News Archives - Anaphylaxis Campaign

Spare Pens in Schools: Department of Health release guidance on the use of adrenaline auto-injectors in schools

21st September 2017 by anaphylaxis

Updated: 22nd September 2017

The Anaphylaxis Campaign is delighted to share that yesterday the Department of Health released its guidance document “Guidance on the use of adrenaline auto-injectors in schools” to help schools in England develop policies for keeping and using emergency adrenaline auto-injectors (AAIs).

The guidance comes prior to new legislation coming into effect on 1st October 2017 which will enable schools in the UK to purchase AAIs without a prescription, for emergency use on children who are at risk of anaphylaxis but whose own device is not available or not working. We have been informed the health departments in Scotland, Wales and Northern Ireland expect to publish their own guidance shortly.

Our Allergy Aunts have received questions through the Anaphylaxis Campaign helpline from school nurses and school staff about spare pens in schools, The Human Medicines (Amendment) Regulations 2017 and recent guidance issued by the Department of Health. Our top tips and advice to some of the most frequently asked questions are here.

The legislation was passed following two years of campaigning by the Anaphylaxis Campaign and other organisations – Allergy UK, the British Society for Allergy & Clinical Immunology (BSACI), the British Paediatric Allergy Immunity and Infection Group (BPAIIG), and the Royal College of Paediatrics and Child Health (RCPCH) – to enable a change in the law to allow schools, pre-schools and nurseries to hold generic adrenaline auto-injectors, and ensure they have sufficient trained staff to operate the devices in case of an emergency.

Lynne Regent, CEO of the Anaphylaxis Campaign, says:

“The Anaphylaxis Campaign is delighted that, after two years of extensive campaigning, the legislation is now in place to allow all schools in the UK to keep a potentially lifesaving dose of adrenaline spare in case of emergency. We are sure that this will enhance the safety of severely allergic children in schools across the UK and provide reassurance for parents, carers and school staff.”

The Anaphylaxis Campaign helps raise awareness of severe allergies and anaphylaxis within schools and provide support to parents and carers of school age children.

Our free online anaphylaxis training course AllergyWise for Schools is designed to ensure that key staff in schools are fully aware of the signs and symptoms of anaphylaxis, how to provide emergency treatment and the implications for management of severely allergic children from Key Stages 1 to 5 in an education setting. Find out more and register here.
We also have AllergyWise for Healthcare Professionals, an essential “train the trainer” resource for school nurses, first aid trainers, community nurses and nursery nurses with responsibility for training others which is accredited by the Royal College of Nursing (RCN), with discounted access for Professional Members of the Anaphylaxis Campaign. Find out more and register here.
School nurses are also welcome to join as a Healthcare Professional Member of the Anaphylaxis Campaign. Our members receive information and advice tailored for doctors, nurses, clinical professionals, first aid trainers and researchers with an interest in severe allergy, while helping us to raise the profile of severe allergy and support others who live with life threatening allergies. Find out more here.

The Department of Health guidance for schools is available here.

You can also access our links to information and advice for schools here.

Find out more about the ‘Spare Pens in Schools’ campaign here.

If you have any other questions or concerns please contact our helpline team at info@anaphylaxis.org.uk or call 01252 542 029.

Have you been prescribed an Emerade® Adrenaline Auto-Injector? Temporary Supply Issue

12th September 2017 by anaphylaxis

12th September 2017

The Anaphylaxis Campaign has been contacted by several of our supporters who raised concerns about the availability of Emerade® in the UK.

We contacted Bausch + Lomb Incorporated who distribute the injector. We understand from our conversation that there is a temporary supply issue of Emerade® 150mcg, 300mcg and 500 mcg doses. However, new supplies are due to be delivered this week and stock is expected to be available in the week commencing Monday 18th September 2017.

We will continue to speak with the distributor and keep you updated with information.

Emerade® is an adrenaline auto-injector used for the emergency treatment of severe allergic reactions (anaphylaxis). Emerade® is a Prescription only Medicine.

If you have any concerns please speak to your pharmacist or contact our helpline team at info@anaphylaxis.org.uk or call 01252 542 029.

Nut bans on aeroplanes, Anaphylaxis Campaign’s point of view

1st September 2017 by anaphylaxis

Lynne Regent, CEO of the Anaphylaxis Campaign, and Dr Andy Clark, Chair of the Anaphylaxis Campaign Clinical and Scientific Advisory Panel, say:

“We were deeply saddened to hear the moving story of Amy May Shead who was left paralysed after experiencing an allergic reaction whilst on holiday in a restaurant in Budapest in 2014. We have immense sympathy for her family and recognize that Amy’s story has generated significant media interest and debate about travelling with severe allergies.

We understand that flying with a food allergy can be stressful and cause much anxiety in those with a severe allergy. We hope the debate that has been generated about whether nuts should be banned on aeroplanes will help raise awareness of the risks of allergies and anaphylaxis. We encourage all passengers to consider how they can help travel to be less frightening for people with allergies, such as complying with a polite request to not eat peanuts or tree nuts. However, our policy is not to sign any petition other than those set up by our charity.

There are a number of reasons why the Anaphylaxis Campaign and other international allergy charities, with whom we work closely, currently do not advocate for a blanket ban of any allergen in any establishment, including on aircraft.

These reasons include the fact that, even if an airline did choose not to use or sell any products containing peanut or tree nuts, there would be considerable legal obstacles in trying to prevent and check whether passengers have brought products containing peanuts or tree nuts onto a flight. These difficulties would multiply if this suggestion was expanded to a blanket ban of other allergens, such as cow’s milk or latex.

Scientific evidence also shows that the most likely cause of allergic reactions experienced whilst travelling is skin contact rather than contact through inhalation. This means that if you touch a fold-down tray or some other surface that has previously been touched by a passenger eating peanuts, and then touch your eyes or mouth, you could have a reaction. However, risks of cross-contamination are present whenever you might be in close contact with other people who have not washed their hands after touching an allergen. This includes travelling by public transport, at the airport, or in your hotel.

The Anaphylaxis Campaign has already reached out to airlines and will continue to engage with them about key issues affecting those at risk of severe allergies. Our aim is to create a safe environment for all people with allergies by working with and educating the travel industry; focusing on medical facts, food labelling, risk reduction and allergen management.

We hope that debates like this will encourage airlines to assess their risk management plans and take appropriate actions to help people with allergies such as: training in-flight staff to recognize the signs and symptoms of an allergic reaction and anaphylaxis, allowing passengers with an allergy additional time to board in order to clean their seating area and provide clear information about policies regarding allergies.

Our ultimate aim is to help people with severe allergy to be more confidently in control of their lives. We provide medically informed advice and information via our clinical panel to help educate and empower people living with allergies to be aware of risks to their safety when travelling and the precautions they can take to feel reassured and safe.

Every person is different, so if you have concerns about travelling we would encourage you to speak to your GP or allergy specialist who can advise you what to do to minimise risks, such as carrying alcohol wipes to clean surfaces as soon as you get on the plane. By following the top tips available on our website and making sure you’re prepared, travel can be a lot less frightening.”

If you have any other questions or concerns please contact our helpline team at info@anaphylaxis.org.uk or call 01252 542 029.

Statement regarding the inquest of Ishmaeel Ashraf

24th August 2017 by anaphylaxis

24th August 2017

The Anaphylaxis Campaign was saddened to learn of the death of 9 year old Mohammad Ismaeel Ashraf earlier this year and has been in attendance at the coroner’s inquest that has been taking place this week in Birmingham to understand if lessons can be learned from this case.

The inquest raises a number of issues which are likely to be of concern to parents and carers of school-age children, as well as schools and teachers, as the jury concluded that not following the care plan and a delay in administering an auto-injector may have contributed towards Ismaeel’s death.

This illustrates the importance of schools making sure they have individual care plans in place and training and support for all school staff; from school nurses to teachers, from receptionists to caterers.

Every school is likely to have at least one pupil who is severely food-allergic, and many schools will have more; in the UK it is estimated that 5–8 % of children have a food allergy (Food Standards Agency 2015). The vast majority of the children affected are happily accommodated in mainstream schools thanks to good communication among parents, school staff, doctors and education authorities. With sound precautionary measures and support from the staff, school life may continue as normal for all concerned.

However, tragic incidents such as the death of Ismaeel Ashraf are a reminder of the importance of all school staff being able to understand allergies and anaphylaxis and how to manage and care for children at risk.

The Anaphylaxis Campaign helps raise awareness of severe allergies and anaphylaxis within schools and provide support to parents and carers of school age children.

- We have campaigned successfully for the Government to amend the Human Medicines Act to allow schools to buy auto-injectors from a pharmaceutical supplier, without prescription, for use in emergencies. This has been a two year long process and we are delighted that new legislation is coming into effect on 1st October 2017. You can read more on our website here.
- We also provide training to schools through AllergyWise. AllergyWise for Schools is a course designed to ensure that staff in schools are fully aware of the signs and symptoms of anaphylaxis, how to provide emergency treatment and the implications for management of severely allergic children from Key Stages 1 to 5 in an education setting. Access to this training course is now FREE thanks to a grant from ALK. Visit our website for more information here.
- We provide a “train the trainer” course for school nurses and other healthcare professionals who are training school and early years teams in the management of severely allergic children. This course is accredited by the Royal College of Nursing. Visit our website for more information here.
- We also provide advice and support to Healthcare Professionals, including school nurses, through our membership programme. You can find out more about membership here.

Our fact sheet aims to answer aims to answer some of the questions frequently asked by parents and schools. You can read this on our website here.

We also have addressed some of the frequently asked questions associated with allergies in schools below.

If you have any concerns please contact our helpline team at info@anaphylaxis.org.uk or call 01252 542 029.

Some Frequently Asked Questions

What is anaphylaxis and how is it treated?

Anaphylaxis is an extreme and severe allergic reaction. The whole body is affected, often within minutes of exposure to the substance which causes the allergic reaction (allergen) but sometimes after hours.

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 injectors prescribed in the UK at present are Emerade®, EpiPen® and Jext®. These injectors are easy to use and designed for self-administration or administration by any suitably trained individual. If an injector has been prescribed, it should be available at all times – with no exceptions. The emergency services (ambulance) should still be called after use as symptoms may return after a short period and more than one injection of adrenaline may be required to control the reaction.

Our Think ABC video explains how you can spot an anaphylaxis reaction and how to safely treat it.

What are the responsibilities of schools?

Statutory guidance was issued to schools in May 2014 setting out the practical support schools are expected to provide to support children with medical conditions, such as making sure they have individual care plans in place and training and support for all school staff.

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.
- School activities should be designed and developed to ensure the inclusion of food allergic pupils.
- Ensure the staff have received high-quality training in managing severe allergies in schools, including how to use an adrenaline auto injector. The Anaphylaxis Campaign offers online training through its AllergyWise training programme.
- Identify a core team to work with parents to establish prevention and treatment strategies.
- Arrange staff training. (Your school nurse should be able to help you to arrange this). 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 have occurred. The statutory guidance is available here.

What are care plans?

The Paediatric Allergy Group of the BSACI has Allergy Action Plans available for children at risk of anaphylaxis.

These plans have been designed to facilitate first aid treatment of anaphylaxis, to be delivered by people without any special medical training nor equipment apart from access to an adrenaline auto-injector (AAI). They have been developed following an extensive consultation period with health professionals, support organisations, parents of food-allergic children and teachers.

The plans are medical documents, and should be completed by a child’s health professional (and not by parents or teachers, for example).

You can access care plans from the BSACI website here.

FAQs about travelling with allergies

23rd August 2017 by anaphylaxis

23rd August 2017

The Anaphylaxis Campaign were saddened to hear the moving story of Amy May Shead who was left paralysed after suffering an allergic reaction whilst on holiday in Budapest in 2014.

Amy’s story has generated significant media interest and debate about travelling with severe allergies. It’s not uncommon for those with allergies to be anxious about travelling. However, by following our tops tips and making sure you’re prepared, travel can be a lot less frightening.

The Anaphylaxis Campaign provides medically informed advice and information via our clinical panel to help educate and empower the allergic community to take responsibility for their own safety when travelling.

If you have any concerns or further questions, please contact our helpline team at info@anaphylaxis.org.uk or call 01252 542 029.

What advice does the Anaphylaxis Campaign recommend to people at risk of severe allergies when travelling?

We have a whole host of information available on our website including…

What are the risks during air travel?

The following information is derived directly from our ‘Peanut & tree nut allergy factsheet’ available on our website here.

All our factsheets have been certified by The Information Standard as a provider of high quality health and social care information. This means we produce safe and reliable health and social care information.

Some people with peanut allergy report that they experience symptoms when peanut snacks are handed around to passengers with their drinks during air travel. In our view the most likely cause of these reactions is skin contact. If you touch a fold-down tray or some other surface that has previously been touched by a passenger eating peanuts, and then touch your eyes or mouth, you could have a reaction. To minimise the risk, you could carry “wet wipes” to clean surfaces as soon as you get on the plane.

Reactions caused by inhalation of peanut dust are thought to be less likely. A study presented to the 2012 annual meeting of the British Society for Allergy and Clinical Immunology found that peanut protein does not easily become airborne and therefore significant exposure to peanut protein via inhalation is unlikely (Makinson et al, 2012). However, you must be guided by your doctor or consultant, and your allergy history. If you know you are at the high end of the risk scale (for example, you have reacted by inhaling peanut allergen in the past) then it would be sensible to contact the airline well in advance to request that peanuts are not distributed on your flight.

Is there a risk through contact through touch or smell?

The following information is derived directly from our ‘Peanut & tree nut allergy factsheet’ available on our website here.

People with peanut allergy are often concerned that casual contact with peanut – such as through touch or smell – could trigger a life-threatening reaction.

A study undertaken in the USA (Simonte et al 2003) gives some reassurance. Researchers observed 30 children with severe peanut allergy while they were being exposed to peanut butter through touch and smell. Accidental contact was simulated by pressing a dab of peanut butter on the child’s back for one minute, and by holding a dish containing three ounces of peanut butter one foot from the child’s nose for 10 minutes.

- None of the children experienced anaphylaxis.
- There were no reactions to inhalation.
- During contact with the back, one-third of the children had a mild reaction, such as redness, itching, or a single hive limited to the site of contact. Medication was not needed to treat these reactions.

Researchers concluded that at least 90% of similarly allergic children would not experience a severe reaction to similar exposures. However the study looked at peanut butter but not peanut in other forms. We know of a very small number of people who claim to have reacted to touch or smell. Importantly, we advise you to be guided by your allergy doctor.

Statement on the death of Paul Ryan

18th August 2017 by anaphylaxis

18th August 2017

The Anaphylaxis Campaign is saddened to learn today of the death of Paul Ryan, a 53 year old head teacher from Coventry, due to a severe allergic reaction to antibiotics.

The news emerged following an inquest at Coventry Coroner’s Court which concluded no-one was to blame for Mr Ryan’s death.

From the media report, we understand that Mr Ryan was prescribed a course of antibiotics to combat an ear infection. The GP was aware of Mr Ryan’s allergy to the penicillin-based drug amoxicillin and therefore prescribed an alternative medication containing erythromycin. Unfortunately Mr Ryan had an undiagnosed allergy to this medication and died after experiencing anaphylaxis, a severe allergic reaction.

The media report may raise concerns for anyone with, or caring for someone with, an allergy to drugs. However, we understand that at the inquest it was made clear that to be allergic to both types of antibiotics is extremely rare.

Drug allergy is most common in adults, especially the elderly, and there is more than one type of drug allergy. Any symptoms believed to have been caused by a drug should be taken seriously and medical advice should be sought from your GP. Because drug allergy is a complex area, referral to a specialist who can manage drug allergy is important in most cases.

If someone starts experiencing severe symptoms this may be a sign the person is experiencing anaphylaxis and they should receive immediate emergency medical attention. We have a fact sheet with more information about the signs and symptoms of anaphylaxis here.

We also have a fact sheet which aims to answer some of the questions which you and your family might have about living with an allergy to drugs to help you to minimise risks and learn how to treat an allergic reaction should it occur. You can read this on our website here.

If you have any concerns please contact our helpline team at info@anaphylaxis.org.uk or call 01252 542 029.

You can read the original news story in the Coventry Telegraph here.

Australian oral immunotherapy trial has ‘life changing’ results for children with peanut allergy

17th August 2017 by anaphylaxis

17^th August 2017

An Australian oral immunotherapy trial has had life changing effects for a group of children with peanut allergy.

Oral immunotherapy works by slowly introducing small amounts of an allergen like peanut into the diet of a person with an allergy, gradually building up to larger amounts in the hope the immune system learns to tolerate the food.

48 children were enrolled in the original trial and randomly given over an 18 month period either a combination of the probiotic Lactobacillus rhamnosus mixed with peanut protein in increasing amounts, or a placebo.

At the end of the original trial in 2013, 82% of children who received the immunotherapy treatment were considered to be tolerant to peanuts compared with just 4% in the placebo group.

The researchers documented how often the children ate peanut and any allergic reactions experienced in the 4 years after treatment ended. Additional tests such as skin prick tests and a peanut challenge test were performed.

The trial was randomised, double-blind and placebo-controlled. This means that neither the researchers nor the children and the parents knew who was receiving the placebo treatment until after the trial was completed.

Four years after initially receiving treatment, the majority of children have continued to eat peanuts as part of their normal diet and 70% have passed an oral challenge test and are now considered to be tolerant to peanuts.

The research study funded by the Murdoch Children’s Research Institute and Australian Food Allergy Foundation concluded that “probiotic and peanut oral immunotherapy provides long-lasting clinical benefit and persistent suppression of the allergic immune response to peanut” which is very positive news for children with peanut allergy and those who care for them.

The Lancet Child & Adolescent Health has a podcast with by Professor Mimi L K Tang of the Royal Children’s Hospital, Victoria, Australia about the results of the trial that you can listen to on iTunes.

You can read more about allergy testing on our website here.

Those interested can also access the abstract of the research published in the Lancet Child & Adolescent Health here.

The Anaphylaxis Campaign welcomes updated MHRA advice following a review of all adrenaline auto-injectors approved in the EU

16th August 2017 by anaphylaxis

16th August 2017

Yesterday the Medicines and Healthcare products Regulatory Agency (MHRA) released updated advice for healthcare professionals and people with allergies and their carers on adrenaline auto-injectors (AAIs) following a review of all devices approved in the EU.

The review recommended

that healthcare professionals prescribe two AAIs, which patients should carry at all times
that needle length of the AAI device is now stated in the product information
that manufacturers update their educational materials to help train people with allergies and their carers how to use their AAI
that manufacturers should carry out studies in humans to more fully understand when and how much adrenaline reaches the blood stream, and how quickly and effectively it acts on body tissues

Anaphylaxis Campaign actively campaigns for people to be prescribed two AAIs. We firmly recommend that once prescribed they should always be kept with the patient so they have access to them at all times in case one is broken or misfires, or a second injection is needed before emergency help arrives. We therefore welcome this expression of support from the MHRA that patients should actively be prescribed two AAIs.

If you or your family member has a severe allergy and has been prescribed an AAI we recommend reading the updated patient advice sheet here.

We also advocate for better training for healthcare professionals and patients and their carers to ensure that everyone thoroughly understands how to use their prescribed device.

We provide specialised training for patients, carers and healthcare professionals via our Allergy Wise online courses. Click here for more information about our accredited courses.

Statement regarding BBC Radio Bristol video on Epipen usage

14th August 2017 by anaphylaxis

14^th August 2017

On Wednesday 9^th August 2017 at 7:03AM BBC Radio Bristol shared a video on Facebook created by a local mother advising how to use an EpiPen® and encouraged viewers to watch and share in order to save someone’s life.

We were contacted by our supporters who were concerned that the video didn’t provide accurate enough information on how to administer adrenaline correctly. The Anaphylaxis Campaign reached out to BBC Radio Bristol to address these concerns and are pleased to hear that the video has been taken down.

Whilst we recognise the good intentions of BBC Radio Bristol in sharing this video in order to raise awareness about the dangers of anaphylaxis, we would encourage anyone who would like to understand clearly what to do in the event of an emergency to refer to advice produced with the help of medical experts.

Anaphylaxis is the most severe form of allergic reaction and can be life threatening. If someone is having a severe allergic reaction, it is vital that they receive an adrenaline injection administered in the right way.

The manufacturers of all three injectors currently prescribed in the UK (EpiPen®, Jext® and Emerade®) have advice videos available online which demonstrate clearly the recommended positioning of the adrenaline injection site (the front quarter of the outer thigh).

We have a factsheet about adrenaline available on our website and produced videos ‘Think ABC – Spotting and treating anaphylaxis reaction’ and ‘Administering Adrenaline’ which are available on YouTube.

We are a member of the Information Standard and all the information we produce is evidence based and checked by our expert Clinical and research reviewers.

A statement regarding the American comedian George Lopez

11th August 2017 by anaphylaxis

11^th August 2017

The American comedian George Lopez recently performed a sketch which included jokes about travelling with allergies and nuts in schools.

We recognise that comedians often push social boundaries, expressing views that are controversial or exaggerate the norm to challenge their audience, make people think and provide entertainment. However, in this instance his comments caused concerns for our supporters.

We do not wish to be humourless, but severe allergies are not a laughing matter. We are concerned that joking about such a serious issue may cause people to think that the risks are less severe.

In the UK, 1-2% of adults have a food allergy. This, combined with the 5-8% of children with a food allergy, equates to about 2 million people. Every year around 20 people will die from anaphylaxis and there has been an increase in hospital admissions for allergic reactions and anaphylactic shock in England of more than a third in the past five years.

Anaphylaxis is the most severe form of allergic reaction and can be life threatening. The whole body is affected, often within minutes, but sometimes within hours, of exposure to a substance which causes an allergic reaction. Where foods such as nuts are concerned, even mild symptoms should not be ignored because future reactions may be severe.

There are currently no known cures for allergies or anaphylaxis, however, there are several management approaches that allergic individuals can adopt to live a normal life and avoid reactions. Avoidance techniques such as excluding an allergen from diets or contact in daily life are very important.

We have a fact sheet on our website about peanut allergy and tree nut allergy as well as advice about travelling with allergies and an FAQ sheet for schools.

We would encourage everyone to read the information to consider how you can best support people living with severe allergies to avoid reactions.