EAACI Food Allergy and Anaphylaxis Guidelines: managing patients with food allergy in the community

Abstract

The European Academy of Allergy and Clinical Immunology (EAACI) Food Allergy and Anaphylaxis Guidelines, managing patients with food allergy (FA) in the community, intend to provide guidance to reduce the risk of accidental allergic reactions to foods in the community. This document is intended to meet the needs of early-childhood and school settings as well as providers of non-prepackaged food (e.g., restaurants, bakeries, takeaway, deli counters, and fast-food outlets) and targets the audience of individuals with FA, their families, patient organizations, the general public, policymakers, and allergists. Food allergy is the most common trigger of anaphylaxis in the community. Providing children and caregivers with comprehensive information on food allergen avoidance and prompt recognition and management of allergic reactions are of the utmost importance. Provision of adrenaline auto-injector devices and education on how and when to use these are essential components of a comprehensive management plan. Managing patients at risk of anaphylaxis raises many challenges, which are specific to the community. This includes the need to interact with third parties providing food (e.g., school teachers and restaurant staff) to avoid accidental exposure and to help individuals with FA to make safe and appropriate food choices. Education of individuals at risk and their families, their peers, school nurses and teachers as well as restaurant and other food retail staff can reduce the risk of severe/fatal reactions. Increased awareness among policymakers may improve decision-making on legislation at local and national level.

Parents’ and caregivers’ experiences and behaviours when eating out with children with a food hypersensitivity

“…Caregivers should be encouraged to use practical techniques, for example: informing eating out venues in advance [5], and supporting their child’s involvement in these responsibilities as befits their developmental stage. Clinicians, support charities and retailers/caterers can further contribute by helping caregivers to construct an individual ‘management plan’ within their child’s nursery/school.…”

“…Food allergies are usually mediated by IgE; reactions typically occur extremely quickly after ingestion and although symptoms are sometimes mild (e.g. urticarial rash or itchy mouth), reactions can be life-threatening (anaphylaxis) [4, 5]. People with food allergies need to be ready to treat reactions caused by accidental ingestions with oral antihistamines for milder symptoms, or injectable adrenaline (epinephrine) for anaphylaxis.…”

El niño alérgico en la escuela. ¿Qué es lo que se necesita saber?

“…2 Es importante que esta proporcione a la escuela, identificado con el nombre del niño, el material para ser utilizado en caso de emergencia; que todo el personal de la escuela posiblemente involucrado en el cuidado del niño conozca la localización de este material; y que periódicamente se compruebe la fecha de vencimiento del mismo. 2,32 El papel del equipo de atención de la salud es esencial en la educación de los pacientes y los cuidadores acerca de las medidas eficaces para prevenir la reacción anafiláctica, y en su capacitación para la detección temprana y el manejo adecuado de esta situación, de tal forma que se eviten los malos resultados y la muerte del paciente. 33 Es importante saber que los objetivos esenciales para el rescate con éxito de un paciente con una reacción anafilaxia son:…”

“…Las iniciativas de promoción de la salud escolar son una manera eficaz para resolver a corto plazo la mejora en el cuidado de los niños con enfermedades alérgicas crónicas, de acuerdo con las recomendaciones de la European Academy of Allergic and Clinical Immunology (EAACI) 32 que pueden ser reforzadas por la participación activa de los equipos de la salud siempre en asociación con los equipo de la educación. 43 Esta podría ser una estrategia clave para garantizar la institucionalización y sostenibilidad de las acciones y los proyectos.…”

Long-term increase in epinephrine availability associated with school nurse training in food allergy

“…Previous studies have shown that school personnel have poor understanding of anaphylaxis signs and symptoms and the use of injectable epinephrine devices. 7 Prompt recognition of symptoms of a food allergy is imperative for early administration of lifesaving epinephrine.…”