Updated 23 June 2014

Food allergy a rising global health problem

This year World Allergy Week takes place from 8-14 April with the Allergy Society of South Africa (ALLSA) profiling the global theme “Food Allergy—A Rising Global Health Problem”.

In South Africa, ALLSA is utilising the opportunity World Allergy Week brings to include a potentially fatal allergic condition referred to as “Anaphylaxis” and to issue a call to action to the public to learn about Food Allergies and Anaphylaxis as the incidence and consequences of both conditions are frequently under-recognised – with potentially life-threatening consequences.

About Anaphylaxis

Anaphylaxis is a serious, sudden and severe allergic reaction that may be life threatening. It must be treated as an emergency, and patients who have anaphylaxis or are at risk for anaphylaxis must know how to reduce their risk by preventing exposure to potential triggers, knowing how to recognize early signs and be prepared for emergency treatment at any time. The most common anaphylactic reactions are to foods, insect and bee stings, medications and latex. If you are allergic to a substance, your immune system overreacts to this allergen by releasing chemicals that cause allergy symptoms. Typically, these bothersome symptoms occur in one location of the body. However, some people are susceptible to a much more serious anaphylactic reaction.

What happens in anaphylaxis
• Why some people become allergic to foods or venoms or medicines (Antigens) is not well understood.  
• What is known is that a special class of antibody known as IgE antibody is produced by allergic people who have become sensitized to that specific allergen.  
• These antibodies recognise the allergens and bind to them, causing the release of very powerful chemical substances such as histamine from certain cells in body.  
• These chemicals result in the symptoms of anaphylaxis.
• The body’s natural response to anaphylaxis is to release a natural body chemical called adrenaline. Adrenaline, the fight or flight chemical, is the natural antidote to the anaphylactic reaction.
Prevent anaphylaxis
• To prevent anaphylaxis, people who have a reaction must identify the trigger and then avoid future exposure.  
• This is done by a trained allergist taking a good history, doing allergy tests and occasionally by doing specific very controlled challenges.
About Food Allergy
Food hypersensitivity is the non-specific term which refers to any adverse or untoward reaction to food or food additives. Food allergy is a type of food hypersensitivity in which the body's immune system is directly involved and overreacts to a particular protein in that food. There are several types of hypersensitivity reactions to food which are non-allergic, some of the symptoms of food intolerance and food allergy are similar, but the differences between the two are very important.

Food allergy reactions can be life-threatening, in some cases even in response to tiny amounts of the food, so people with this type of allergy must be very careful to avoid their food triggers. Food intolerances are not life threatening and the person may often tolerate small amounts of the triggering food, and have symptoms only on intake of larger amounts. Another interesting cause of a non-allergic reaction is psychological reactions to foods in people who are convinced that they cannot tolerate a certain food.

How is food allergy treated?
•     At the moment, there is no “cure” for food allergies. Avoidance of the offending  food(s) is the mainstay of treatment. The patient needs to be educated about food  labelling and hidden sources of the food.  
•     At the same time it is essential to provide a balanced diet which contains enough protein, calories, minerals and vitamins. Close co-operation between the patient, the doctor and a qualified dietician is important to ensure this.  
•    For immediate-type reactions the patient needs to be educated on how to recognise and treat an allergic reaction, in case they accidentally eat the food they are allergic     to. This requires an emergency action plan and emergency treatment.  
•     For milder reactions, an antihistamine is given.  
•     For more severe reactions involving the airway or circulatory system, a dose of adrenaline may be needed and can be life-saving. The doctor will select whether or not the patient needs an adrenaline pen to keep at home/school if they are at risk of severe reactions.  
•     For delayed type reactions, strict avoidance of offending foods is the key to successful treatment. If the recommended diet is not providing adequate symptom relief, medication may have to be added to the treatment in certain cases. The doctor will usually decide on the appropriate medication, depending on the patient's symptoms and underlying condition.
•     There are some experimental treatments for food allergy such as oral tolerance  induction (oral immunotherapy) and anti-IgE antibodies, which are still very much at  the research stage. Such treatment options are not routinely available in South Africa and internationally are still restricted mainly to the research setting. 

(Press release, OZ Healthcare Communications and ALLSA, March 2013)

(Picture: food allergies from Shutterstock)


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Dr Morris is the Principal Allergist at the Cape Town and Johannesburg Allergy Clinics with postgraduate diplomas in Allergology, Dermatology, Paediatrics and Family Medicine dealing with both adult and childhood allergies. obesity and diabetes societies and runs a trial centre for new drugs.

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