Allergies

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More than Half of Allergy Sufferers Put at Risk by Restaurants and Takeaways

As research finds more than half (58%) of allergy sufferers have had their lives put at risk by restaurant or takeaway staff, law firm Slater  and Gordon is  calling on businesses to have better allergen control. Last year, the high-profile tragic deaths of Megan Lee and Natasha Ednan-Laperouse (both 15), highlighted the need for tighter food sanitation restrictions within outlets that prepare or serve food to the public. Both were victims of lax attention to allergen advice either not being present, or being ignored entirely.

The new study of 1,000 food allergy sufferers found that 30% of those with allergies said they had suffered a reaction more than once after eating food from a restaurant, takeaway or other eatery which they had deemed safe.

Shane Smith, a lawyer at Slater and Gordon which commissioned the research, said: “These results are astonishing. Most of us have a friend or loved one with a potentially fatal allergy, yet so many restaurants and takeaways still seem to regard it as being of little importance.

“Comments like “it can’t be that bad” and “it won’t hurt you this once” show just how much work is still needed to educate owners and staff about the very real dangers.

“For those with an allergy it is not a choice but a serious condition which could kill them if ignored”.

Megan’s parents are calling for greater awareness by medical professionals after being told their daughter’s allergies were “mild”. They are also campaigning for better allergen control including more frequent spot checks of eating establishments, closer monitoring of the ‘out of five’ hygiene rating certificates and mandatory insurance to protect those affected.

The takeaway Megan ordered from was still displaying the top rating it had been awarded in 2013, more than three years earlier, and had also failed to inform the local authority of a change of ownership, which should have prompted a fresh inspection.

Astonishingly, 58% said they had experienced negative treatment including being ignored, not having their allergies taken seriously and even being accused of being ‘fussy’. 42% of those affected admitted it has made them avoid eating our or ordering food in.

Shane Smith added: “Being able to order a takeaway or go out for a meal is something most of us take for granted, but for those with a food allergy it can mean the difference between life and death.

“Anything that makes the experience safer must be welcomed and this research shows that it is badly needed.

 “One change we would like to see is for public liability insurance to be made mandatory for all establishments preparing and serving food to the public with strict conditions to encourage them to take allergen control seriously.

“In recent years we have seen a number of high-profile cases in which people have died due to ignorance around this topic. Protecting the public must be the top priority before any more lives are lost”.

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New treatment for peanut allergies shows promise




New treatment for peanut allergies shows promise

New treatment for peanut allergies shows promise

 

 

 

 

 

 

 

 

 




“Peanut allergy treatment ‘in sight’,” reports BBC News, on a study investigating the effectiveness of a new drug to reduce the symptoms seen in people with severe peanut allergies.

Peanut allergy is increasingly common in children in countries such as the US and UK, and usually continues into adulthood. There is currently no approved treatment for peanut allergy and in severe cases the allergy can be life threatening.

The new drug being tested is called AR101 and is based on peanut protein. Its dose is gradually increased to build up tolerance to peanut protein, and after this people continue to take a daily dose of AR101 to try to maintain that tolerance.

The goal of treatment is not to “cure” peanut allergies, but to make people with severe allergies less likely to experience a serious allergic reaction (anaphylaxis) if they are accidently exposed to peanuts.




The current study compared this treatment with a “dummy” powder (a placebo) in almost 500 children and young people with severe peanut allergy. It found that after 6 months of treatment, about two thirds (67%) of those taking AR101 could eat 600mg or more of peanut protein without serious symptoms, compared to only 4% of those taking the placebo. The study did not assess how long or how often AR101 needs to be taken to maintain peanut tolerance in the long term.

It is important to note that this drug is not yet approved in the US or UK. If it does get approved for use in the NHS it is likely to be under the supervision of specialists.

Where did the story come from?

The study was carried out by researchers from several international institutions including Emory University in the US and University College Cork, Ireland. The study was designed and funded by Aimmune Therapeutics, the company who developed the drug (AR101) being tested in this research.

The study was published in the peer-reviewed New England Journal of Medicine (NEJM) and is free to read online.

The UK media coverage on this topic was generally balanced and accurate. Much of the coverage focused on the story of a 6-year old British girl, who before treatment, risked death if exposed to just tiny traces of peanuts. By the end of the study she was able to tolerate eating 7 peanuts.

What kind of research was this?

This was a double-blind randomised controlled phase 3 trial called the PALISADE trial. It aimed to investigate whether a new drug called AR101 could help people with severe peanut allergies to tolerate exposure to small doses of peanut protein, with less severe symptoms.

A double-blind randomised-controlled trial (RCT) is the most reliable way to test the effectiveness of an intervention, in this case a new treatment. A phase 3 trial is used to assess the effectiveness and safety of the drug compared with a placebo (as in this study), different doses of the same drug, or other interventions. This is the last stage of trials that need to be conducted successfully before the drug company can apply to have its drug given a licence to be used in practice (rather than just in research studies).

What did the research involve?

This trial was carried out in 10 countries in North America and Europe.

Researchers screened 842 children and adults (aged 4 to 55) with a peanut allergy to see if they were eligible to participate. They selected people who reported a history of peanut allergy, had a blood test to confirm that their immune system reacted against peanut protein or a reaction to peanut protein on skin-prick testing. They were then closely supervised to see their reaction to eating a very small amount of peanut protein, and only those who could tolerate no more than 100mg dose of peanut (approximately one third of a peanut kernel) were selected to take part. People with severe asthma, or whose asthma was not well controlled were not allowed to take part.

A total of 555 participants (499 children and 56 adults) were randomly assigned to receive either the AR101 drug or a placebo in identical looking powder form. The dose of both AR101 and the placebo were gradually increased. First, participants were closely supervised over a day while they took doses which were gradually increased from 0.5mg to 6mg.

After this, the participants’ doses were increased every 2 weeks starting at 3mg and gradually increasing to 300mg if tolerated, over a period of about 6 months.

Following this, there was a 6-month maintenance phase where participants received a constant dose of 300mg peanut protein. The trial lasted a year.

At the end of the 12 months, all participants were again closely supervised while they consumed increasing doses of first 300mg, then 600mg, and finally 1,000mg of peanut protein, to see how much could be tolerated without having any symptoms that caused the doctors concern about increasing the dose (called “dose-limiting” symptoms). This would include any reaction (even if mild) that needed to be treated with drugs. All of the tolerance tests were conducted in a research facility under medical supervision, so participants could receive immediate medical attention if they experienced a severe allergic reaction.

The researchers were mainly interested in assessing the proportion of children and adolescents who could tolerate a single dose of at least 600mg of peanut protein without dose-limiting symptoms. They looked at whether this proportion was higher among those who took AR101 than those who took the placebo.

What were the basic results?

The researchers recruited 496 children and young people aged 4 to 17 years of age.

At the end of the year of treatment, 250 of the 372 participants who took AR101 (67%) were able to ingest a dose of 600mg or more of peanut protein without serious symptoms, compared with only 5 of the 124 (4%) participants who received the placebo (95% confidence interval (CI) 53 to 73).

During this final test the severity of symptoms after consuming the peanut protein was also assessed. A quarter (25%) of participants who had been taking AR101 had moderate symptoms, compared with 59% in the placebo group. Severe symptoms were experienced by 5% of participants in the AR101 group and 11% in the placebo group.

A greater proportion of participants taking AR101 experienced severe side effects, such as difficulties breathing, while taking the drug (4%) than those taking placebo (about 1%).

No significant effect of AR101 was found in the small number of adult participants (55 people) who were included in the study.

How did the researchers interpret the results?

The researchers concluded that in their phase 3 trial, when children and adolescents who were highly allergic to peanuts were treated with AR101 for a year they were able to tolerate consuming higher doses of peanut protein with less severe symptoms than those who had received placebo.

Conclusion

This was a well-conducted study. The research showed that young people with peanut allergy could experience a reduction in the severity of their symptoms and a greater ability to tolerate small amounts of peanut protein following treatment with AR101 compared with placebo.

As children who are severely allergic to peanuts can have life-threatening reactions to even very small amounts of peanuts consumed accidentally, the need to develop this sort of treatment to allow them to tolerate such amounts is particularly important.

There are, as the researchers mention, a few limitations to this trial. For example, the researchers looked mainly at participants aged 4 to 17, and no significant effect was found in the few adults enrolled in the trial. They may go on to assess why this treatment appeared to work in children and adolescents but not in adults. Also, the study did not evaluate for how long or how frequently AR101 needs to be taken to maintain peanut tolerance in the long term.

AR101 does not yet have a licence in the US or UK. The next step for the drug company is to submit the results of its studies to the bodies who regulate drugs, so they can assess if AR101 is effective and safe enough for wider use.

This and other similar ongoing studies offer hope for parents and children with serious peanut allergies. It is vital to note that this study involved a carefully prepared drug, and every time the participants were tested for their reaction to eating peanut protein, they were very carefully supervised by medical professionals who could give treatment if they had a severe allergic reaction. Tolerance testing should not be attempted at home. Allergic reactions can be life threatening if not treated immediately.

Analysis by Bazian
Edited by NHS Website

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Nearly a quarter of us may be allergic to our own homes




Allergic to our own homes

Allergic to our own homes

At least 12 million Britons now suffer from allergies caused by dust mites, The Independent has today reported. The newspaper says that a report by the charity Allergy UK has revealed an epidemic of “home fever”, a range of symptoms caused by dust mites and other triggers around the home.

The report has been published as part of Indoor Allergy Week, which is intended to raise awareness of the kind of steps that can be taken to remove allergy triggers, or ‘allergens’, from the home. A survey in the report suggests that, currently, around two-thirds of people with allergies experience symptoms such as sneezing and itchy eyes caused by allergens including dust mites, chemicals, pets and mould.

This new report raises lots of questions, such as whether its small survey of symptoms in 1,600 allergy sufferers is actually strong enough evidence to suggest that there is an epidemic sweeping the nation.




Also, the report’s suggestions to change your mattress and use an air filter are likely to raise a few eyebrows since the awareness week is being run in conjunction with a mattress company and an air filter manufacturer.

 

What is “home fever”?

“Home fever” is a term used by Allergy UK to describe out-of-season hay fever symptoms. The most common of these are runny nose and sneezing, symptoms which the charity reports have risen greatly in recent years. Unlike regular hay fever, which is usually triggered by high pollen levels that vary seasonally, “home fever”, Allergy UK suggests, is triggered by allergens such as dust mites, moulds, cleaning products and pets that are present in the home or office. These can cause symptoms throughout all seasons.

 

Who compiled the report?

The news is based on a report by Allergy UK that surveyed more than 1,600 allergy sufferers about indoor allergies. The report was released ahead of Allergy UK’s Indoor Allergy Week, launched today, which aims to raise awareness about indoor allergies caused by house dust mites, moulds and pets.

As mentioned above, the awareness-raising week and report are supported by a mattress company and an air purifier manufacturer. It is not clear what role these companies had in the survey, which featured recommendations to prevent “home fever” by replacing your mattress and using an air purifier. This affiliation may be something to take into account when considering the report’s recommendations.

Allergy UK is a national charity supporting people with allergies, food intolerance and chemical sensitivity.

 

What did the report say?

The survey asked allergy sufferers what triggered their symptoms, offering the possible options of house dust mites, cleaning products, mould or pets. Participants could choose more than one option. The most popular answer was house dust mites at 57.6%, followed by pets (45.2%), cleaning products (31.2%) and mould (30.9%).




The report says these figures have risen since the last survey was published in February 2010. The Allergy UK report does not give any detail on the characteristics of the people surveyed or how many people answered each question. It also does not include any statistical analysis to say whether the differences observed between years are real or the result of random variation that occurs when different groups of people are surveyed. We must be very cautious in taking these figures at face value without more information about how the survey was carried out.

The most commonly reported symptoms of indoor allergy or “home fever” were runny nose (67.8%), sneezing (66.9%) and itchy eyes (62.1%).

Other findings include:

58.9% of indoor allergy sufferers found their symptoms were worse in the bedroom. The authors suggest that this was due to dust mites in the bed, quoting figures that “the average bed harbours 2 million dust mites and the average pillow doubles in weight over a period of six months due to dust mite faeces”.

16% of allergy sufferers said they wash bed linen every three weeks or less often, and 58% of those surveyed said they are washing at 30 or 40 degrees. This is two weeks longer than Allergy UK recommends and at a temperature that they say does not kill any dust mites present.

13% of allergy sufferers had had their current mattress for 11 years or more, and 3% kept theirs for 20 years or longer.

The authors suggest people “too often confuse allergy symptoms with a common cold or flu and, therefore, don’t treat the root cause of the problem”. Allergy UK believes the root cause is allergens such as dust mites, which trigger these allergic reactions and symptoms.

 

How common are household allergies?

Allergy UK estimates that at least 12 million people are allergic to their own home and so could be classed as household allergy sufferers. NHS Choices reports that indoor allergies are very common and that 10-20% of the population has an indoor allergy. The top estimate of 20% would be broadly in line with the figure suggested by Allergy UK, although it is not apparent how the charity has reached this estimate.

Most sufferers first develop indoor allergies in childhood, with 80% of cases developing before the age of 20. Men and women are equally affected by indoor allergies.

 

What causes household allergies?

The main cause of indoor allergies or “home fever” are house dust mites. Dust mites are microscopic creatures that survive well in warm damp conditions such as the average UK home. Beds provide the ideal environment for dust mites as they can feed on the skin cells we shed, obtain warmth from our bodies and gather water from our sweat and exhaled breath. They are also commonly found in carpets, upholstered furniture, fabrics and furry toys. While they are completely harmless to most people, in some they can trigger an allergic reaction. The allergen that triggers most allergic reactions is the mite droppings. These can collect in pillows, mattresses, duvets, upholstery and carpets.

Other common causes of indoor allergies include allergens from animals and from mould spores.

 

What can I do to ease my allergies?

Allergy UK recommends many ways to manage symptoms and reduce the amount of indoor allergens in the home.

Buy products that have been tested to ensure they prevent the escape of the house dust mite allergen.

Use allergen-proof barrier covers on all mattresses, duvets and pillows.

Dust regularly but use a damp duster first, then a dry cloth. Otherwise, you are just moving the dust around.

Wash all bedding that is not encased in a barrier cover (for example sheets and blankets) every week. Washing at 60 degrees or above will help eliminate house dust mites. The allergens produced by house dust mites dissolve in water so, while washing at lower temperatures will wash the allergens away temporarily, the mites will survive and produce more allergen after a while.

If possible, remove all carpeting in the bedroom and vacuum all surfaces of upholstered furniture at least twice a week.

Change your mattress every 8-10 years and replace pillows every year.

Use a high-temperature steam cleaner to rid carpets of dust mites.

Use light, washable cotton curtains, and wash them frequently. Reduce unnecessary soft furnishings.

Washable stuffed toys should be washed as frequently and at the same temperature as bedding. Alternatively, if the toy cannot be washed at 60 degrees place it in a plastic bag in the freezer for at least 12 hours once a month and then wash at the recommended temperature.

Reduce humidity by increasing ventilation. Use trickle-vents in double-glazing or open windows. Use extractor fans in bathrooms and kitchens.

If necessary, use a dehumidifier to keep indoor humidity between 30 and 50%, plus an air purifier to trap large airborne allergens such as pollen, house dust mite debris and mould spores.

These are just some of the recommendations given. To read the recommendations in full visit the Allergy UK website.

One point to note is that in the Allergy UK publication participants reported on various symptoms, most commonly runny nose, sneezing and itchy eyes (typical symptoms of allergy), but also a wider range of symptoms such as wheezing, disturbed sleep and poor concentration. The full range of symptoms offered is not specific to allergy, and could cover many things, including symptoms of the common cold and flu.

Additionally, participants appear to have self-reported what they believe triggers their symptoms. Therefore, taking these things into account, people with respiratory symptoms, irritable skin, poor concentration or difficulty sleeping should not necessarily assume that these symptoms are due to household allergies. If symptoms persist it may be advisable to see your GP.

Do these preventative measures work?

A recent high-quality systematic review looked at the evidence on whether controlling exposure to house dust mites improved asthma symptoms in people who were sensitive to house dust mites. Chemical and physical preventative measures were examined, including mattress covers, vacuum-cleaning, heating, ventilation, freezing, washing and air filtration. Measures of asthma included subjective wellbeing, medication use and various established measures of airway function.

The review, which included 3,121 patients from 55 studies, concluded that these measures had no effect on asthma symptoms (i.e. they were no more effective than doing nothing) and that such measures could not be recommended.

This high-quality review focused on symptoms of asthma caused by dust mites and not the more general symptoms of a runny nose and sneezing as described for “home fever”. It also does not specifically address each of the Allergy UK recommendations. However, it raises an important question. If controlling exposure to dust mites in these ways fails to improve asthma allergic reactions caused by house dust mites, would they be effective in preventing “home fever” also caused by dust mites?

Currently it is not known whether these preventative measures are effective in preventing “home fever”. This should be kept in mind before making potentially costly changes to your bedroom or house to reduce dust mite allergens.

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Allergic rhinitis – signs, symptoms, causes and treatments




Allergic rhinitis

Allergic rhinitis

Introduction

Allergic rhinitis is inflammation of the inside of the nose caused by an allergen, such as pollen, dust, mould, or flakes of skin from certain animals.




It’s a very common condition, estimated to affect around one in every five people in the UK.

Signs and symptoms

Allergic rhinitis typically causes cold-like symptoms, such as sneezing, itchiness and a blocked or runny nose. These symptoms usually start soon after being exposed to an allergen.

Some people only get allergic rhinitis for a few months at a time because they’re sensitive to seasonal allergens, such as tree or grass pollen. Other people get allergic rhinitis all year round.

Most people with allergic rhinitis have mild symptoms that can be easily and effectively treated. But for some symptoms can be severe and persistent, causing sleep problems and interfering with everyday life.

The symptoms of allergic rhinitis occasionally improve with time, but this can take many years and it’s unlikely that the condition will disappear completely.

When to see your GP

Visit your GP if the symptoms of allergic rhinitis are disrupting your sleep, preventing you carrying out everyday activities, or adversely affecting your performance at work or school.

A diagnosis of allergic rhinitis will usually be based on your symptoms and any possible triggers you may have noticed. If the cause of your condition is uncertain, you may be referred for allergy testing.

Read more about diagnosing allergic rhinitis.

What causes allergic rhinitis?

Allergic rhinitis is caused by the immune system reacting to an allergen as if it were harmful.

This results in cells releasing a number of chemicals that cause the inside layer of your nose (the mucous membrane) to become swollen and excessive levels of mucus to be produced.

Common allergens that cause allergic rhinitis include pollen – this type of allergic rhinitis is known as hay fever – as well as mould spores, house dust mites, and flakes of skin or droplets of urine or saliva from certain animals.




Read more about the causes of allergic rhinitis.

Treating and preventing allergic rhinitis

It’s difficult to completely avoid potential allergens, but you can take steps to reduce exposure to a particular allergen you know or suspect is triggering your allergic rhinitis. This will help improve your symptoms.

If your condition is mild, you can also help reduce the symptoms by taking over-the-counter medications, such as non-sedating antihistamines, and by regularly rinsing your nasal passages with a salt water solution to keep your nose free of irritants.

See your GP for advice if you’ve tried taking these steps and they haven’t helped. They may prescribe a stronger medication, such as a nasal spray containing corticosteroids.

Read more about treating allergic rhinitis and preventing allergic rhinitis.

Further problems

Allergic rhinitis can lead to complications in some cases. These include:

nasal polyps – abnormal but non-cancerous (benign) sacs of fluid that grow inside the nasal passages and sinuses

sinusitis – an infection caused by nasal inflammation and swelling that prevents mucus draining from the sinuses

middle ear infections – infection of part of the ear located directly behind the eardrum

These problems can often be treated with medication, although surgery is sometimes needed in severe or long-term cases.

Read more about the complications of allergic rhinitis.

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Introducing MyAsthma: The World’s First Asthma App Certified as a Mobile Medical Device (Class I)




MyAsthma

MyAsthma

Designed with healthcare experts, the MyAsthma app allows people to track and understand their disease while monitoring potential environment and lifestyle asthma triggers.





The UK has some of the highest asthma rates in Europe with nearly 5.4m Brits –one in 11 children (1.1 million) and 1 in 12 adults (4.3 million) –presently receiving treatment for asthma.

Asthma attacks hospitalise someone every 8 minutes and on a daily average, 185 people are admitted to a hospital because of asthma attacks in the UK; and nearly three Brits on average die from asthma every day.

Every 20 minutes, a child is admitted to a hospital in the UK because of an asthma attack; and every classroom has three children on average suffering with asthma.

The NHS is spending approximately £1 billion every year to treat and care for people with asthma.

The MyAsthma app has been designed to be the most clinically relevant, connected and environmentally contextual mobile medical device application ever developed in respiratory care. Data from the app builds a personal asthma summary for the person using it, by capturing environmental, pollen and activity data, the app can allow users to record and see factors that may trigger their asthma.

Patients can also share the information from the app with their healthcare professional and allow them to better understand the status of their asthma.




The MyAsthma app, can also be used by carers who can track up to five people’s conditions on their smartphone. Designed to fit into everyday life the app connects with leading wearables such as Fitbit, but also fitness services including Apple Health and Strava to understand exercise and sleep information.The app by GSK is free to download from the UK Apple App Store and it is compatible with iPhones running iOS 9+.

We have on hand Dr. Dominick Shaw who was part of the team from The University of Nottingham that co-developed the app; he has also published several research papers on severe asthma to further the progress of the disease monitoring and management, as well as Kai Gait, co-developer of the app from GSK.

(The World’s First Asthma App Certified as a Mobile Medical Device (Class I). Class I is self-certified, so this meant GSK built, documented, tested and monitor the app with rigorous processes and ongoing validation. They registered the app through the UK with the Medicines and Healthcare products Regulatory Agency (MHRA) being the controlling body).