has been
adequate).
What will happen if I give adrenaline and the child is not having a reaction?
The heartbeat could increase and the child may have palpitations for a few minutes. There should
be no serious side effects unless the child has coexisting heart problems.
Once the injector has been used how do I dispose of it?
Place it in a rigid box and take it to the hospital with you to show the A&E staff what has been used.
The hospital will then dispose of it for you.
What is the difference between an asthma attack and an allergic reaction?
While a severe allergic reaction could include asthma there would probably be other symptoms
present. These may include swelling in the throat and mouth, nettle rash anywhere on the body,
generalised flushing
of the skin, abdominal cramps, nausea or vomiting. If the symptoms look particularly severe – for
example, if the allergic child is going floppy – then this is very likely to be a severe allergic reaction
requiring immediate treatment.
Can school pets be a problem for the allergic child?
Some food-allergic children may also be allergic to pets; this needs careful thought and discussion
with an allergic child’s parents.
Should parents insist on a school being a peanut-free zone?
Generally speaking the Anaphylaxis Campaign would not necessarily support ‘peanut bans’ in all
schools. Schools do however have a duty of care to all pupils, so need to have procedures in place to
minimise the risk of a reaction occurring in a food-allergic child. Schools may wish to write to
parents asking for their cooperation in making life safe for allergic children. Call our Helpline Tel:
01252 542029 for more advice.
Shared responsibilities
What are the family’s responsibilities?
Tips on how the family can help the allergic child include:
Notify the school of the child’s allergies. Ensure there is clear communication.
Work with the school to develop a plan that accommodates the child’s needs throughout the school
including in the classroom, in dining areas, in after-school programmes, during school sponsored
activities and on the school bus. Ask your doctor, allergy specialist or paediatrician to help.
Provide written medical documentation, instructions and medications as directed by a doctor.
Replace medications after use or upon expiry.
Educate the child in allergy self-management, including what foods are safe and unsafe, strategies
for avoiding allergens, how to spot symptoms of allergy, how and when to tell an adult of any
reaction, and how to read food labels.
Provide a “stash” of safe snacks for special school events and periodically check its supply and
freshness.
Review policies and procedures with the school staff, the child’s doctor and the child (if age
appropriate) after a reaction has occurred.
What are the school’s responsibilities?
Tips that might help the school to ensure the safety of an allergic child include:
Ensure that catering supervisors are aware of an allergic child's requirements.
Review health records submitted by parents.
Include food-allergic children in school activities. Pupils should not be excluded based on their
allergy.
Ensure the staff have received high-quality training in managing severe allergies in schools,
including how to use an adrenaline auto injector.
Identify a core team to work with parents to establish prevention and treatment strategies. Arrange
staff training. Ensure all staff can recognise symptoms; know what to do in an emergency, and work
to eliminate the use of allergens in the allergic pupil’s meals, educational tools, arts and crafts
projects.
Ensure that medications are appropriately stored, and easily accessible in a secure location (but not
locked away) central to designated staff members.
Review policies after a reaction has occurred.
What are the pupil’s responsibilities?
Be sure not to exchange food with others.
Avoid eating anything with unknown ingredients.
Be proactive in the care and management of your food allergies and reactions (based on the age
level).
Notify an adult immediately if you eat something you believe may contain the food to which you
are allergic.
Notify an adult immediately if you believe you are having a reaction, even if the cause is unknown.
Always wear your medical alert bracelet or some other form of medical identification.
Special Tips
Steps that may be taken for keeping the allergic child safe at break and lunch time:
Tables should be cleaned thoroughly before and after eating.
Remind children to wash their hands.
Ensure the cooks and lunch time staff all know the allergic child.
Educate the school pupils about food allergy, maybe in the form of an awareness day or as a
fundraising event – the Anaphylaxis Campaign can help with fundraising ideas; email us at
info@anaphylaxis.org.uk.
Disclaimer – The information provided in this Factsheet is given in good faith. Every effort has been taken to
ensure accuracy. All patients are different, and specific cases need specific advice. There is no substitute for
good medical advice provided by a medical professional.
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Discussion
Subject:
Allergy Awareness Week - 4 General Avoidance and Pets!
Category:
General information
Main Topic
Maria Khoudary/sqa
Today 09:55
General Avoidance Advice
Allergen avoidance is difficult for people with allergy to substances in the air, such as pollen.
For example, tiny pollen spores are windborne and travel for miles on air currents. It can be
easier to avoid allergens due to pets and house dust mite, but evidence suggests that it is
probably necessary to rigorously carry out several allergen avoidance measures in order to
see an improvement in symptoms. Just doing one or two things half-heartedly may not make
any difference.
Remember that:
Allergic inflammation and symptoms develop over a long time so benefit may not be
immediate.
Cigarette smoke makes all allergic conditions worse because of the aggravation of already
inflamed skin and membranes. Nobody should smoke in the house of an allergy
sufferer.
Early exposure of babies to allergens and smoke is associated with later development of
allergic disease.
People with sensitive airways and skin should avoid all unnecessary chemicals, such as
air fresheners and most commercial cleaning materials (contact Allergy UK for
cleaning tips).
Allergy test results should be interpreted by an allergy expert in conjunction with clinical
history. Diagnosis by alternative methods is not recommended.
Allergy to Domestic Pets
Throughout history man has had a close association with animals, both at work and in
domestic life. However, contact with animals inevitably leads to exposure to animal
allergens, and pets are now one of the major causes of allergic disease.
In the UK, pets are the second most important cause of allergy in the home with 50% of
asthmatic children sensitised to the allergens of cats and 40% to dog allergen. There can also
be reactivity to rabbits, hamsters and other furry domestic pets in these children.
Dog and cat allergy
Dog and cat allergen is found in the animals' saliva, sweat and urine. Animals frequently
groom themselves so the allergens coat the hair and skin cells (dander), which, when shed,
spread throughout the home or other buildings. Once the saliva dries, it becomes airborne
very easily.
These allergens can be very persistent in the environment, with detectable levels found in
homes where no pets have lived for many years, and dog allergen can be found in schools,
having been brought there on the clothing and shoes of pupils and teachers. Cat allergen in
particular is very 'sticky' in this way.
Despite popular belief, all dogs possess the allergenic material known to produce allergic
reactions in humans, and therefore reported differences of sensitivity to different breeds
probably relates more to level of exposure. Even breeds that are described as 'hairless' still
have allergens found in dander from skin sources. It is possible that longer hair may harbour
other allergens such as dust mite, pollens and moulds, to which an individual may also be
sensitive. Other persons may be sensitive to substances found on the dog, such as flea powder
or soaps.
Also, many dogs (and cats) have skin problems such as eczema, so because of their dry skin
and irritation, spread larger amounts of dander.
Exposure to cats during a child's first year of life is an important factor in the development of
sensitisation to this allergen. Some studies have shown that children who grow up in homes
with pets have more severe symptoms than those in homes without pets; other studies have
shown that there may be a protective effect from growing up with pets. However, for those
who have eczema, hay fever or asthma, removing pets is the best advice, even if there is no
obvious allergy to them at present.
In dogs, routine and proper grooming, preferably outdoors, has been shown to greatly
decrease shedding of hair and may decrease skin irritation and secondary bacterial infection.
Grooming, preferably by someone other than the sensitive individual, should therefore be an
important part of a management strategy for dog-allergic patients.
Bathing a cat once or twice a week can reduce cat allergens in the home by 90%. Confining a
cat to one part of the house is unlikely to be effective as people will transfer cat allergens to
other parts of the house on their clothes as they move around from room to room.
Other pets
Rabbits, small rodents and caged birds are very popular pets. Rabbits and guinea pigs are
usually housed outdoors, whilst gerbils, hamsters, mice, rats and birds are commonly kept in
the living room or even in the bedroom. These animals, especially budgerigars and hamsters,
are particularly associated with allergic asthma. In small mammals, urine is the most potent
source of allergen, and materials lining cages will be heavily contaminated. Allergenic
chemicals will be released into the air as the animal moves around the cage disturbing the
litter and bedding. As many of these are nocturnal creatures, activity such as racing around
the cage and wheel means that very high levels of allergen are released into the air, usually in
children's bedrooms whilst they sleep, a frequent cause of allergy symptoms.
Fine dust in the air from bird feathers and droppings is not only associated with allergy but
can, rarely, cause a more serious disease, 'Bird Fancier's Lung', which results in a permanent
scarring of the lungs. People who have bird aviaries are at risk from this.
Some people report problems from feather pillows. However, this reaction is usually not due
to the feathers themselves but to house dust and feather mites.
Advice
Do not obtain any new pets.
Restrict pets to outdoors or to limited areas in the house - certainly not in the bedroom.
Wash cats and dogs regularly.
Keep your pets healthy and well-groomed (where appropriate).
People who are in contact with animals outside the home (e.g. horses, or other people's
cats) should change their shoes and clothes, and wash their hair, when arriving home.
If possible, remove carpets from rooms where pets are kept. Vacuum floors regularly.
Remaining carpets should be cleaned with a high-temperature steam cleaner and
vacuumed regularly with a high-filtration (HEPA) vacuum-cleaner such as those
awarded our Seal of Approval endorsement.
Clean all surfaces (including walls) regularly.
Wash all pet bedding and baskets regularly.
'Allergy Control Solutions' are available that alter animal allergens to make them less
reactive. They can be sprayed on carpets and soft furnishings, and can be added to
water when washing fabrics. Use in accordance with manufacturers' instructions.
Products are also available to condition the animals' skin and reduce the amount of
allergen that is release into the environment (e.g. 'Petal Cleanse').
Consider using a good air filter to reduce allergen levels in the air, or ventilate rooms
well.
Do not allow pets to lick your hands or face.
When returning from a walk during the spring and summer you should wipe your dog
over with a damp cloth.
Discussion
Subject:
Allergy Awareness Week - 5
Category:
General information
Main Topic
Maria Khoudary/sqa
Today 10:46
Allergy: getting tested
If you suspect that you or your child may have an allergy, you can use NHS services to
get your allergy diagnosed. This may involve having one or more allergy tests.
An allergy test can establish whether you have an allergy and what you're allergic to.
“Knowing what you're allergic to is key to managing your condition,” says Allergy UK’s
Lindsey McManus.
“If you have hay fever, you probably don’t need allergy testing as it may be obvious from
your symptoms that you’re allergic to pollen. But it’s important to find out the precise cause
if your symptoms are more complicated. For example, perennial rhinitis (runny nose all year
round) can be triggered by a variety of allergens, such as house dust mites and mould, or a
food allergy could be triggered by one of a number of foods in your diet.”
Allergy testing also has a role in monitoring a diagnosed allergy, says Lindsey.
“Babies and children with an allergy, such as certain food allergies, often grow out of them.
Regular testing can establish if the allergy has gone. It’s helpful for the parents and the child
to know that they no longer have an allergy to milk or eggs, for example, so that they no
longer have to avoid that food.”
NHS allergy testing
If you suspect an allergy, the first port of call is your GP. If, after discussing your symptoms,
your GP thinks you may have an allergy, they may offer a blood test (formally known as a
RAST test) to identify the cause of your allergy. Or they may refer you for testing. Most
allergy tests are done in hospital outpatient clinics.
Find your local NHS allergy clinic.
Not every NHS hospital has an allergy clinic, so you may have to wait longer and travel
further for testing in some parts of the country.
At the allergy clinic, the type of test you're offered will depend on your symptoms. Possible
tests include the following.
Skin prick test
A skin prick test is usually the first test to be done when looking for an allergen. It’s quick,
painless and safe, and you get the results within about 20 minutes. Your skin is pricked with a
tiny amount of the suspected allergen to see if there's a reaction. If there is, the skin around
the prick will very quickly become itchy, and a red wheal will appear.
Blood test
The blood test used to test for allergens is called a specific IgE test (formally known as the
RAST test). It's used to measure the number of IgE antibodies in your blood that have been
produced by your immune system in response to a suspected allergen.
Patch test
The patch test is used to see if a skin reaction, for example eczema, is caused by contact with
a specific chemical or substance. A small amount of the suspect substance or chemical, such
as nickel, is added to special metal discs, which are taped to your skin for 48 hours and
monitored for a reaction.
This test is usually carried out at a dermatology (skin) department in a hospital.
Food challenge
A food challenge, also called an oral challenge, is the most accurate way to diagnose a food
allergy. During the test, you're given the food to which you think you are allergic in gradually
increasing amounts to see how you react. Only one food can be tested at each appointment.
Commercial tests
Some commercial allergy testing kits, such as hair analysis tests, kinesiology tests and VEGA
tests, are not recommended by doctors because there is little scientific evidence to support
them.
Private allergy testing
If you choose to have private allergy testing, it's important to see a reputable, trained
specialist. Allergy UK has an online service to help you find an accredited local private
allergy specialist.
For more information on any of the information displayed this week, please see Allergy UK
or NHS Livewell
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