Allergy Clinic

Childhood allergy seems to be increasing rapidly. In the Western world, peanut allergy prevalence is doubling every 5 years or so! We are not sure why.

We are also increasingly recognising cow’s milk protein allergy, especially in the first year of life. This may lead not only to a typical allergic reaction such as swelling, redness and welts, but at times irritability, eczema, bowel disturbance and gastroesophageal reflux in an infant.

Ballarat Paediatric Practice conducts skin allergy testing, and in the context of the child’s history and examination findings, interpretations of the results are made. Allergen avoidance measures, Epipens, dietary changes such as transferring to a hypoallergenic infant formula are often subjects of discussion. Even exclusively breastfed infants may react to proteins transmitted through maternal breast milk, and in particular, cow’s milk protein. We used to think that breast milk quality was always "just right". That is true to a certain extent, and breast milk is generally best. However, certain dietary proteins ingested by the mother, such as cow’s milk, soy milk, eggs, nuts, fish and soy are transmitted to the baby who in turn may develop allergic symptoms.

Currently the waiting period for Allergy Testing at the Ballarat Paediatric Clinic is about two months.

Below find information that is sent out to all families prior the appointment.

Allergy Testing Information:

Avoiding known allergic triggers is an important part of allergy and asthma management. Allergy testing (using Skin Allergy tests or RAST blood tests) helps your doctor to confirm which allergens you are sensitive to, so that appropriate avoidance advice can be given.

Which Allergens should be tested for?
Allergy testing is usually performed in people with suspected hay fever (allergic rhinitis), asthma or reactions to stinging insects or food allergy. In people with hay fever or asthma, allergy testing usually includes house dust mite, cat and dog dander (perhaps other animals if contact occurs), mould spores, pollen from relevant grasses, weeds or trees and in some cases, occupational allergens. Testing can also be used to confirm suspected allergies to foods and stinging insects.

It is important to note that:
Allergy test results cannot be used on their own and must be considered together with your medical history
Medicare rebates are available for Skin Allergy tests or RAST (blood) tests in Australia.

Skin Allergy testing
Skin allergy testing is the most convenient and least expensive method of allergy testing. As results are available within 20 minutes, this allows you to discuss the results with your doctor at the time of testing. Skin allergy testing has been shown to improve the accuracy of diagnosis in published clinical studies.

Skin allergy testing is most commonly performed on the forearm, although the back is sometimes used. The arm is first cleaned with alcohol. A drop of commercially-produced allergen extract is placed onto a marked area of skin. Using a sterile lancet, a small prick through the drop is made. This allows a small amount of allergen to enter the skin.

If you are allergic to the tested allergen, a small mosquito-like lump will appear at the site of testing over 15-20 minutes.

Skin tests are slightly uncomfortable, but are usually well tolerated, even by small children. Your child should be reassured that this procedure does not hurt. We are more than happy to demonstrate on mum/dad/siblings to decrease anxiety. Local itch and swelling normally subsides within 1-2 hours. More prolonged or severe swelling may be treated with an oral antihistamine, topical corticosteroids cream and an ice-pack. Occasional people will experience feel dizzy or light-headed and need to lie down. Severe allergic reactions from allergy testing in asthma or hay fever are very rare.

Skin Allergy testing is not a reliable way of confirming suspected reactions to aspirin or food additives, and you will need to discuss such concerns with your doctor.

Below find some facts and statistics from the Australian Society of Clinical Immunology and Allergy.

Quick Facts on Allergies in Australia

• The frequency of allergic disease has approximately doubled in the last 25 years.
• 20% of Australians have at least one allergy, one of the highest rates in the developed world.
• Peanut allergies in children have doubled in the past 5 years with approximately 2% (or 2 in every 100) children affected.
• The Australasian Society of Clinical Immunology and Allergy (ASCIA) state that in Australia and New Zealand, around:
  • 1 in 3 people will develop allergies at some time during life;
  • 1 in 5 will develop atopic dermatitis;
  • 1 in 6 will have an occurrence of hives (urticaria);
  • 1 in 10 people have asthma;
  • 1 in 20 will develop a food allergy (usually transient); and
  • 1 in 100 will have a life-threatening allergy known as anaphylax

Allergies are not harmless, but are manageable!

• Allergies are a significant problem in Australia and should not be ignored. Untreated allergies can have an impact on quality of life.
• Hayfever, for example, results in poor quality sleep, fatigue and daytime sleepiness. Adults and children are often more irritable and moody than healthier people and find it harder to make decisions. School-aged children with hayfever can have issues at school with concentration and have difficulty recalling information taught in class.
• Untreated allergies can also worsen other chronic respiratory problems such as asthma, sinusitis and skin disorders such as eczema and urticaria (hives).
• When food allergy does occur, reactions are usually of rapid onset, severe and obvious. They are almost always accompanied by rashes, throat swelling, vomiting or sometimes a more subtle worsening of atopic eczema.
• Nuts, fish, shellfish, milk and eggs are the most common food allergies in children and can be tested to detect sensitivity.
• Some allergies to foods, drugs and insect stings can lead to a potentially life threatening reaction called anaphylaxis - a systemic allergic reaction which can be fatal, and leads to the death of 10 to 20 Australians each year. BUT, anaphylaxis is readily treated with a medically prescribed Epi-pen carried at all times and easily administered by people at risk.
• With appropriate diagnosis and management most asthma, eczema and allergy sufferers will lead normal, active lives with little disturbance to their quality of life.

AUSTRALASIAN SOCIETY OF CLINICAL IMMUNOLOGY AND ALLERGY (ASCIA)
ASCIA is the peak professional body of Clinical Allergists and Immunologists in Australia and New Zealand.
www.allergy.org.au

Browse our comprehensive Factsheet for further information