Disclosures. Objectives. Update on Food Allergies; where are we at and where are we going? Pre-Test. Food Allergy 3/8/2016. Adverse food reactions
|
|
- Osborn Berry
- 7 years ago
- Views:
Transcription
1 Disclosures Update on Food Allergies; where are we at and where are we going? Speakers Bureau: Meda Pharmaceutical Jodi Shroba MSN RN CPNP Division of Allergy/Immunology Children s Mercy Hospital Kansas City Missouri Objectives At the end of this session, participants will be able to; Explain current management of food allergies Explain when introduction of allergenic food to infants is appropriate Identify ongoing research in food allergy Pre-Test A 9 month old is in your office for WCC. Patient has severe eczema, and the mother is questioning if she can add peanut butter to the diet? Based on the LEAP study, your advice would be: A. Ok to give peanut butter B. Avoid until child is 3 years old C. Send to Allergist for feeding introduction D. Perform an IgE blood test Food Allergy Adverse food reactions An adverse reaction that is reproducible upon exposure to a given food The most common food allergens are: Egg Milk Wheat Soy Peanuts and tree nuts Fish and shellfish 1
2 Food Allergies Worldwide U.S. Prevalence The Big 8 Diagnosis of a food allergy HISTORY is the most important!! Testing should be based on patient s medical history and not consist of large general panels of food allergens. Serum specific IgE test can help identify foods that may provoke an IgE mediated reaction, but alone these tests are NOT diagnostic. Patient History What particular food was suspected Amount of the food ingested What other foods were ingested at the same time How was the food prepared Has this food been previously tolerated Age of onset Timing of ingestion to onset of symptoms 2
3 Onset of Symptoms Timing of onset after ingestion Anaphylactic reactions will typically occur within the first 20 minutes, but can be as late as 2 hours of ingestion Symptoms that occur after 12 hours are not typically related to an IgE mediated response Diagnosis and Management of Food Allergies Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel Released in December 2010 In summary, the guidelines do the following: Provide 43 concise recommendations to a wide variety of healthcare professionals on how to diagnose food allergy, manage ongoing food allergy, and treat acute food allergy reactions Identify gaps in the current scientific knowledge to be addressed through future research Identify and provide guidance to help standardize patient management Available at px Dietary Restrictions The introduction of solid foods should NOT be delayed beyond 4-6 months. Potentially allergenic foods may be introduced at this time Restricting diet beyond 6 months of age can lead to inadequate nutrient intake, growth deficits, and feeding problems. Prevention of Food Allergy The following strategies are NOT recommended: Restricting maternal diet during pregnancy or lactation as a strategy for preventing food allergies The use of soy formula instead of cow s milk formula is NOT recommended to prevent milk allergy Vaccination of Egg Allergic Children Less severe or local reaction to egg is NOTa contraindication to influenza vaccine Two methods of delivery: Give dose and observe for 30 minutes Give 10% of dose then observe for 30 minutes and then give 90% of dose Patients who have had a severe reaction including angioedema, hives, allergic asthma or anaphylaxis should be evaluated by an allergist, as they may be able to receive the influenza vaccination Food Allergy Management Avoidance of food allergen Education Preparedness for allergic reactions Food allergy and anaphylaxis plan Injectable Epinephrine available 3
4 Education Allergen avoidance Reading a food label Anaphylaxis emergency action plan implementation Early recognition of signs and symptoms of anaphylaxis Appropriate IM epinephrine administration (including prescription and training) Medical identification jewelry or an anaphylaxis wallet card Auto-injectors Foods Generally Tolerated Peanut Oil That has been highly refined Not cold pressed, expeller pressed or extruded peanut oil Soy Lecithin Coconut oil and shea nut oil/butter Let s LEAP into the next topic. Background to LEAP study feeding guidelines suggest delaying introduction of peanut until age 3 to deter risk of developing peanut allergy 2008 DuToit et al: UK babies avoiding peanut until age 3 were 10 times more likely to develop peanut allergy than Israeli babies fed Bamba before 9 months (not a RCT) Could timing of introduction promote primary prevention? 4
5 LEAP (learning early about peanut allergy) Hypothesis: early introduction of peanut based products (before 11 months of age) would lead to the prevention of peanut allergy in high risk infants Eligibility: Infants at least 4 months of age and less than 11 months of age Severe eczema, egg allergy or both LEAP Enrollment 834 infants screened 194 excluded (SPT >4mm or did not have severe eczema) 640 underwent randomization 542 negative skin prick 98 positive skin prick (defined as 1-4mm wheal) Randomly assigned to peanut consumption or avoidance Consumption vs. Avoidance Consumption group: fed 2g of peanut protein 3x a week until they reached 60 months of age Bamba (peanut butter and puffed maize) Smooth peanut butter Avoidance group: avoidance continued until 60 months of age LEAP Results Negative SPT group 13.7% prevalence of peanut allergy in avoidance group 1.9% in the consumption group Positive SPT 35.3% in the avoidance group 10.6% in the consumption group Conclusion The early introduction of peanuts significantly decreased the frequency of the development of peanut allergy among children at high risk for this allergy and modulated immune response to peanuts. Consensus Document There is now strong scientific supporting early introduction of peanut containing products into the diet of high-risk infants early on in life (between 4 11 months of age) in countries where peanut allergy is prevalent, since delaying may be associated with an increased risk of developing peanut allergy. Infants with early-onset atopic disease, such as severe eczema or egg allergy in the first 4-6 months of life may benefit from evaluation by an allergist or physician trained in management of allergic diseases to assist in implementing these suggestions regarding the appropriateness of early peanut introduction. Consensus Communication on Early Peanut Introduction and the Prevention of Peanut Allergy in High-Risk Infants
6 Guidance for introduction of peanuts Infants with early onset atopic disease in 1 st 4-6 months of life Evaluation by an allergist/ allergy trained provider Peanut SPT Peanut oral challenge Consensus Communication on Early Peanut Introduction and the Prevention of Peanut Allergy in High-Risk Infants What we don t know Recommend introduction of peanuts to all infants prior to 11months of age Do they have to ingest 2g of peanut protein 3 times a week Could they ingest less for a shorter period of time If discontinued will tolerance persist Can this be applied to other foods Gruchalla RS and Sampson HA. N Engl J Med 2015: 372: LEAP-ON Follow up study 556 of initial 628 patients were enrolled 550 (280 in peanut avoidance and 274 in peanut consumption) had a peanut allergy outcome that could be evaluated 12 months of peanut avoidance at the end of the primary trial Peanut allergy more prevalent in peanut avoidance group than consumption group (18.6% vs. 4.8%) Conclusion: Children at high risk for peanut allergy that had been introduced in 1 st year of life and continued consumption for 5 years, followed by 12 month period of avoidance was not associated with an increase in prevalence of peanut allergy. EAT (Enquiring about Tolerance) Study Enrolled 1303 exclusively breast-fed infants at 3 months of age in UK Randomly assigned to: early introduction of 6 foods (peanuts, cooked egg, cow s milk, sesame, whitefish and wheat) or standard introduction group (exclusively breast fed until 6 months of age) Prevalence of food allergy was significantly lower in early introduction group that standard introduction (2.4% vs. 7.3%) Peanut and egg also showed significantly lower allergy with the ingestion of 2g per week of these foods Conclusion: Trial failed to showed efficacy of early introduction vs. standard introduction in an-intention-to treat analysis. Question if prevention of food allergies by early introduction may be dependent on adherence and dose Du Toit G et al. N EnglJ Med; March 4, AvailableatNEJM.org Perkins M, et al. N EnglJ Med; March 4, Available at NEJM.org Protein stability What s new in Food Allergy Research??? Protein components that are stable to heat and digestion are more likely to cause a severe reaction Components that are labile to heat and digestion may be tolerated or only cause mild/local reactions Sastre J. Clinical and Experimental Allergy; 2010, 40;
7 Components Milk Casein-stable protein, does not denature when baked Alpha-lactalbumin-labile, will become denatured when baked Beta-lactoglobulin-labile, will become denatured when baked Egg Ovomucoid- heat stable Ovalbumin- labile Peanut Components Ara h 1,2,3 Seed storage proteins, highly likely to cause reactions even at very low levels of sensitization. Ara h 2 is often considered to be the most important predictor of clinical allergy. Ara h 9 Lipid Transfer Protein, associated with more severe oral allergy syndrome and systemic reactions especially in Southern Europe Ara h 8 PR-10 protein, heat labile protein and cooked food is often tolerated. Very low likelihood of causing reactions, and a common cause of asymptomatic sensitization due to pollen cross-reactivity. Pros of component testing Adding baked milk and egg has been associated with increase chance development of tolerance 70% of cow milk and egg allergic children can tolerate baked allergen in diet Improve quality of life Expand diet Promote inclusion in social activities Enhance diagnostic accuracy and possibly severity risk Sastre J. Clinical and Experimental Allergy; 2010, 40; Bird et al, JACI In Practice 2015; 3:1-11. Leonard et al, JACI In Practice; 2015; 3: Cons of component testing Can t predict type of reaction or significance of cross reactivity Studies limited to a few foods Results have been varied based on geographic area and population age Not routinely recommended for diagnosis of food allergy Cost Oral (OIT) Sublingual (SLIT) Epicutaneous (EPIT) Food Allergy Immunotherapy Slide courtesy of Andrew Bird MD, ACAAI Conference November
8 OIT Process 1. Ingestion of allergen specific flour in food vehicle with 6-8 doses given on day 1 2. Build-up dosing every 1-2 weeks under observation until target dose is reached over 6-12 months 3. Daily home maintenance dosing (typically years) 4. Oral food challenge is used to assess allergen reactivity threshold during desensitization and functional tolerance after therapy completed OIT side effects GI complaints are the most common complaint Development of EoE has been reported About 10-15% develop GI symptoms which cause cessation of treatment Oropharyngeal symptoms also quite common, but easy to treat Anaphylaxis may develop at any time Febrile illness, concomitant allergen exposure, menses and exercise may exacerbate symptoms Omalizumab before and during OIT has shown promise in limiting side effects and reduced time to target dose Jones S, et al. J Allergy Clin Immunol 2014; 133(2), Jones S, et al. J Allergy Clin Immunol 2014; 133(2), Status of OIT Questions that need to be answered: Long term efficacy (e.g. tolerance development) Minimize side effects Risks compared to avoidance FDA approval and standardization QoL issues Industry sponsored phase 2 trials are complete Phase 3 trials have begun in 2016 Anticipated to be on the market by 2020 SLIT Gradual increase in dose of allergen extract that are placed under the tongue and then spit out or swallowed SLIT dosing is much less than OIT, generally less than 10mg/day Has been successful in causing desensitization, but patients have reacted at lower doses than OIT Not as effective as OIT, but safer with less side effects Slide courtesy of Andrew Bird MD, ACAAI Conference November 2015 Jones S, et al. J Allergy Clin Immunol 2014; 133(2), EPIT Comparison of SLIT, OIT & EPIT Delivery of allergen to skin surface through an allergen containing patch Adverse events mostly local erythema/eczema occurring at site of application and lasting several days Large clinical trials underway, and hopefully there will be a product on the market in the coming years Jones S, et al. J Allergy Clin Immunol 2014; 133(2), Jones S, et al. J Allergy Clin Immunol 2014; 133(2),
9 Testing in Siblings Things to Consider 876 children (sibling with food allergy) enrolled as part of Chicago Family Cohort Food Allergy study 53% were sensitized to a food with positive testing, but no symptoms 13% had a true food allergy Milk most common, followed by egg and peanut Conclusion: limit testing in siblings Gupta R, et al. Annals of Asthma, Allergy and Immunol. Nov 2015; 115, A3. Atopic Dermatitis and food allergies Retrospective chart review of 298 patients that had a concern for food triggered AD 19% with no previous history of immediate reactions, developed new immediate reactions after the initiation of an elimination diet 70% were cutaneous reactions; 30% were anaphylaxis Cow s milk and egg most common foods Avoidance of food was associated with an increase risk of developing immediate reactions Conclusion: strict elimination diet need to be thoughtfully prescribed Chang A, et al. J Allergy Clin Immunol 2015: In press. Conclusion Avoidance is still recommended treatment Be prepared for reactions Encourage early introduction if possible, or refer to allergist to help with introduction Limit testing to only foods in question Consider baked egg and milk if possible Ongoing research to decrease sensitivity and induce tolerance Post Test A 9 month old is in your office for WCC. Patient has severe eczema, and the mother is questioning if she can add peanut butter to the diet? Based on the LEAP study, your advice would be: A. Ok to give peanut butter B. Avoid until child is 3 years old C. Send to Allergist for feeding introduction D. Perform an IgE blood test Post Test A 9 month old is in your office for WCC. Patient has severe eczema, and the mother is questioning if she can add peanut butter to the diet? Based on the LEAP study, your advice would be: A. Ok to give peanut butter B. Avoid until child is 3 years old C. Send to Allergist for feeding introduction D. Perform an IgE blood test 9
10 Open to the public Public Comment on addendum guidelines to prevent peanut allergy Open until April 18, 2016 Available at endum-public- Comment/Documents/FoodAllergyGuidelinesAdd endum.pdf Questions? Contact Info: 10
llergy Testing: When to test, when not to and what to do with the results
llergy Testing: When to test, when not to and what to do with the results Kelly Maples, MD, FAAAAI, FACAAI Assistant Professor of Pediatrics and Internal Medicine CHKD/EVMS Sensitization Allergy The results
More informationThe Diagnosis of Food Allergy
The Diagnosis of Food Allergy Robert A. Wood, MD Professor of Pediatrics and International Health Director, Pediatric Allergy and Immunology Johns Hopkins University School of Medicine Disclosures Research
More informationThe challenge of food allergies
2:15 3 pm Food Allergies and Food Intolerance: Update on Guidelines Presenter Disclosure Information The following relationships exist related to this presentation: Maria Garcia-Lloret, MD: No financial
More informationAllergy Testing Test Request and Result Interpretation. Learning Objectives
Allergy Testing Test Request and Result Interpretation Dr. Kareena Schnabl, MSc, PhD, FCACB Clinical Biochemist, Genetic Laboratory Services University of Alberta Hospital Newborn Screening & Biochemical
More informationFood Allergies. Food Allergy statistics: True Prevalence of Food Allergy
Food Allergies Food Allergies Food Allergy statistics: 11 million Americans, including adults 6% of US children 2% of adults have shellfish allergy True Prevalence of Food Allergy Patient/Parent Self Report
More informationFood Allergies In Our Schools
Food Allergies In Our Schools Shenae M. Rowe, RDN Registered Dietitian Nutritionist Food & Nutrition Director Warrick County School Corporation Perception by public: 20 25% Reality: Infants/Children: 5.1%
More informationDIET AND ECZEMA IN CHILDREN
DIET AND ECZEMA IN CHILDREN It has been known for many years that what children eat may have an effect on their eczema. There has been an ever-increasing interest in the part that diet plays in the development
More informationIgE-mediated Food Allergies
The image part with relationship ID rid13 was not found in the file. IgE-mediated Food Allergies Kirsi M. Järvinen-Seppo, MD, PhD Click to edit Presenter Name Dept. of Medicine, Division of Allergy, Asthma
More informationEpinephrine Auto-Injectors & Trends in Oral Immunotherapy
Epinephrine Auto-Injectors & Trends in Oral Immunotherapy Erika Gonzalez-Reyes, MD Chief of Allergy, Immunology & Rheumatology Associate Professor of Clinical Pediatrics Baylor College of Medicine Children
More informationFood Allergy Diagnosis and Management in the United States
Guidelines for the Diagnosis and Management of Food Allergy in the United States NIAID Summary for Patients, Families, and Caregivers National Institute of Allergy and Infectious Diseases U.S. DEPARTMENT
More informationThe percentage of people with food allergy in the community
The percentage of people with food allergy in the community By Pia Nørhede Why is it important to know the percentage of people with food allergy in the community? Individuals with food allergy develop
More informationFood Allergies and. Food allergies and the immune system. Food allergies and the immune system
Food Allergies and Intolerances Food allergies and the immune system Food allergies and True allergies involve an adverse reaction/ response by the body s immune system to a usually harmless substance
More informationPrimary Care Management of Food Allergy and General Public Knowledge and Beliefs
Primary Care Management of Food Allergy and General Public Knowledge and Beliefs Ruchi S. Gupta, MD, MPH Associate Professor of Pediatrics Ann and Robert H. Lurie Children s Hospital Northwestern Feinberg
More informationAnaphylaxis: A Life Threatening Allergic Reaction
Anaphylaxis: A Life Threatening Allergic Reaction What is Anaphylaxis? Anaphylaxis is a sudden, severe, and potentially fatal allergic reaction that can cause a wide range of symptoms, including breathing
More informationLesson 3 Managing Food Allergies
Lesson 3 Managing Food Allergies Lesson at a Glance Time Allowed (1 hour) 5 minutes Introduction to Managing Food Allergies 15 minutes Objective 1: Creating a Food Allergy Policy Topic Activity Materials
More informationAllergy Evaluation-What it all Means & Role of Allergist
Allergy Evaluation-What it all Means & Role of Allergist Sai R. Nimmagadda, M.D.. Associated Allergists and Asthma Specialists Ltd. Clinical Assistant Professor Of Pediatrics Northwestern University Chicago,
More informationFood Allergies and Intolerances. Nan Jensen RD, LD/N Pinellas County Extension
Food Allergies and Intolerances Nan Jensen RD, LD/N Pinellas County Extension Overview of Presentation Statistics What is food allergy? What foods causes allergies? What is a food intolerance? Possible
More informationBSTA Anaphylaxis /Stock Epinephrine Policy
BSTA Anaphylaxis /Stock Epinephrine Policy (Severe Allergic Reaction) It is the policy of Beehive Science and Technology Academy to provide at least two (2) doses of auto- injectable epinephrine (hereinafter
More informationEmergency Anaphylaxis Management: Opportunities for Improvement. Ronna Campbell, MD, PhD August 31, 2015
Emergency Anaphylaxis Management: Opportunities for Improvement Ronna Campbell, MD, PhD August 31, 2015 disclosures Anaphylaxis Roundtable discussion held at the 2014 American College of Allergy, Asthma
More informationAllergies: ENT and Allergy Center of Missouri YOUR GUIDE TO TESTING AND TREATMENT. University of Missouri Health Care
Allergies: YOUR GUIDE TO TESTING AND TREATMENT ENT and Allergy Center of Missouri University of Missouri Health Care 812 N. Keene St., Columbia, MO 65201 (573) 817-3000 www.muhealth.org WHAT CAUSES ALLERGIES
More informationWilliam E. Berger, M.D., M.B.A. Clinical Professor Department of Pediatrics Division of Allergy and Immunology University of California, Irvine
Allergic Reactions & Access to Emergency Response William E. Berger, M.D., M.B.A. Clinical Professor Department of Pediatrics Division of Allergy and Immunology University of California, Irvine Mechanistic
More informationSample Rhode Island School Food Allergy Policy
Sample Rhode Island School Food Allergy Policy Intent [DISTRICT] is committed to the safety and health of all students and employees. In accordance with this and pursuant to Rhode Island General Laws 16-21-31
More informationAdvocating for Undesignated Stock Epinephrine in Your School
TOOLKIT Advocating for Undesignated Stock Epinephrine in Your School Why Undesignated Stock Epinephrine Matters in K 12 Schools Access to epinephrine auto injectors (EAIs) that have not been prescribed
More informationPaediatric Allergy SIG. Food allergy Associate Professor Rohan Ameratunga. Food allergies. Update on food allergy
Food allergy Associate Professor Rohan Ameratunga Food allergies I was on an elimination diet Update on food allergy Introduction Epidemiology Current management of food allergy New approaches in children
More informationWarroad Public Schools Allergy/Anaphylaxis Management Guidelines
Warroad Public Schools Allergy/Anaphylaxis Management Guidelines Background Food allergies are on the rise. According to data included in CDC s guidelines, nearly 1 in 5 students (16-18 percent of children)
More informationAnaphylaxis: a severe, life threatening allergic reaction usually involving swelling, trouble breathing, and can progress to shock
Allergy is a condition in which the immune system causes sneezing, itching, rashes, and wheezing, or sometimes even life-threatening allergic reactions. The more you know about allergies, the better prepared
More informationManaging Food Allergies in Schools. USDA Food and Nutrition Service Agency Samia Hamdan, MPH, RD Julie Skolmowski, MPH, RD Laura Walter, MPH, RD
Managing Food Allergies in Schools USDA Food and Nutrition Service Agency Samia Hamdan, MPH, RD Julie Skolmowski, MPH, RD Laura Walter, MPH, RD Today s Roadmap Overview of food allergies Accommodating
More informationTESTING FOR FOOD ALLERGIES. Laine Keahey, MD Arizona Allergy Associates
TESTING FOR FOOD ALLERGIES Laine Keahey, MD Arizona Allergy Associates Objectives Understand what blood tests(rast) and skin tests are measuring Learn what the size of a positive skin test really means
More informationManagement of food allergy in Europe - An overview using Germany as an example
Management of food allergy in Europe - An overview using Germany as an example Disclosure In relation to this presentation, I declare that there are no conflicts of interest. Allergy Societies in Europe
More informationFood Allergy & Anaphylaxis. Abigail S. Harada, MD
Food Allergy & Anaphylaxis Abigail S. Harada, MD Overview Food allergy is an important public health problem that affects both adults and children and may be increasing in prevalence Despite risk of severe
More informationAnaphylaxis and Epinephrine Auto-Injector
Lesson Guide Anaphylaxis and Epinephrine Auto-Injector Lesson Length: 45 minutes Guidance for the Instructor To complete this lesson and meet the lesson objectives, you must: Welcome participants and explain
More informationFood Allergen Management Training
Food Allergen Management Training Training Overview Food Allergens What they are and what they do? Allergen Management in Manufacture Making food safe for all consumers Training and Education Raising awareness
More informationJohn M. Kelso, MD, James T. Li, MD, PhD, and Matthew J. Greenhawt, MD, MBA
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Update on Egg Allergy and Influenza Vaccine (Nov 2011) John M. Kelso, MD, James T. Li, MD,
More informationFood allergy and intolerance
Food allergy and intolerance Summary A food allergy occurs when the immune system reacts to a harmless food. Food intolerance occurs when the body has a chemical reaction to eating a particular food or
More informationName of Policy: Antigen Leukocyte Cellular Antibody Test (ALCAT)
Name of Policy: Antigen Leukocyte Cellular Antibody Test (ALCAT) Policy #: 165 Latest Review Date: February 2015 Category: Laboratory Policy Grade: C Background/Definitions: As a general rule, benefits
More informationFinancial Disclosures. Diagnosis and Management of Food Allergies. Scenario 1. Objectives WHAT IS FOOD ALLERGY?
Financial Disclosures Diagnosis and Management of Food Allergies J. Andrew Bird, M.D. Assistant Professor of Pediatrics and Internal Medicine Division of Allergy and Immunology Director, Food Allergy Center
More informationGestione della dermatite atopica
Gestione della dermatite atopica Peroni Diego Clinica Pediatrica di Verona Pathogenesis of atopic eczema Genes Environment Abnormal TH2 immune response to environmental allergens Skin hyperresponsiveness
More informationEpinephrine Auto-Injector Trends & Oral Immunotherapy Treatment
Epinephrine Auto-Injector Trends & Oral Immunotherapy Treatment Travis A. Miller, M.D. Medical Director, The Allergy Station @ SACENT 1528 Eureka Road, Suite 102 Roseville, CA 95661 (916) 736-6644 Disclosures!
More informationGlossary of Terms. Section Glossary. of Terms
Glossary of Terms Section Glossary of Terms GLOSSARY Acute: Symptoms which can occur suddenly with a short and severe course. Adrenaclick /Generic Adrenaclick : a single use epinephrine auto-injector that
More informationAnaphylaxis & Administration Of Stock Epinephrine. Training for Michigan Schools. From: Michigan Association of School Nurses
Anaphylaxis & Administration Of Stock Epinephrine Training for Michigan Schools From: Michigan Association of School Nurses August 2014 Welcome & Thank You Today we will Learn & Practice Learn to recognize
More informationGet Trained. A Program for School Nurses to Train School Staff in Epinephrine Administration
A Program for School Nurses to Train School Staff in Epinephrine Administration The Get Trained School Nursing Program was created through an unrestricted grant from Mylan Specialty. The Program is intended
More informationFood allergy /anaphylaxis
Food allergy /anaphylaxis A food allergy or hypersensitivity is an abnormal response to a food that is triggered by the immune system. Allergic reactions are often mild, but can be sometimes very dangerous.
More informationFood Allergen Fundamentals
Food Allergen Fundamentals Introduction to allergen principles for the food industry January 2016 The Allergen Bureau Ltd ACN 162 786 389 This presentation gives a general overview of food allergens and
More informationGUIDELINES FOR THE MANAGEMENT OF STUDENTS WITH SEVERE FOOD ALLERGIES
GUIDELINES FOR THE MANAGEMENT OF STUDENTS WITH SEVERE FOOD ALLERGIES DEFINITION AND BACKGROUND Students with severe, sometimes life threatening, food allergies attend Howard County Public Schools. Two
More informationAnaphylaxis. Exceptional healthcare, personally delivered
Anaphylaxis Exceptional healthcare, personally delivered 2 Introduction Anaphylaxis (also known as anaphylactic shock) is a severe, potentially fatal allergic reaction. Anaphylaxis is caused by your body
More informationAntioch College Policy on Food Allergies
Antioch College Policy on Food Allergies Purpose: It is the purpose of this document to inform students and staff the procedures used by the College to identify and provide services for students with allergies
More informationAnaphylaxis - severe allergic reaction
Anaphylaxis - severe allergic reaction Summary Anaphylaxis is the most severe allergic reaction and is a medical emergency. An injection of adrenaline is needed to treat the allergic reaction. The most
More informationAllergies and Autoimmune Inner Ear Disease
Allergies and Autoimmune Inner Ear Disease Allergy is the term used to describe an over-reaction of the body to a substance that is normally harmless to most people. This substance is called an allergen,
More informationFood Allergies in Childhood
Food Allergies in Childhood Mimi Tang Royal Children s Hospital, Melbourne, Australia Murdoch Children s Research Institute, Melbourne University of Melbourne, Australia Food Allergies in Childhood Approach
More informationR 5331 MANAGEMENT OF LIFE-THREATENING ALLERGIES IN SCHOOLS
R 5331/page 1 of 8 A. Definitions R 5331 MANAGEMENT OF LIFE-THREATENING ALLERGIES IN SCHOOLS 1. Anaphylaxis - A serious allergic reaction that is rapid in onset and may cause death. Anaphylaxis is a rapid,
More informationGuidelines for anaphylaxis emergency medication (adrenaline [epinephrine] autoinjector) prescription
Guidelines for anaphylaxis emergency medication (adrenaline [epinephrine] autoinjector) prescription Introduction The aim of these guidelines is to outline the appropriate prescription of adrenaline (epinephrine)
More informationCatering Guide to Severe Food Allergies
Catering Guide to Severe Food Allergies Allergic reactions can occasionally be life-threatening and people who know they are at risk must always remain vigilant when food is around. The most common dietary
More informationIt is recommended that auto-injector device trainers of each type be available for practice
NASN Get Trained- PA Edition Script A Program for School Nurses to Train School Staff in Epinephrine Administration The Get Trained School Nursing Program was created through an unrestricted grant from
More informationAllergy/Anaphylaxis Standard Operating Procedure (S.O.P.) Universal Food Precautions
Allergy/Anaphylaxis Standard Operating Procedure (S.O.P.) Universal Food Precautions INTRODUCTION Food allergies are a growing food safety and public health concern that affect an estimated 4% 6% of children
More information3 Food Standards Agency, London, UK
Chapter six From Hazard to Risk e Assessing the Risk Charlotte Bernhard Madsen 1, Geert Houben 2, Sue Hattersley 3, Rene W.R. Crevel 4, Ben C. Remington 5, Joseph L. Baumert 5 1 DVM Research Leader Division
More informationAllergy Testing Clinical Coverage Policy No: 1N-1 Amended Date: October 1, 2015. Table of Contents
Table of Contents 1.0 Description of the Procedure, Product, or Service... 1 1.1 Definitions... 1 2.0 Eligible Beneficiaries... 2 2.1 Provisions... 2 2.1.1 General... 2 2.1.2 Specific... 2 2.2 Special
More informationSection I New Policy with copy of updated Epipen Order, and protocol. Section II Anaphylaxis Management Algorithm
Anaphylaxis Policy Contents Section I New Policy with copy of updated Epipen Order, and protocol Section II Anaphylaxis Management Algorithm Section III Demonstration of Epipen use for all staff members
More informationThis annual data report demonstrates findings consistent with previous reports:
DATA HEALTH BRIEF: EPINEPHRINE ADMINISTRATION IN SCHOOLS Massachusetts Department of Public Health Bureau of Community Health Access and Promotion School Health Unit August 1, 29 July 31, 21 (School Year
More informationSee, Think, and Act! Anaphylaxis (Severe Allergies)
See, Think, and Act! Anaphylaxis (Severe Allergies) California After School Resource Center (CASRC) Administered for the California Department of Education (C.D.E.) Hello. My name is Robyn Sakamoto. Welcome
More informationLe spectrum des entéropathies
Le spectrum des entéropathies 14:30 Enteropathies Celiac disease GI manifestations of food allergy Eosinophilic gastro-enteropathies Inflammatory Bowel Disease (IBD) Crohn s disease, Ulcerative colitis,
More information100% WHEY PROTEIN PARTIALLY HYDROLYZED in Infant Formula and REDUCING THE RISK OF ALLERGY IN INFANTS EXECUTIVE SUMMARY
QUALIFIED HEALTH CLAIM PETITION 100% WHEY PROTEIN PARTIALLY HYDROLYZED in Infant Formula and REDUCING THE RISK OF ALLERGY IN INFANTS EXECUTIVE SUMMARY The prevalence of allergic (atopic) diseases continues
More informationAnaphylaxis Management. Pic 1 Severe allergic reaction which led to anaphylaxis
1 Anaphylaxis Management Pic 1 Severe allergic reaction which led to anaphylaxis What is an allergic reaction? 2 An allergy is when someone has a reaction to something (usually a protein) which is either
More informationEGG IS THE MOST COMMON FOOD ALLERGY IN INFANTS AND YOUNG CHILDREN AND THE MOST LIKELY ALLERGY TO FADE
egg egg allergy allergy How common is egg allergy? EGG IS THE MOST COMMON FOOD ALLERGY IN INFANTS AND YOUNG CHILDREN AND THE MOST LIKELY ALLERGY TO FADE OVER TIME ESPECIALLY AFTER THE AGE OF THREE. ALMOST
More informationWORKING P A P E R. Prevalence, Natural History, Diagnosis, and Treatment of Food Allergy. A Systematic Review of the Evidence
WORKING P A P E R Prevalence, Natural History, Diagnosis, and Treatment of Food Allergy A Systematic Review of the Evidence JENNIFER J. SCHNEIDER CHAFEN, SYDNE NEWBERRY, MARC RIEDL, DENA M. BRAVATA, MARGARET
More informationYoon Nofsinger, M.D. Tampa ENT Associates, 3450 East Fletcher Avenue, Tampa, FL 33613 Phone (813) 972-3353, Fax (813) 978 3667
Yoon Nofsinger, M.D. Tampa ENT Associates, 3450 East Fletcher Avenue, Tampa, FL 33613 Phone (813) 972-3353, Fax (813) 978 3667 General Information: Allergies and Injection Therapy 1. General: You have
More informationCorporate Medical Policy Allergy Immunotherapy (Desensitization)
Corporate Medical Policy Allergy Immunotherapy (Desensitization) File Name: Origination: Last CAP Review: Next CAP Review: Last Review: allergy_immunotherapy 7/1979 11/2014 11/2015 10/2015 Description
More informationPeanut and Tree Nut Allergy
Peanut and Tree Nut Allergy Allergy to peanut and tree nuts is the most common food allergy in adults and children. However, since most children start eating other foods first, allergies to other foods
More informationALLERGIC REACTIONS. Mary Horvath RN, CSN. M.Ed. Certified School Nurse Bridge Valley Elementary Doyle Elementary
ALLERGIC REACTIONS Mary Horvath RN, CSN. M.Ed. Certified School Nurse Bridge Valley Elementary Doyle Elementary STATISTICS Allergic reactions affect up to 15 million people in the United States, including
More informationNEWS LETTER #1 Clair Thunes, PhD (916)248-8987 clair@summit-equine.com www.summit-equine.com
NEWS LETTER #1 Clair Thunes, PhD (916)248-8987 clair@summit-equine.com www.summit-equine.com As we look outside our windows many of us are seeing the emergence of Spring a welcome relief to the drudgery
More informationAdrenaline autoinjector (EpiPen) for acute allergic anaphylaxis
for acute allergic anaphylaxis This review of adrenaline autoinjector was first published in December 2003. This update describes the change to the PBS listing to allow prescribing immediately after hospital
More informationYORK REGION DISTRICT SCHOOL BOARD. Policy and Procedure #661.0, Anaphylactic Reactions
WORKING DOCUMENT YORK REGION DISTRICT SCHOOL BOARD Policy and Procedure #661.0, Anaphylactic Reactions The Anaphylactic Reactions policy and procedure address staff responsibilities with regard to providing
More informationASTHMA IN INFANTS AND YOUNG CHILDREN
ASTHMA IN INFANTS AND YOUNG CHILDREN What is Asthma? Asthma is a chronic inflammatory disease of the airways. Symptoms of asthma are variable. That means that they can be mild to severe, intermittent to
More informationFood Allergy Gluten & Diabetes Dr Gary Deed Mediwell 314 Old Cleveland Road Coorparoo 4151 3421 7488
Food Allergy Gluten & Diabetes Dr Gary Deed Mediwell 314 Old Cleveland Road Coorparoo 4151 3421 7488 SUMMARY Type 1 diabetes Onset common in Children Insulin requiring Immune origins with attack on the
More informationManaging severe allergies
Managing severe allergies June 2011 Providing a safe, supportive and nurturing environment is a goal of Chesterfield County Public Schools. This includes preventing and managing severe allergic reactions
More informationNIAID. Food Allergy. An Overview. National Institute of Allergy and Infectious Diseases
Food Allergy An Overview NIAID National Institute of Allergy and Infectious Diseases U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health NIAID HEALTH INFORMATION National Institute
More informationNIAID Guidelines for the Diagnosis and Management of Food
Welcome to the Educational Webinar on Food Allergy: Epidemiology, Diagnosis and Management in the Medical Home Goal of Program: To improve outcomes for all children with asthma, allergy and anaphylaxis
More informationPosition Statement. Anaphylaxis in schools and other child-care settings August 1998 AAAAI Board of Directors
Position Statement Anaphylaxis in schools and other child-care settings August 1998 AAAAI Board of Directors AAAAI Position Statements and Work Group Reports are not to be considered to reflect current
More informationSupplement Questions asked in the 1st International Basic Allergy Course
Supplement Questions asked in the 1st International Basic Allergy Course 1. CLINICAL MANIFESTATION What is the percentage of people who have both combined food and inhalant? What is the difference between
More informationAdministering epinephrine for acute anaphylactic type allergic reactions
Administering epinephrine for acute anaphylactic type allergic reactions Training for first aiders in schools People known to be allergic (1.5 hours) MAJ-2013-2 2 Goal of program Reduce the morbidity and
More informationNIAID. Guidelines for the Diagnosis and Management of Food Allergy in the United States. Summary of the NIAID-Sponsored Expert Panel Report
Guidelines for the Diagnosis and Management of Food Allergy in the United States NIAID Summary of the NIAID-Sponsored Expert Panel Report National Institute of Allergy and Infectious Diseases U.S. DEPARTMENT
More informationAllergy and Immunology
Allergy and Immunology PEANUT ALLERGY Peanuts contain protein that can cause an allergic reaction in 1-2% of children. The severity of reactions to peanuts can vary. Mild reactions are most common and
More informationDivision of Immunology 1 Blackfan Circle Boston, MA 02115 (617) 919-2484. Project Inventory
Title: A 5-year prospective study in infants with atopic dermatitis to determine risk factors, with a focus on pets and pests, on the development of asthma and allergic diseases Principal Investigator:
More informationBrewton City Schools Anaphylaxis Preparedness Guidelines
Brewton City Schools Anaphylaxis Preparedness Guidelines Background In response to Act#2014-405 by the Alabama Legislature, the Brewton City School System recognizes the growing concern with severe life-threatening
More informationInsect and Animal Allergens. Stinging Insect Allergy. A Patient s Guide
Insect and Animal Allergens Stinging Insect Allergy A Patient s Guide Stinging insect allergy can cause severe and sometimes life-threatening reactions. Each year, many people are stung by insects such
More informationFood Allergies and Epinephrine in Schools
c1 Food Allergies and Epinephrine in Schools Presented June 6, 2012 Mathew Swinburne, JD Staff Attorney The Network for Public Health Law -Eastern Region Slide 1 c1 cmeneses, 5/29/2013 In the United States
More informationAnnual Epinephrine Training Program for Connecticut s Unlicensed School Personnel
Annual Epinephrine Training Program for Connecticut s Unlicensed School Personnel Developed by the Connecticut State Departments of Education and Public Health in consultation with the Connecticut School
More informationRecognition and Treatment of Anaphylaxis in the School Setting
Recognition and Treatment of Anaphylaxis in the School Setting Authorization Code of Virginia 54.1-3408. Professional use by practitioners. 2. That the Department of Health, in conjunction with the Department
More informationHome challenge or hospital challenge to confirm the diagnosis of cow s milk allergy (i.e. after a short period of milk exclusion usually 2-4 weeks)
Additional file 1: Home challenge or hospital challenge to confirm the diagnosis of cow s milk allergy (i.e. after a short period of milk exclusion usually 2-4 weeks) 1. DO NOT challenge if the infant
More informationJHCF-R2. Food Allergy Guidelines September 4, 2014. Alexandria City Public Schools School Health Guidelines Managing Food Allergies in Schools
Food Allergy Guidelines September 4, 2014 Alexandria City Public Schools School Health Guidelines Managing Food Allergies in Schools 1 Alexandria City Public Schools School Health Guidelines Managing Food
More informationWeaning learning to like new tastes and textures
Complementary feeding or weaning is introducing solid foods in addition to your baby s milk feeds. Babies develop at different rates so begin when your baby is ready by six months, but not before four
More informationEvolution of Risk Assessment of Food Allergens
Evolution of Risk Assessment of Food Allergens Simon Brooke-Taylor PhD ILSI Seminar "Food Allergens Science & Challenges for Southeast Asia" 7 April 2015 Allergens of concern Cereals containing gluten
More informationInfluenza Vaccine Protocol Agreement (O.C.G.A. Section 43-34-26.1)
Influenza Vaccine Protocol Agreement (O.C.G.A. Section 43-34-26.1) This Influenza Vaccine Protocol Agreement (the "Protocol") authorizes the Georgia licensed pharmacists (the "Pharmacists") or nurses (
More informationSt Mark s Anglican Community School
St Mark s Anglican Community School Allergy Awareness Policy Peanut & Nut Allergy and Anaphylaxis Rationale In most schools some children are anaphylactic. St Mark s Anglican Community School is committed
More informationFood Allergy Management Plan
Food Allergy Management Plan CARE OF THE STUDENT WITH FOOD ALLERGIES AT RISK FOR ANAPHYLAXIS PURPOSE: To provide guidance in managing students with food allergies at risk for anaphylaxis at school. BACKGROUND:
More informationRise of the killer peanuts
Rise of the killer peanuts Epi Then, Epi Now Taher Vohra, MD Henry Ford Hospital Department of Emergency Medicine ObjecCves To define anaphylaxis To review the epidemiology of anaphylaxis To discuss treatments
More informationSchools + School Nurses = Safe and Healthy Students. Presenter s Guide
Schools + School Nurses = Safe and Healthy Students Presenter s Guide Slide 1 Slide 1: Title Welcome participants Introduce Self Schools + School Nurses = Safe and Healthy Students Add Presenter s name
More informationA ragweed pollen as a treatment for a ragweed allergy? It s called immunotherapy.
A ragweed pollen as a treatment for a ragweed allergy? It s called immunotherapy. RAGWITEK is a prescription medicine used for sublingual (under the tongue) immunotherapy to treat ragweed pollen allergies
More informationFood Allergy. An Overview. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health
Food Allergy An Overview U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Allergy and Infectious Diseases Food Allergy An Overview U.S. DEPARTMENT OF HEALTH
More informationGuidelines for Anaphylaxis Management in Schools
Guidelines for Anaphylaxis Management in Schools Department of Education and Early Childhood Development Government of Newfoundland and Labrador Guidelines for Anaphylaxis Management in Schools 2 Gove
More informationAllergy diagnosis: pros and cons of different tests, indications and limitations
REVIEW Allergy diagnosis: pros and cons of different tests, indications and limitations P.L.P. Brand Princess Amalia Children's Clinic Isala Klinieken P.O. Box 10400 8000 GK Zwolle the Netherlands Fax:
More information