How to manage severe allergies

This is according to Professor Michael Levin, head of paediatric allergy in the department of paediatrics and child health at the University of Cape Town.

Levin was speaking at the annual congress of the Allergy Society of South Africa (ALLSA) in Port Elizabeth earlier this month.

It may be cause of unexplained deaths

Levin states that an estimated 1,5 % of South Africa’s population is currently at risk of experiencing anaphylaxis. He points out that exact numbers are difficult to determine, and undiagnosed anaphylaxis may in fact be the cause for some of the unexplained deaths reported each year.

“The first thing to understand is that an allergy is not a disease. It is an immune response that the body has to particular substances to which it has become hypersensitive. Some of the most common allergens are certain types of food, pollen, fur, or dust,” explains Levin.

“When we talk about anaphylaxis, we refer to an extreme, often life-threatening allergic reaction to an antigen.”

According to Fiona Mcguirk, product manager at Cipla Medpro, knowing whether one is at risk of experiencing anaphylaxis is extremely important.

“Anyone who has experienced an allergic reaction to food, medication or insect venom, needs to take the time to learn more about their condition. Part of this is to determine exactly what one is allergic to, and to make informed decisions from there.”

Mcguirk adds that antigens that cause allergies, usually vary throughout one’s life. “Food allergies are common in young children, while teens and adults are usually at risk of developing allergies to medication or insect bites.”

Get tested

McGuirk explains that a doctor should assist patients in identifying their allergies and the risk of experiencing anaphylaxis.

“It often happens that people are exposed to a number of potential antigens at the same time, which makes it difficult to determine exactly what caused the reaction. Blood tests or skin tests will help to zero in on the exact antigen causing the problem. Patients can then make the necessary lifestyle changes to avoid the substances that they react to.”

Anaphylaxis: Who is at risk?

According to Levin, people at risk of anaphylaxis are typically individuals who have had severe allergic reactions in the past, or individuals living with asthma as well as a severe allergy.

“Individuals’ risk of having an anaphylactic episode may also vary depending on their time in life, or the presence of contributing factors such as medication.”

Levin adds that the risk of anaphylaxis may have a significant impact on an individual’s quality of life. “Especially people at severe risk of anaphylaxis will always need to keep an EpiPen within reach in case of a severe reaction.”

4 pillars of managing allergies

Levin says that managing allergies and one’s risk of anaphylaxis are based on four pillars.

Education

“Firstly, education is key. Knowing how to identify allergic reactions when they first appear is vital. With so much importance placed on patient education, ALLSA has launched a separate organisation called The Allergy Foundation of South Africa (AFSA), aimed at the patient, to fulfill this exact need.

“Visit their very informative website: www.allergyfoundation.co.za, where all your queries regarding allergy are answered and you can gain access to a list of allergy professionals in your area to contact for clinical diagnosis and management.”

Identify triggers

The second pillar is correctly identifying one’s trigger.

“Knowing what you are allergic to and knowing how to avoid those antigens forms the basis of understanding of how your lifestyle needs to change. If your trigger is difficult to avoid (such as bee stings), it may necessitate the need to carry an EpiPen at all times,” says Levin.

Drug therapy and immunotherapy

The third and fourth pillars are drug therapy and immunotherapy.

“Patients can be prescribed medication to deal with their allergies, or they can apply for immunotherapy, which aims to desensitise the body to trace amounts of certain antigens. This is a long-term approach, taking between three and five years, and is about 80 – 95% effective. However at this stage, there really is not a reliable form of immunotherapy for food allergies,” says Levin.

“With an estimated three quarters of a million people in South Africa currently at risk of anaphylaxis, teaching individuals more about the early warning signs and their options, is an important step in changing our approach to managing these risks.”

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