By Chandrea Serebro
Allergy rates are increasing dramatically around the world, and the severity of the cases and the numbers are scary. The last 10 to 15 years have seen a steep rise in food allergies across westernised countries. Hayley Katz, director of Allergy Alive (facebook.com/allergyalive), says that severe allergic reactions, which include anaphylaxis, a severe and sudden allergic reaction which is life-threatening, have emerged as a “global epidemic”, with 20-30% of the world’s population suffering from some form of allergy. “Allergic conditions, which include food allergies and asthma, have become a substantial and evolving global public health crisis.” Allergy Alive seeks to initiate positive and impactful change, prevent unnecessary deaths, improve the quality of life, and safeguard the rights of adults and children affected by this serious, escalating public health issue. “We aim to make all sectors of our community, including governmental, educational, food manufacturers, food retailers, restaurant outlets, and informal medical sectors aware of this very real problem.”
Just walking down the aisles of most supermarkets, one can see the extent of the seriousness and scope of allergies today from the numerous allergy-free products that are now readily available on store shelves. More and more health-related practitioners are expanding their practices to include allergies. Leigh-Ann Silber, registered dietician and nutritional consultant who has a special interest in allergies, explains, “It can be very scary when a child is diagnosed with an allergy. It can seem very overwhelming at first and entail a lot of work for the parent and/or sufferer going forward.” Of greatest concern are those who are diagnosed with severe allergies that are potentially life-threatening. Other less severe allergies may cause reactions such as rashes, respiratory problems, or gastric problems. These may not be life-threatening, but they still have a major impact on a person’s quality of life, particularly affecting children. According to Hayley, “Allergies have huge social and emotional implications for a child and their family. Children and families with severe allergic disorders can experience a much reduced quality of life. The child’s interpersonal relationships, sense of belonging, self-esteem, self-image, and academic functioning may all be adversely affected. As these children are vulnerable, they may become targets for bullying.”
“My husband and I discovered by accident that our youngest son, Jacob, was allergic to eggs. Upon further investigation and many visits to the doctor, we discovered that he had many allergies, all of which are life-threatening. This is very scary to any mom and I knew then that, being the control freak I was, I needed to do whatever was necessary to keep him safe, without limiting my other children or making Jacob feel different from his peers,” says Chantal Waisman. She got involved with Allergy Kids (www.allergykids.co.za), an organisation started by her friend Bonnie Bester, who had formed it after research led her to recognise the need for allergy information relevant to an SA audience. “It started as a support forum for parents of kids with allergies, and we have since started producing a range of allergy awareness wristbands and broadening our offerings. We help parents with the basics of allergies, diabetes, asthma, and eczema. We find alternative allergy-free foods, menus, and recipes.” Wearing an allergy bracelet has allowed Jacob the freedom to go on play-dates, to parties, and even to day camps in the school holidays. “Our philosophy is that he mustn’t live in a bubble. He is not different from any other child and he should not be treated as such.” Hayley explains, “There is no cure and there are no preventative treatments to protect against life-threatening reactions. Strict avoidance of problem foods and the use of emergency medication when a reaction does occur are the only ways to prevent and treat any potentially fatal reactions. For millions of children and adults, the smallest amount of a problem food can mean the difference between life and death.”
According to Specialist Allergists at the Allergy Society of South Africa (ALLSA), a child without any family history of allergies is at a 15% risk of developing an allergic condition in the first few years. A child where one parent has an allergic condition is at a 40 to 50% risk, and if both parents have allergies the child is at a 60 to 80% risk of developing an allergic condition. Until less than ten years ago, world guidelines recommended avoidance of allergenic foods in the diets of young children or gradual introduction, particularly for those at risk to developing food allergies. Now, however, ISRAEL21c reports that the Learning Early About Peanut (“LEAP”) allergy study has shown that peanut allergies can be prevented by feeding children nut-based products, like Bamba, the number-one selling snack in Israel, in infancy. “The timing of introducing solids and the culture of avoiding potential food allergens until one or two years of age has been thrown into question,” says Hayley, and “the LEAP study, which represents the latest international research, recognises that we need to reassess the feeding policies of infants in an attempt to prevent an ‘allergic march’ from reflux, to eczema, to food allergies and asthma.”
“The first steps in managing food-related allergies are education and changing one’s diet. That is where the dietician comes in. We coach the parent/client/child and educate them. It is a process that requires a change of attitude. It’s not only about excluding certain foods from the diet, but ensuring that the person is also getting the right balance along with sufficient nutrients without any deficiencies of nutrients as a result of the necessary exclusions,” explains Leigh-Ann. “Empathy and compassion are critical. Parents need to know they are not alone and that there is a wealth of information out there that they can access to help them navigate the process of learning how to keep their child safe while maintaining optimal health and peace of mind.”
Leigh-Ann Silber’s top tips for coping with an allergy
1. Awareness – learn about the allergy (but do not just rely on Google – yes it can direct you, but you need an individualised approach).
2. Dieticians and allergy specialists are trained to help you. Make use of these practitioners. Dieticians can help guide you in label reading, recipe substitutions, ideas for meals, and menu planning.
3. Get in the kitchen and gain confidence in creating new dishes. Get the kids involved. There is a great variety of allergen-free foods available these days.
4. Learn how to communicate effectively and clearly to others involved in your child’s life about the allergy.
5. Become confident about how to deal with the allergies and confident in your ability to promote safe care for your food allergy child, while creating a sense of normalcy at the same time.
6. Always have two EpiPens (or the equivalent) available – one at home and one with the child at all times.
“When my son Motti was nine months old, I was advised to give him egg, so we sat down with scrambled eggs and after one bite he was screaming. I waited a minute and saw his face covered in red welts. I freaked out and called the first doctor we could get hold of. Straight away we put him on allergy medication and within an hour it calmed down. After that we learned that each time he has anything that has been in contact with egg he will have a reaction – ranging from welts on his face to more extreme reactions. From that very first day, I feel like I’ve learned to walk around with an ‘egg detector’. It’s extremely hard to stop a toddler from putting everything he finds in his mouth, so I’ve learnt to keep egg out of my house. We use egg substitutes in almost everything or just use recipes that exclude egg altogether. We check every label for hidden ingredients. The hardest thing for me as a mother is when we are out and Motti is around food. Many people don’t realise that egg can be an issue for children, while other people know it is an issue, but don’t seem to understand allergies at all. In a short period of time, we have learned a lot about allergens in products and how important it is to keep medication within arm’s reach. We have changed the way we eat and live. In order to feel normal again, I have put rules in place for myself. Making my child feel exactly the same as others has been the biggest help. Whenever we are out I make sure to have plenty of egg-free snacks. I don’t want my child to feel like he is less than others because of his allergy. I also learned to ask what is being made so I can bring him something similar or the same but egg-free. I never leave home without his medication and keep it at all of the houses I visit regularly. Perhaps the most important thing that I have learned is to be more sensitive to others with any allergy, and I have learned to be in awe of mothers dealing with it too.”
Jodi Gordon’s son, Keegan, is highly allergic to bees, which was discovered after he was stung for the first time when he was a year old and localised reaction at the site of the sting. Never having dealt with bee stings before and unaware that bee sting reactions worsen each time one gets stung, Jodi never thought much of it again. One morning when Keegan was in Grade One, Jodi received a call from the school to say he had been stung by a bee and that she needed to come and collect him as he had a severe swelling, but was okay. Within a minute after that first phone call, Jodi received another one to say that they could not wait for her to get there and needed to get him to a hospital as he was turning purple and battling to breathe. “I was frantic and sped like crazy to the hospital which was around the corner from the school. When I arrived I entered the emergency section to see my child attached to a drip and oxygen, swollen, the colour of a plum – it was terrifying. The hospital had administered emergency adrenaline and cortisone and other life-saving medications to quickly open his breathing passages. Thank goodness he recovered fully after two days in hospital and a battery of tests.” From then, Keegan had to carry an EpiPen with him everywhere, plus medication had to be available wherever he was. “Being an active, sporty little boy, it was very hard to be in control of the bees – I just could not! I had to be everywhere watching and making sure he was okay. About three years later, Keegan was playing in the garden and my older son came screaming inside that Keegan had been stung by a bee. Within seconds I had pulled out the sting and grabbed his EpiPen, but I saw that he was already turning purple and gasping for air, so I jabbed him with the auto-injector and raced to the hospital. On the way he was passing out despite the adrenalin injection. He was having a very severe reaction and, within seconds of our arrival, they had connected a drip and did all they had to and he was okay. After this, Keegan went for desensitising for about three years, which amounted to a weekly injection of bee venom to build up his tolerance. About two years ago he got stung again on the beach and he was absolutely fine, so I can say it definitely worked and would urge anyone with children to desensitise them. He still carries his EpiPen around at times, but as a mother of a now 15-year-old, at least I know he is safer having been desensitised and, should he get stung, he is in a better position. Allergies are a terrifying thing – you cannot escape them, so you have to do whatever you can to alleviate them, as best as you can.”
The numbers World Wide
Allergies are a widespread global concern, with millions of adults and children suffering from at least one allergy. Each year the number of allergy sufferers increase by 5%, half of all affected being children.
There has been a 615% increase in hospital admissions for anaphylaxis in the 20 year period between 1992 and 2012. (Turner et al, JACI, 2015)
In the last decade, the cases of food allergies have doubled and the number of hospitalisations has increased alarmingly. (EAACI, 2015)
Over 20 000 people were admitted to hospital annually with allergic reactions, 62% of those reactions were emergencies. (HSCIC, 2014)
By 2025, asthma will represent the most prevalent chronic childhood disease. (EAACI, 2014)
Over 150 million people have allergies in Europe. (EAACI, 2014)
6 to 8% of children have a proven food allergy. (National Institute for Health and Clinical Excellence, 2011)
In the UK, an estimated 10 million adults suffer from more than one allergy. (Mintel, 2010)
- Courtesy of Chantal Waisman, Allergy Kids ↑