Allergies – the growing threat

12:36pm Friday 21st November 2008

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By Barry Nelson  »

It has been estimated that one in five people have some form of allergy. Sometimes it can be life-threatening. Health Editor Barry Nelson looks at this growing problem and asks mother-of-five Ruth Campbell how allergies affect her sons’ everyday lives.

WHEN Dr Dasa Lilic opened her allergy clinic in Durham City a year ago she expected to be busy. Statistics show that the number of people suffering from allergies, including life-threatening peanut allergy, is steadily growing. At least 20 people die in the UK every year after suffering severe allergic reactions, including an estimated five from peanut allergy.

Only last week, 32-year-old Angus Myers from Carrville, near Durham City, collapsed and died at home from a suspected allergic reaction after taking a mouthful of takeaway curry.

It is not known whether the chicken tikka masala meal contained nuts, but curries are often prepared with nut oil and experts advise nut allergy sufferers not to eat curries unless they are certain they do not contain any trace of nuts.

Convinced there was an unmet need, Dr Lilic convinced management of the County Durham and Darlington NHS Foundation Trust to set up a one-year pilot scheme to see if there was any demand for an allergy clinic at the University Hospital of North Durham. From the day it opened in October 2007, her clinic has been swamped with patients.

In the first year, around 400 patients were seen by the new allergy clinic. Many were people who suspected they had potentially lifethreatening allergies, but had never been properly diagnosed or told they must carry adrenaline with them at all times in case they suffer what is know as an anaphylactic shock.

Now she and colleagues, Dr Lucy Hansen and specialist nurse Joanne Smith, struggle to meet what was until a year ago an unmet demand.

“Many of these patients had not been seen by a specialist. They need to be properly assessed, they need to know what they are allergic to and they need to be given the right advice,”

says Dr Lilic.

Crucially, those diagnosed with severe allergies are told to avoid at all costs the substances which can trigger an attack. If they are unlucky enough to have an attack they are told to always carry at least two Epipens, pre-loaded adrenaline dispensers that can deliver a life-saving injection which can buy time until paramedics arrive.

“Anaphylactic shock can be produced by contact with nuts, seafood, shellfish, wasp stings and other allergens in susceptible patients. It is usually the swelling of the airways that kills you,” says Dr Lilic.

According to the Peanut Allergy UK website, anaphylaxis is when the immune system over-reacts to an allergen by producing large amounts of histamine. This causes swelling of the airways and suffocation. It also makes blood vessels leaky, so blood doesn’t get to the organs, but instead enters the tissues. If untreated, the sufferer can die from respiratory or circulatory collapse. Symptoms include a rash, itching, hives, swelling of the face, difficulty breathing, feeling lightheaded, a sensation of impending doom and collapse.

The response to Dr Lilic’s new clinic does not surprise Jules Payne, deputy chief executive of the charity and campaign group, Allergy UK.

“There have been four national reports about allergy services in the last few years and all of them have said there is a growing problem,” says Miss Payne.

Last year the House of Commons Science and Technology Select Committee said the increase of allergies had reached “epidemic” proportions and called for allergy centres to be set up in each region.

“We would like to see more allergy centres and we also need to see more training posts for allergy specialists,”

says Miss Payne.

In a bid to try to fill that gap, Allergy UK has been involved in training pharmacists around the country to offer an allergy screening service.

“The pharmacists offer a good service but anyone who has an extreme allergy really needs to be seen by a specialist,” she adds. “We know there are around 20 anaphylactic shock deaths every year in the UK. They can be caused by nuts, shellfish, latex and medicines.”

Those who die are usually aware that they are prone to severe allergic reaction, says Miss Payne, whose charity has campaigned to increase specialist NHS allergy services around the UK. This is why it is so important to diagnose severe allergies and tell patients what to do in the event of an emergency. Even when people carry Epipens, tragedies can still occur.

“I heard the other day of a young woman who gave one of her Epipens to someone who was having an anaphylactic shock. Later in the same day she went into shock and used her reserve pen, but it didn’t work and she died,” says Miss Payne.

Pub landlady Lucy Snowdon, who runs the Bay Hotel in Runswick Bay, near Saltburn-by-the-Sea, always carries an Epipen with her after being diagnosed with nut allergy eight years ago. Regulars at the pub now know not to ask for a packet of salted nuts when they order a pint. To try to reduce the chance of an attack, packets of nuts are not on sale at The Bay.

“I have had a couple of attacks when my tongue starts swelling and my lips go blue,” says Lucy, who has used her Epipen to reduce the symptoms before seeking hospital treatment.

Dr Lilic is just hoping that her trust agrees to fund her allergy clinic for another year. “There needs to be NHS services that can see these patients and give appropriate treatment and advice. The demand from patients show how important this is.”

■ For information about allergies contact the Allergy UK helpline or visit allergyuk.org