“Food allergies are estimated to cost the Australian economy $7 billion each year, with the greatest contributor being lost productivity”, according to the Australian parliamentary enquiry’s report into allergies from 2020.
While nobody knows why exactly Australia has become the “allergy capital” of the world, 1 in 10 Australian infants are said to have food allergies.
Allergies, which include food, insect, medications allergies, as well as environmental allergies such as allergic rhinitis, allergic asthma and dust mite allergy collectively affect at least 20% of the Australian population—approximately 5 million Australians. The unprecedented growth of food allergies in Australia constitutes the real and ongoing threat to public health. Its tackling requires innovative solutions and the fast-tracking of effective health optimizing approaches such as the oral immunotherapy (OIT) to treat food allergies in Australia. There is no time to wait to adopt some of the existing best-practice solutions to food allergies, such as OIT, which has successfully reversed or at least severely minimized this condition for many OIT patients.
Dr Douglas Jones, a specialist allergist and immunologist from Utah in the United States, who has practiced OIT since 2010, was one of the pioneers of clinical practice guidelines and protocols for conducting OIT safely for many known allergens, including food. He said for Keeping News Local that OIT is far safer and superior to any other known approach in food allergy desensitisation today. The clinics in which he practices alongside a team of colleagues have successfully treated with OIT more than 1,800 patients (including more than 40 Australian families) with a 92% success rate. Dr Jones said:
“When it comes to food allergy, each year treatment is delayed, the heavier the costs physically, psychologically, socially, and financially. There is over a decade’s worth of evidence behind OIT to silence the reasons for not offering it as an option. There is hope for Australian families. I know many parents have been pleading to make this choice available for many years to their doctors and government. I believe they deserve to be heard.”
Melissa Mooney, the founder of parent advocacy group, Food Allergy Goals, said:
“The viability of OIT is no longer a contentious issue. Regulators have told us for so long that it is dangerous and should not be widely accessible in Australia. This is not the view of international experts. That is why Food Allergy Goals is dedicated to supporting progressive allergists who are looking to introduce this treatment in the safest possible way.”
Australian parliamentary enquiry into allergies
In May 2020, a parliamentary enquiry named Walking the Allergy Tightrope has found that “unlike in UK and USA, anaphylaxis fatalities have increased in Australia in parallel with increasing hospital anaphylaxis admission rates”. An anaphylaxis notification scheme was established at that time only in Victoria, while the true extent of anaphylaxis in Australia is unknown.
People in rural and remote areas tend to incur additional burden and costs (such as for travel and accommodation) to seek specialist advice in larger Australian cities, which is not readily available as the waiting period for new patients is excessively long.
Current treatments in Australia are below satisfaction since there are much more promising solutions in use overseas. Expediating their local widespread use would require a change in mentality among Australian immunology bodies and specialists themselves. Australia has been far too slow to recognise various overseas success rates in OIT as a holistic approach to changing human gut health and the allergy status of individuals, although it may take years to achieve it. There are several clinical trials underway, although the widespread clinical use of OIT for food allergies is highly doubtful currently in Australia.
Many consider it risky, however, every outing for food allergy families is incredibly risky as they must rely on good faith by restaurant employees which often can, and does go wrong. NSW Food Authority publishes annually a Name and Shame list for offending businesses whilst imposing fines on those businesses that have breached NSW Food safety laws.
In the United States, by contrast, insurance companies cover a majority of the costs towards OIT per patient as it is ultimately cheaper for the insurer than their previous business-as-usual approach of doing nothing but copping the annual cost of treatment and hospital admissions. Food allergy costs families around $5000 extra per child per year, on average. Once effectively treated, those on-going costs are minimized. Meanwhile Australian food allergy sufferers are being told to be like sitting ducks, hoping for a better future, just to avoid the allergens (if it were that simple!) or use the ladder desensitisation approach (which has reported fatalities in recent years).
Millions of Australians suffering in silence
Families living with food allergy are suffering in silence. There is a huge cost in adjusting one’s daily life to food allergy and even annual holiday plans (if one dares to take a holiday outside of their safe home environment). Ensuring a regular and valid stock of Epi pens, antihistamines, steroids, paying annual visits to specialists, undertaking often traumatic blood or skin prick tests, unforeseen emergency department visits etc. take a huge toll on every-day life of food allergy sufferers and their care givers.
The risk of anaphylaxis creates a massive social, emotional and psychological toll and anxiety of living with food allergy where any accidental exposure can be fatal. Many children are excluded from social events due to having a diagnosed food allergy. Most food allergy sufferers, especially children, have been bullied or mocked because of their condition at least once. This can have profound consequences for their self-esteem, school or work absenteeism, and participation in a variety of social activities requiring any contact with food.
American specialists helping Australian food allergy sufferers
OIT started in the U.S. at around 2004, although the first time it was used was in 1908 in Europe. There are hundreds of trained specialists in the U.S. who now practice OIT across the country, with patients from all over the world.
Keeping News Local has spoken to families who have successfully undertaken OIT overseas and is highlighting some of their experiences and challenges. There are risk factors involved, and no Australian family would make this trip lightly.
Holly Jessop, who traveled to the United States with her family and three allergic children, said:
“Our experience with Dr Jones was life changing and possibly life-saving. My 3 children now eat all the foods that they did OIT for, between all 3 it’s dairy, egg, peanut, soy, cashew/pistachio, sesame. My youngest is in kindergarten and if it wasn’t for OIT I would have had to homeschool him as he was so anaphylactic to dairy. Our lives are forever changed in the best possible way.”
Serbia introducing OIT for food allergies in 2021
Even poor countries like Serbia have started doing OIT in public hospitals for common food allergens, such as milk, egg and peanuts. A local immunologist with affiliation to Boston Children’s Hospital, Professor Marina Atanaskovic-Markovic, the head of Pulmonology and Allergy Department of “Tirsova” children’s hospital in Belgrade, started administering OIT for food allergies in 2021. Several Australian families, including from NSW, have since moved to Serbia to join that pilot project.
Australia urgently needs to catch up with the rest of the world to speed up OIT introduction for food allergies for Australian patients without them having to relocate overseas to access OIT.