Allergy and Anaphylaxis
Food allergy occurs when the immune system becomes sensitised to substances in foods that in usual circumstances would be harmless. In Australia, nine foods account for 90 per cent of food allergic reactions. They are:
• Peanuts
• Tree nuts including cashews, walnuts, almonds, chestnuts etc.
• Cow's milk
• Wheat
• Soybean
• Fish
• Shellfish
• Sesame
Most food allergic reactions are mild, but severe allergic reaction that affects the whole body, called anaphylaxis, can be life-threatening. So how common is severe food allergy in schools?
A snapshot from the West
In 2008 the Western Australian Department of Health conducted the WA Anaphylaxis School and Child Care Survey in order to get a better picture of the problem in Australia. From the 658 schools that responded, the key findings revealed:
• 1 in 74 students were identified as being 'at risk' of anaphylaxis
• 83 per cent of the schools had at least one 'at risk' student; more than 50 per cent had three or more
• 1 in 7 schools had at least 1 student who had had a reaction in the previous 12 months.
Given that every school will at some time almost certainly have to deal with food allergy among its students, awareness of the condition and management are vital to prevent serious illness and injury.
Know the symptoms
Anaphylaxis reactions usually occur swiftly, within 20 minutes of exposure. According to Anaphylaxis Australia symptoms include:
• Tingling of the mouth
• Hives, welts or body redness
• Swelling of the face, lips, eyes
• Vomiting, abdominal pain
• Difficulty/noisy breathing
• Swelling of the tongue
• Swelling/tightness in the throat
• Difficulty talking and/or a hoarse voice
• Wheezing or persistent coughing
• Loss of consciousness and/or collapse
• Paleness and floppiness (in young children)
Making a difference
The Australasian Society of Clinical Immunology and Allergy have produced a set of guidelines that set out four basic steps to help prevent food anaphylactic reactions in schools. These are:
1. Medical Information. Children at risk should be identified at enrolment and documentation covering management of a reaction should it occur should be sought from parents.
2. Educate carers. All those responsible for the care of children should be informed about anaphylaxis including how to prevent and recognise it, and what should be done if a reaction occurs.
3. Take practical strategies to prevent exposure to known triggers. Depending on the age of the children involved, practical measures such as implementing policies relating to food brought to schools and available at school can be taken to reduce the chance of exposure.
4. Age appropriate education of children with severe food allergies to help them participate in managing their condition.
There is, however, no national policy for the management of anaphylaxis within schools so you should consult your state education department for appropriate guidelines for your school.
References:
WA Anaphylaxis School & Child Care Survey 2008 - Western Australian Department of Health; November 2008
Anaphylaxis Australia. What is Anaphylaxis? http://www.allergyfacts.org.au/whatis.html
Australasian Society of Clinical Immunology and Allergy. ASCIA Guidelines for Prevention of Food Anaphylactic Reactions in Schools, Preschools and Childcare. http://www.allergy.org.au/content/view/31/258/
Related Readings
Peanut Allergy Not Always Permanent
