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When faced with a child having a severe allergy attack, reaction time is of the essence.

More and more cases are being reported worldwide of children dying or suffering multiple heart attacks at school following a major allergy attack. A survey by Pharma Dynamics, which involved 800 learners between the ages of 10 and 18 and teachers from independent, government and Model C schools across the country, found that none of the students nor the teachers knew what to do in case of a severe allergic attack, putting children’s lives at risk.

According to international studies the incidence of anaphylaxis (a serious allergic reaction that is rapid in onset and may even cause death) is on the increase. It’s as simple as a teacher offering a child a treat for good behaviour, without knowing about the child’s allergy, or children sharing their lunchboxes with their friends who may be allergic.

What causes an allergy?

Dr Michael Levin, head of the division of paediatric allergy at the Red Cross Children’s Hospital, explains that the main causes of allergic attacks in children is foods. And peanuts are the biggest culprit. Other foods include milk, egg, wheat, soy, fish and shellfish. Certain medications can also cause reactions. These include some antibiotics (penicillins and cephalosporins), painkillers (aspirin, NSAIDS, opiates) and radio contrast media (X-ray based imaging techniques). Bee and wasp stings are also a major cause. Rarer causes are blood products, vaccines and allergen extracts in people undergoing injection immunotherapy.

What are the signs of an allergic reaction?

“There are certain common signs that indicate a child is having a severe allergic attack,” says Levin. “Look out for urticarial rashes (hives), angioedema (swelling) and tingling of the palms and soles. Signs of severe anaphylactic attacks include upper airway (high-pitched ‘grating’ sound, coughing, throat clearing) or lower airway (wheezing, difficulty breathing) obstruction, abdominal issues (pain and vomiting), loss of blood pressure (leading to fast weak pulses and loss of consciousness) and central nervous signs (feeling of panic or extreme lethargy).”

Levin says it’s important that parents and teachers know the difference between a mild episode and a severe anaphylactic attack. “An antihistamine is usually sufficient for mild attacks, but do not leave the child alone. Keep them under close observation and call their relative. If they have an adrenaline injection (such as epipen), keep it on hand in case the attack progresses. In a severe attack, immediately inject the adrenaline into the large muscle of the thigh. If the child is asthmatic, a dose of their reliever pump should be administered (six to 10 puffs, one at a time) and an antihistamine given. Call an ambulance and notify them that it is an emergency. If there is no improvement in five minutes a second dose of adrenaline should be given.”

Living with an allergic child

Lori Bentley from Joburg knows first hand how challenging it is to have a child with a severe allergy. When Lori’s son Ross was just days old, he was diagnosed with eczema and later developed asthma. At age five, he suffered a near-fatal severe allergic attack.

“He was bouncing on a hammock that had collected a layer of pollen and had a severe asthma attack from inhaling the pollen,” says Lori. “We were just lucky because I saw him within seconds of the reaction. We rushed him to hospital, where they treated him and then told me he was critical. He tested positive for seven airborne allergens as well as peanuts. He is at risk of life-threatening anaphylactic attacks.

While we do everything in our power to avoid nuts, we have had a few close calls. A friend brought around some homemade soup a family member had cooked for her. When Ross broke out in hives and started complaining of stomach cramps I knew he was having an allergic reaction. But, I had no idea where the nut products had come from. After investigating, it turned out that the vegetables in the soup had been sautéed in peanut oil. There have been a few other cases over the years, so we always have to be on our toes.”

Lori explains that having a food allergic child changes what you would think of as a “normal” life. “You develop a new ‘normal’ where you read labels on every new product you consider buying. You always ask if your child has his meds on him when he goes anywhere. And you worry a lot when they go out on trips with their school or with friends. My son has also had to accept his condition. and has become less paranoid. . I have become an allergy advocate as a result. My biggest achievement has been educating and training the staff of my child’s school to recognise and react to an allergy attack.

Allergy action plan

  • Ensure your child’s school is fully aware of his or her allergies.
  • Provide the school with emergency contact information and clear procedures for handling medical issues.
  • Explain the early warning signs of an allergic attack to your child’s teachers so they can be alert for early symptoms.
  • Provide the school with multiple adrenaline auto-injectors to use in case of anaphylaxis and be sure to check the expiry date. Show teachers how to administer the medication.
  • Be sure that your child fully understands his or her allergies and knows what they can and cannot eat or be exposed to.
  • Send special snacks and treats your child can eat so he or she doesn’t feel left out on special occasions.
  • Get a medical bracelet for your child to wear.

For guidelines on how to treat children suffering from an allergic attack or how to use an adrenaline auto-injector, parents and teachers can visit Allergy SA or Allergy Expert.

To connect with other parents of children with allergies, visit Allergy Epicentre.

Vanessa Papas