‘People don’t take my daughter’s anaphylaxis seriously — half her class are supposedly allergic to something’

It may seem as though every second person is “allergic” or “intolerant” to one thing or another, but while reactions to pollens and dust mites may affect up to a quarter of the population in this country, only a very small number of people actually have food allergies.

“My youngest daughter has anaphylaxis, which is a very serious condition and if she ingests a tree nut, the result could be fatal,” says Anna Brennan. “It is a really terrifying situation to be in because we have to be on alert all the time, both at home and particularly when we are out anywhere.

“We have to read the labels of pretty much everything that comes into the house, and, these days, because everyone is afraid of being sued, most items say ‘may contain traces’ so it is really difficult to know if it actually might contain a nut trace or they are only saying that in case of the one in a million chance that a crumb of a nut might have fallen off someone’s jumper into a vat in the factory.

Alarming ailment

“Monitoring her safety outside the house is even more alarming because people really don’t take her anaphylaxis seriously and this, I’m convinced, is down to the fact that half her class in school are supposedly allergic to something. But nothing more than a rash will happen to them if they eat an allergen, so people lump my daughter in the same bracket. I’ll say that she’s anaphylactic and they will say, ‘oh, yes, my daughter is allergic too’, while at the same time buying whatever it is she is allergic to and having it in the house as they say, ‘it’s fine if she doesn’t eat it herself’.”

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The Dublin woman says that her daughter, who is now 16, is at a “terrifying age” for anaphylaxis as she is more independent and spending more time out of the house. She is also increasingly worried about her drinking alcohol as ‘this is when caution goes out the window’ and an accident may happen when she unintentionally eats something which contains nuts.

“I live in absolute fear of this happening,” she admits. “She will soon be 17 and already the birthday parties with alcohol have started. When she was young and invited to a party, I could tell the other parent about her condition and even provide food for her to have when she was at someone else’s house, but obviously you can’t be doing that with a teenager. When people have a few drinks they become careless and I am so worried about this for her, even kissing someone could be a problem, because if they have eaten something with nuts in it, it could affect her.

“I took her to see a specialist so that she could hear first-hand from the doctor exactly how serious her condition is and why she should never go anywhere without her adrenalin pen — this in itself is a pain for her as it is a big object to be carrying around and I know she is conscious of it, so had been “forgetting it” when she was going out with her friends. We also bought her a smartwatch which is linked to a medical service and has all her details on it, in case something happened to her — but she doesn’t like wearing it.

“The specialist told her in no uncertain terms what would happen if she ingests an allergen and also said that because everyone seems to think that they or their child are allergic to something these days, people don’t take anaphylaxis as seriously as they should. He also said that doctors are too free and easy about handing out Epipens, so when someone who is not anaphylactic has a mild or moderate reaction to an allergen and quite obviously doesn’t need adrenalin, then it makes people think that everyone with an adrenalin pen is in a similar situation.

“This is of course, not the case and people like my daughter could become seriously ill or die if not treated immediately. I really think that there should be more education and understanding about the difference between allergy and anaphylaxis.”

[ ‘I didn’t know what anaphylaxis meant until my daughter died’ ]

Dr Iseult Sheehan is the clinical director of Allergy Ireland. She says that while mild allergies are quite common, the more serious ones are less so. “Allergies to inhalants such as grass pollen and house dust mite are the most common type,” she says. “Inhalant allergies cause allergic rhino-conjunctivitis symptoms such as nasal congestion and itchy red eyes.

“This type of allergy is very common and affects about 26 per cent of people in Ireland. Food allergy is less common and is found in about 5 per cent of young Irish children and about 2 per cent of Irish adults. The most common food allergies are egg, milk, nuts, fish and shellfish.

“While a genetic predisposition to developing allergies exists and is passed on within families, the specific allergy itself is not. Atopy is a predisposition towards developing allergies and certain atopic conditions are linked with a higher risk of particular allergies. For instance, infants suffering from eczema have a much higher risk of developing food allergy. It is also known that up to 90% of asthmatics suffer from inhalant allergies which cause co-existing asthma and allergic rhinitis.”

Dr Sheehan explains the difference between allergy and anaphylaxis and says that it is vital that the latter is taken seriously. “An allergy is when your immune system has misidentified a usually harmless substance such as peanut as a threat and developed immune memory against that substance,” she says.

“This means that re-exposure to that substance triggers allergic symptoms, but not necessarily anaphylaxis [which] is a severe life-threatening allergic reaction. It is most commonly triggered by ingestion of a food or medication that an individual is allergic. It is vital that those at risk of anaphylaxis avoid their allergen trigger and they need to carry the adrenalin pens in case of an accidental ingestion.

“Of course, having a severe allergy can be frightening for both the individual and their family. It is difficult to eat out or go to birthday parties for fear of an accidental exposure to what they are allergic to. They need to remain vigilant and carry their adrenalin pens — and this is a big responsibility for a family.”

Alcohol hazard

Dr Sheehan says that when a child is moving into adulthood it can be daunting for allergy sufferers as they need to safely manage their allergies without their parents’ involvement.

“This is a challenging period and during this time they are at increased risk of having a severe allergic reaction,” she says. “They are often socialising more which involves eating out or takeaways and in addition, alcohol can impact decision-making. The priority is that allergy sufferers are not held back, but having a good support system is key. They need to get confident at checking food labels and communicating their allergy. Wearing medi-alert jewellery is recommended — and it is important that they are linked in with an Allergy clinic and/or their GP.”

One of the most common allergies experienced in Ireland is asthma and this can often go hand in hand with anaphylaxis, which, in turn, can add to the severity of the condition. “Asthma is an atopic condition and is strongly linked with allergic rhinitis, a condition caused by allergies to inhalants such as house dust mite, pollens, mould or animal dander,” says Dr Sheehan. “In terms of anaphylaxis, the medical term used to describe life-threatening allergic reactions, respiratory compromise is often a feature and as such suffering from a chronic respiratory condition such as asthma is known to increase the risk of adverse outcomes including fatality.”

Facial swelling

The Dublin-based expert says that as well as knowing the difference between allergy and anaphylaxis, it’s important to note that food intolerance is “entirely different” to food allergy. “Food intolerance symptoms include bloating, flatulence, lower abdominal cramps and diarrhoea while food allergy symptoms include rash, facial swelling and respiratory symptoms,” she says.

“There is no medical test for food intolerances and instead it is necessary to exclude the suspected food before reintroducing it to gauge the effect. But it’s important to note that this approach should never be used for a suspected food allergy and it should be done under the guidance of your GP or dietitian.

Dr Sheehan would advise any parent who believes their child has an allergy or anaphylaxis to seek medical advice to learn how to deal with the condition appropriately. “Certainly, if a person is suffering from symptoms which they suspect are allergic in nature then identification of the culprit is very important in ensuring that their condition is managed appropriately and effectively,” she says.

“Skin-prick testing, or alternatively IgE specific blood tests are used in all reputable centres so strictly avoid companies offering other types of tests which have no scientific basis. It is vital that the results are interpreted by a doctor in a reputable clinic.”