Tuesday 24 October 2017

Access to allergy jab is 'win-win' say experts

Hundreds at risk of fatal allergic reaction without life-saving jabs, writes Allison Bray

TOO SOON: Emma Sloan (14) died after an allergic reaction to nuts when a pharmacy refused her mother an EpiPen
TOO SOON: Emma Sloan (14) died after an allergic reaction to nuts when a pharmacy refused her mother an EpiPen
Allison Bray

Allison Bray

Almost two years after a teenage girl died in moments after suffering a severe allergic reaction as her mother begged in vain for a life-saving adrenaline injection, more than 140 children have been diagnosed with severe and potentially fatal anaphylaxis in the republic .

Despite repeated calls for the Department of Health to ease restrictions on emergency access to epinephrine injectors which can prevent instant death from anaphylactic shock, a leading immunologist said Government inertia is putting more lives at risk.

"We thought Emma Sloan's death would change things, but nothing has happened," UCC immunology professor and allergy consultant Prof Jonathan Hourihane told the Sunday Independent.

"I met with Leo Varadkar at his office on February 4 and nothing has happened since. The Department of Health is doing nothing about this," said Dr Hourihane, who is also chair of the Irish Food Allergy Network.

His comments come as a small town in rural Canada has become one of the first in the world to set up 24 emergency first-aid kits in local restaurants, fire halls, schools and community and sports centres providing immediate emergency access to epinephrine injectors, in the event of someone having a severe anaphylactic reaction.

Nurse Kelly Dunfield, (51), who pioneered the concept in the small dairy farming community of Sussex, New Brunswick, said she was partly inspired by the tragic story of another 14-year-old schoolgirl who also died of anaphylactic shock after ingesting a dairy product in lasagne, of which she was highly allergic.

Ms Dunfield, who is also an emergency department nurse, said she and an allergy specialist came up with the idea of the injection boxes similar to the now commonplace practise of having heart defibrillators available in community settings in case of heart attacks.

"I thought why aren't we doing this with Epi-Pens?," she said of the epinephrine injectors.

Typically a person suffering from severe anaphylactic shock has about 10 minutes to get an epinephrine injection before their airways swell up, cutting off their breathing. But unlike here, epinephrine can be bought from pharmacists without a prescription in Canada.

However, Ms Dunfield said the nature of the EpiPens used in Sussex means they are virtually foolproof. Each cabinet contains one injector each for adults and children which must be replaced after each use or after its expiration in 18 months.

The Allerject product, which costs around €75, looks like a deck of cards that can be held in the palm of a hand and comes with simple voice and written instructions to administer to the thigh like a stapler as a first emergency response, followed by a visit to A&E.

Yet despite the simplicity of the life-saving device, Prof Hourihane said when he tried to introduce a similar pilot scheme at the UCC campus back in 2009, he had to pull 20 similar units from the walls over potential legal issues with the former Irish Medicines Board, now known as the Health Products Regulatory Authority.

"The day before we went live, we sought advice from the Irish Medicines Board and after six months, they came back to say there's no advice," he said.

Despite repeated requests for permission to run the project from the Department of Health, Prof Hourihane said he is still awaiting an answer, however the Health Department said an announcement on emergency access to certain medicines is imminent.

"We had this ready to go. It's an obvious win-win and we would have been the first in the world to do it," he said.

Emma Sloan's mother Caroline said if the pilot project had been adopted here, her daughter might still be alive.

She begged a pharmacist for an EpiPen after Emma went into anaphylactic shock from a peanut, but he refused her one without a prescription.

Sunday Independent

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