London children have returned to the classroom after a six month break due to the Covid-19 pandemic. To reassure concerned parents, official figures from the Office for National Statistics (ONS) show that only two (0.005%) of the 38,156 deaths from coronavirus during March and April in the UK were children aged 14 or under, and eight (0.02%) recorded in the 15-19 age range. In comparison, in a survey of children with allergies conducted by the Anaphylaxis Campaign, 80% of respondents had experienced anaphylaxis and 61% had been admitted to hospital when they last experienced a severe allergic reaction.
With allergic diseases on the increase and around 5-8% of children in the UK having at least one food allergy, Anaphylaxis Campaign and Allergy UK are urging parents, teachers and school staff to check the expiry dates of life-saving AAI pens, review preventative measures, and refresh staff training, after the long Covid-19 lockdown.
Peanuts, tree nuts, milk and eggs are some of the most common allergens responsible for adverse reactions in children, and most classrooms can expect to have at least one child with an allergy, with 20% of severe food allergic reactions occurring while a child is at school. A very severe allergic reaction can cause anaphylaxis which affects more than one body system such as the airways, heart, circulation, gut and skin. Anaphylaxis is a potentially life-threatening reaction and always requires an immediate emergency response.
Amena Warner, Head of Clinical Services at Allergy UK said: “For many parents the prospect of their child being back at school will bring with it some worries and anxiety. In this time of coronavirus, and after such a long break, those worries will be heightened as children face restrictions that will significantly change the ‘normal’ school experience. For parents of children with food allergy their anxiety will be particularly acute with very specific worries about the care and safety of their child in this ’new normal’ school environment.
“Schools have implemented many changes to keep pupils and staff safe during the Covid- 19 pandemic including social distancing bubbles, regular hand washing and cleaning of shared spaces. A ‘no sharing of food’ policy will be one additional protective measure for the food allergic child who should always be aware that they should not share or accept food from others.
“However, all schools must also ensure measures are in place and they are adhering to the strict guidance governing the health care and safeguarding needs of children in schools which includes the administration of allergy medication and adrenaline auto-injectors (AAIs).”
The treatment for anaphylaxis is an injection of adrenaline and children at risk of anaphylaxis are often prescribed adrenaline auto-injectors (AAIs) to use in an emergency. Children prescribed adrenaline should have two AAIs available to use at all times. Parents and schools are being encouraged to ‘Check It, Don’t Chance It’ to ensure the safeguarding of children with allergies:
- Expiry Dates: With schools having been closed for six months it is important that schools holding either the child’s own AAIs or ‘spare’ AAIs check that they are still in date. AAIs are typically dispensed with a shelf life of 12-18 months so many held in schools are likely to have expired and will need replacing. When replacing expired AAIs schools can register their new devices on the manufacturer’s website to receive future timely text and email alerts when the expiry date approaches.
- Storage: Adrenaline must also be stored correctly. Pens (AAIs) should be kept in their original containers to prevent light exposure, must not be stored above 25c and must not be refrigerated or frozen. All AAIs have a small window that allows the adrenaline inside to be checked. The liquid should be clear and colourless. Any AAIs where the liquid appears discoloured or contains particles should be replaced. AAIs should be stored in a safe, but easily accessible place where they are no more than five minutes away from the child at any time.
- The child’s weight and dose of adrenaline: AAI pens are available in two doses 150mcg and 300mcgs. Children grow fast so parents are urged to keep an eye on their child’s weight and ask their GP to prescribe the higher dose AAI once they have reached the appropriate weight as instructed by the adrenaline manufacturer.
- Allergy Action Plan: Every child with severe allergies needs to have an allergy action plan which should be kept with their AAIs. Check that this plan is up to date at all times.
- Training: Check that all school staff are fully aware of the signs and symptoms of anaphylaxis, how to provide emergency treatment and the implications for management of severely allergic children in school. Free training is available at www.allergywise.org.uk and the SAAG (School Allergy Action Group) free online toolkit for the development of a whole school management policy is available at www.allergyuk.org