Student research
by
Debbie Cohen
Master of Nutrition and Dietetics, The University of Sydney
Supervisors: Velencia Soutter, Robert Loblay, Anne Swain
June 1999
Full Text - PDF (742 KB)
Introduction:
Food-induced anaphylaxis is the most severe form of food
allergy. It consists of a complex of symptoms which can
be fatal if prompt emergency treatment is not given. Since
there is no known cure, management involves strict avoidance
of known food allergens and prompt emergency action when
there has been inadvertent exposure to the offending food.
Injectable adrenaline is the drug of choice for anaphylaxis,
however its prescription can complicate the management of
at-risk children and may contribute to parental anxiety.
There is little informaion available regarding the circumstances
surrounding episodes of food-induced anaphylaxis or the
impact this condition has on the lives of patients and their
families.
Aim:
To investigate a range of issues regarding the management
of children at risk of food-induced anaphylaxis.
Methods:
The population surveyed in this study were children who
had been identified as being at risk of food-induced anaphylaxis.
Data was collected using a written questionnaire, which
explored various aspects in the management of children with
food-induced anaphylaxis and recorded the circumstances
surrounding previous anaphylactic reactions, such as location,
food triggers and emergency treatment.
Results:
Three hundred and three episodes of anaphylaxis occurred
in 164 children. Almost half of those surveyed had experienced
multiple reactions often to different foods. Peanut, egg
and cow's milk were the most common food triggers and the
majority of reactions occurred in the child's own home.
Administration of adrenaline once a reaction had occurred
was infrequent. While most schools had an emergency action
plan for dealing with episodes of accidental exposure, several
respondents had encountered problems with the school system,
especially in relation to the administration of adrenaline.
Nutritional concerns of parents and the social impact of
food-induced anaphylaxis on patients and their families
were also investigated.
Discussion:
Children with an identified food allergy should undergo
skin prick tests for a range of other foods wich could potentially
cause anaphylaxis. In addition, all carers of at-risk children
should be educated regarding the prevention and management
of anaphylaxis, including the use of injectable adrenaline.
A training package for schools would be useful to reduce
anxiety amongst school personnel and to help ensure the
safety of children at risk of anaphylaxis while at school.