Anaphylaxis 
11th July 2004
This is my new website address. Please update your links.
My friend Noj has kindly created me a new guestbook. Thanks Noj!
4th April 2003
This is the first time I have edited this site since I first uploaded it on the 23rd of November 1997. I am now 20 and go to the University of New South Wales where I study Bachelor of Commerce, majoring in Actuarial Studies and Finance. I would like to take this opportunity to thank all of you who have signed my guestbook and emailed me over the years. I really appreciated and enjoyed reading your comments, however I'm afraid most of it is now lost. For some reason my guestbook and my little counter have disappeared??? This is actually the first time I have visited this page since early 2001, and it was working fine then, so I don't know what has happened to them. I wish I had saved my guestbook or at least read it more often. Well, it can't be helped. I will try and get a new guestbook going soon, but until then please excuse the dead links at the botton of the page. My HTML is extremely rusty so I could only manage updating my email address this time around. oh yeah...I also added a new counter! =)
23rd November 1997
My name is Cameron Sew Hoy, I am 14 years old and I am a Year 9 student at North Sydney Boys High School. Each year, all students from Years 7 to 9 at my School have to do a Major Science Assignment. This year I chose ‘Anaphylaxis’ as the topic for my research because I have three people in my family who suffer from allergies (my mum, my youngest sister, and myself) with my youngest sister, Lisae also suffering from anaphylaxis. I thought it would be a very interesting topic to study as I wanted to know more about this life-threatening allergic reaction.
To aid in my research I sent out 30 surveys to people situated in New South Wales, who suffered from Anaphylaxis. I was referred to them by Mrs Julianne Yeates, Vice President of F.A.C.T.S. Assoc. Inc., of which my family are also members. I was quite thrilled with my response (21), as I was unsure if people would take the time to fill it out. Results from this survey were used throughout my assignment to help me in my understanding of how different people coped with Anaphylaxis in various situations. Some of these results will be mentioned below.
Following, is an edited version of my assignment, which I hope you find both interesting and useful.....
Anaphylaxis is the most severe and potentially deadly of all allergic reactions. It is a sudden, severe allergic reaction that involves the whole body. If the condition is not treated immediately with injected adrenaline, and possibly also an antihistamine injected into a vein, or even steroids intravenously in very severe cases, the outcome can be extreme breathlessness, gross swelling of the body (particularly the wind pipe), heart failure and death. Anaphylaxis causes a constriction or narrowing of the airways and the
blood vessels, resulting in difficult breathing, rapid pulse, a fall in blood pressure, and even cardiovascular collapse and shock. Anaphylaxis is a critical medical emergency requiring immediate injections of the hormone epinephrine, which opens the airways and blood vessels. It is also treated with antihistamines, and steroids, among other medications.
Anaphylaxis can be the result from a number of causes:
- Violent reaction following the eating of food. Peanuts, nuts, shellfish, milk, eggs, and fish are the foods that most commonly cause anaphylactic reactions.
- A reaction to a drug.
- As a result of skin testing or immunotherapy.
- Insect stings are also sometimes responsible for anaphylactic shock.
Anyone who has asthma and food allergies may be at an increased risk for having a life-threatening reaction involving the respiratory tract. However, food allergy tends to occur in children under five years old, who commonly have atopic eczema and a family history of asthma and/or eczema. It is an uncommon cause of adverse reactions to food in adults. Anaphylaxis is
also often experienced by people who have a history of allergies and therefore have memory cells ready to provoke an immediate and widespread allergic response as soon as an allergen is detected in the body.
From the results collected from the survey distributed to anaphylactic sufferers, 100% of the people who answered question 2,
"Does your family have a history of allergies?",
responded that their family did have a history of allergies. This may indicate that the chance of having allergies can be inherited, however other sources do not support these findings.
During an anaphylactic reaction the body thinks a harmless substance is harmful and sends out an army of chemicals including histamine to combat the invader or "allergen". These chemicals are released throughout the whole body, including the lungs, mouth, eyes, throat, stomach, and skin, causing an allergic reaction in each area. The allergic reaction takes place on a cellular level. When the allergen enters the body, it stimulates the production of cells called B lymphocytes. Once the allergen locks onto the B
lymphocyte, the B lymphocyte then rapidly and repeatedly divides, creating hundreds of new cells called plasma cells that release substances called antibodies or immunoglobulins in massive amounts. These antibodies attempt to render allergens harmless in a number of different ways. If the allergen produces a toxin, for instance, the antibody may be able to directly neutralise the harmful substance. Or, antibodies can force enemy microbes together into a clump, allowing other immune system cells such as T lymphocytes to rapidly destroy them.
After the crisis that stimulated their release is over, antibodies circulate in the body for some time, then die off. At the same time that activated the B lymphocytes into producing antibodies, they also produced "memory cells". These cells can immediately recognise the specific allergen that first provoked their production. When that allergen re-enters the body, memory cells quickly stimulate an immune system reaction to mount
a quick response to try and destroy it as quickly as possible.
Most people who have had an allergic reaction first sense a feeling of foreboding - their body does not feel ‘right’. Early symptoms of anaphylaxis may include itchiness of palms or soles, faintness, feeling of generalised warmth, tingling, or metallic taste in the mouth, throat or chest discomfort, and breathing difficulty. Advanced symptoms of anaphylaxis may include facial swellings, hives, breathing difficulty, choking or coughing, vomiting or stomach upset, dizziness, loss of consciousness, diarrhoea, cramping and a drop in blood pressure. These symptoms can occur in as little as 5 to 15
minutes, but life-threatening reactions may progress over hours.
Here are how some people felt when they were having an anaphylactic reaction (taken from results of survey):
- Tiffany Sew Hoy (9) said, "In mild cases my mouth tastes funny. I get itchy around the mouth and lips, and it comes up in spots with swelling. In severe cases I vomit, swell up, can’t breathe and have an uncontrollable itch all over my body."
- Ms Clements said that her daughter, Claire (6 months), "Usually becomes distressed quickly (5 minutes). Gets itchy, welts on chest and groin, vomits."
- Ms McKenzie said that when her son, Chris (15) is in anaphylactic shock, he gets "swelling of the lips and tongue, throat. There is also a tightening of throat, and then he goes unconscious."
- Ms Tebble said this of her son, Michael (7), "When he has ingested the offending food, he will start to cough, produce lots of phlegm, swell up in the face, vomit - and without medication, stop breathing."
If you are having an anaphylactic reaction, get help immediately! It is critical that you avoid denying your symptoms and you should try to stop the reaction as soon as possible. You will need an epinephrine (adrenaline) injection to help stop the reaction. You must then immediately go to the nearest emergency room or hospital for treatment. Epinephrine buys you little time until they can get professional help.
People can protect themselves from an anaphylactic reaction by taking the following steps:
- Discuss their concerns including any serious reaction to medication with a board certified allergist.
- Educate themselves about the allergy.
- Read food labels. When in doubt about ingredients, don’t eat the food. Never assume anything!
Accidents are bound to happen. People should also take the following precautions to be sure they minimise their reaction:
- Carry a supply of epinephrine (adrenaline), available via prescription as an EpiPen® or AnaKit®, at all times.
- Keep epinephrine in several places, including the school and the baby-sitter's home if the patient is a child.
- Inspect the epinephrine kit and replace it if it has become discoloured or has reached the expiration date.
- People should teach themselves, and other family members how to use the
epinephrine kit. Practice until the directions for its use are second nature.
- Wear a Medic Alert® bracelet or necklace noting your allergy in case you become unconscious during a severe reaction.
The only treatment, once anaphylaxis is established, is an injection of adrenaline which restores the blood circulation. Any other medication is too slow. Adrenaline is available via prescription in the form as an EpiPen® or AnaKit®, and a supply should be carried by the sufferer at all times. There are also other medications which can be used in less severe cases, these include steroids, antihistamines, and cortisone.
If you suspect you are suffering from a serious allergic reaction, ask your doctor’s advice or an allergy clinic. You should be ready to answer a wide range of questions about your day-to-day life. Any of the following methods may be used to identify the cause of your allergy.
Case Histories
All investigations of allergy begin with a detailed case history. When you first go to an allergy clinic, the relevance of some of the information required will not always be obvious to you. However, a painstaking picture of your way of life, built up month after month, will provide valuable clues to diagnosis. Your case history would cover family history, the symptoms and their circumstances, your habits at home, your professional and leisure activities, your environment, your eating habits, and your general state of
health.
Even so, tracing the cause of an individual allergy is still far from straightforward. For example, there may be a number of contributing allergens, some inhaled and others eaten. You may consult a doctor about an isolated symptom but careful questioning may eventually reveal a much more complicated picture.
Skin Tests
Skin tests involve introducing into the skin (usually behind the forearm or on the back) a small quantity of very pure allergens and in known concentrations. There are three methods which are:
- Cuti-reaction or scratch-test: the doctor makes a tiny cut or superficial incision and then deposits a tiny drop of allergen inside.
- Intradermoreaction: the allergen is injected by syringe (with a very fine needle) under the skin. This is considered quite dangerous as there is a greater risk of anaphylactic shock.
- Prick test (the most common): this involves placing a drop of allergen on the skin and then making a tiny injection through it using a needle point.
In all three tests, very dilute preparations of allergens are used. In all three cases the reaction can be read after 20 minutes. If the reaction is positive, the medicine will observe a pimple, or tiny swelling, an erythema (redness) or pruritus (rash).
Blood Tests
The most common used blood test is the estimation of specific IgE (immunoglobulin E) in the blood. It involves detecting the presence of these antibodies directed against allergens present in the environment. IgE testing is carried out on a sample of blood serum taken from the patient by needle. There is no need to fast before the blood test. This method is based on the use of tiny confetti made of purified allergens. In the presence of the allergic patient’s serum, these allergens and the IgE serum will link up making an antigen-allergen complex. A very refined analysis technique will then reveal the reaction and determine how acute it is. One advantage of this method is that the patient does not have to come into direct contact with the allergen, therefore suffering less.
Inductive Tests
The principle behind the inductive test is to reproduce the symptoms of the allergic reaction by bringing the patient into contact with the suspected allergen. If the reaction occurs, it can be concluded that the allergen used is the culprit.
These induction tests are only carried out when there is a discrepancy between the case
study, skin tests and the results of the biological examination (e.g. specific IgE tests).
They must be carried out in special centres as their interpretation is difficult and they
may involve risk.
There are Support Groups available all around the world to assist and help people to cope with anaphylaxis. In Australia, we have the Food Anaphylactic Children Training and Support Association known as F.A.C.T.S.. The main objectives of Support Groups are to help people suffering form anaphylaxis and their families cope with the problem, and to offer advice as to how the problem should be handled. (Attached to this assignment is an information letter sent out by F.A.C.T.S. to new anaphylactic sufferers). I would also
like to add that 20 out of 21 of my respondents are members of F.A.C.T.S..
It is also possible for sufferers to get information and help through the Internet. For example, The Food Allergy Network at http://www.foodallergy.org and their email address is fan@worldweb.net.
If you should see someone having an anaphylactic reaction, you should attend to them immediately, as that persons life may be in danger. Here is what you should do:
- Lie the person down and raise the feet.
- Clear the airway and give oxygen by mask if available.
- Administer the Adrenaline auto-injector as instructed.
- Ring for ambulance and state clearly that the person is having an anaphylactic reaction and requires rapid transfer to hospital via Intensive Care Ambulance.
Teachers and students should be educated about anaphylaxis and be aware that this is life threatening. Teacher and students should be aware of who the child is that has anaphylaxis, and what that person is allergic to. The teachers should also be told what to do if an anaphylactic reaction occurs at school. When teachers give out sweets as treats, they need to be aware of the child with food allergies, so as not to give allergenic foods to these children. Also, when birthday parties are celebrated in the Class-room, the child with food allergies should not miss out in the celebrations because they can not share in the food. Perhaps, the birthday child’s parent could make provisions for the person with food allergies, or the anaphylactic child’s parent could bring in some food to replace that provided by the birthday person. Children with anaphylaxis should be given the opportunity to lead as normal lives as possible, as long as others around them are aware
and responsible. The School Canteen Manager and her staff also need to be educated about children who have food allergies, and explain what anaphylaxis is to them. They need to know the composition of the foods they sell, so that if a child asks, "Does it contain any dairy products?", they can answer knowledgeably. They might also carry a range of foods for people with food allergies, so that they are not discriminated against.
Overall, the response from my survey, indicated that most families make it clear to the rest of their family what food items are not allowed within the house or near the sufferer. Many people also said that they shop carefully to make sure the items do not contain the unwanted food. Here are some precautions in which anaphylactic sufferers take to prevent anaphylaxis happening at Home (taken from responses of survey):
- Mrs Sew Hoy said, "Everyone in the family is aware of what products contain dairy/peanuts. We all read the labels on food products. If anyone eats or handles the ‘allergic’ foods, we make sure their hands, offending area and all the utensils are washed thoroughly. We do not allow pets (e.g. dogs, cats) in the house (because of household dust, pollen, etc.). We also take our shoes off at the entrance of the house. The whole family eats very little dairy foods and only occasionally."
- Mrs Evans said, "Jake’s food gets cooked separately from ours. We keep a list on the fridge of the foods that Jake is allowed to eat."
- Mr Bartl said, "We read labels and avoid suspect foods if labelling is inadequate. Avoid exposure to the problem food."
- Ms Tebble indicated that, "Most of the time the products in our cupboard are safe for Michael and if on a rare occasion something he is allergic to comes into the house, we keep it out of reach, wash dishes twice to remove residue and also warn him not to touch it."
- Ms Burke said that in her home, "All utensils are used only once then washed. Hands are washed constantly. Dairy products are situated on top of shelf of fridge. Younger brother also has the same restrictions although he tests negative. No visitors are given dairy products."
- Mrs Yeates, Vice President of F.A.C.T.S. said, "We gave up drinking cow’s milk, soya milk is used instead. The fridge divided with a basket to notify Josh of dairy products. Biscuit tins and jars are labelled to help baby-sitters, etc.. The dishwasher is used to wash all pots and pans to completely eradicate any milk trace if used. Hands are washed
thousands of times a day to eliminate touch reaction. A medical kit with adrenaline and emergency plan is located on fridge."
The responses from my survey showed that most parents who have anaphylactic children, make it aware to the students and teachers of the school. Teachers are also trained in what to do in such a situation. Students of the school are notified and made aware that this child is unable to tolerate particular food stuffs, and to keep that food away from the child. Many respondents also indicated that medication is kept within the school in case of an emergency. Here are some precautions in which anaphylactic sufferers take to
prevent anaphylaxis happening at School (taken from responses of survey):
- Ms Burke said that when her son, Aston (5) is at school, he "..... only eats his own food. Other children sit down with him only if their food has been okayed by the teacher. He sits slightly away from the main group. All children are supervised with hand washing after food has been eaten. Special treats and spare food are kept at school especially for him."
- Ms Neville said, "Kate (7) eats only food provided from home - including birthday cakes kept in the freezer at school. She is only to attend the School Tuckshop if she is accompanied by her teacher who has a list of appropriate products. There is a photo of her in the Tuckshop and Staffroom, to indicate that she has anaphylaxis. All staff have been instructed in correct emergency procedure and all students are aware of Kate’s identity and condition. The attending teacher carries medication with them at all times and also carries a mobile phone. Spare medication is left in the Office. Kate wears a neck pendant with her name on the front, and ‘fatal allergy to egg’ on the back."
- Ms Wurth said that the school "..... has an EpiPen in School’s First Aid Cabinet. The Teachers are willing and prepared to use it. The Principal is aware of the situation. Each year I talk to Lucy’s new teacher. All teachers have watched the video ‘It only takes one bite’. Lucy’s classmates have seen ‘Alexander the Elephant who couldn’t eat peanuts’. A photograph of Lucy (6) and step by step instructions are on a laminated poster in the classroom. Lucy has a container of party food in a locker - she is given some of this food when other children bring in cupcakes, etc., for birthdays."
- Mrs Yeates said, "Joshua (7) is a remarkable little boy being very mature and responsible about his allergy since he started school. He never eats/shares other students food. Occasionally, he buys canteen food after thoroughly checking with me. He readily accepts other treats in replacement for chocolate and birthday cakes brought to school, i.e. from his special treat tin in classroom. He carries a medical kit with him in his school bag and/or everywhere he goes. he is well rehearsed in the emergency procedure and knows the EpiPen can save his life even though it may hurt a bit. He doesn’t really care that much about food, he loves life and knows if he comes across an obstacle with his allergy, we will endeavour to overcome it. There are also many discussions with his teacher."
- Mrs Sew Hoy said that precautions are taken by the school through the education of the staff and children. A ‘Emergency procedure’ poster is put up in the School’s Sick Bay so teachers know what to do. She also checks that the Medical Kit in the Sick Bay is always kept up to date with Phenergen, EpiPen, Ventolin, Atrovent, Medihaler, and Prednisone. Tiffany (9) is very aware and responsible about the foods she eats, and very rarely
purchases items from the Canteen, and then only after it has been carefully checked with her Mother. This is usually limited to icy-poles and lick sticks.
Many of the responses from the survey revealed that when at friend’s homes, the parents are made aware of the child’s condition and are told to take care with the handling of food. The child’s own food is taken to a new friend’s house, so as to reduce the risks. Here are some precautions in which anaphylactic sufferers take to prevent anaphylaxis happening with friends (taken from responses of survey):
- Ms Dwyer said "I always take Tristan’s (3) food with me when we go out and supervise him and other children eating. As well, I make their mothers aware of Tristan's problem. If they have been eating peanut butter sandwiches, I tell them to wash their hands when they finish."
- Ms Burke said that when Aston (7) is at friend’s "I make sure no dairy products are offered. He always takes a snack to the friend’s house, and he always had enough to share. He eats at home before he goes out. He never accept food unless it is first okayed by a parent."
- Mrs Sew Hoy said that when Tiffany (9) is with her friends, she tries to prevent anaphylaxis happening by the "..... education her friend and their parents. I usually make her own food for her so that she can take along (for parties, sleepovers, etc.). I like her to live a ‘normal’ life as possible. She always takes her Ventolin and Phenergen."
- Ms Clements said "All our close friends and family know of her allergies but need constant reminding. I stay near her (1½) as much as possible."
- Ms McKenzie said that when her son (15) is with friends, she makes sure "extreme care is taken with the purchase, preparation, and storage of food. She communicates with the friend’s parents. They are also instructed on the procedure for administering the medication."
Generally, the parents indicated that they took extra care when they are out with their children. They ask questions and when in doubt do not eat the food and pack their own food. Here are some precautions in which anaphylactic sufferers take to prevent anaphylaxis happening in Other Situations (taken from responses of survey):
- Mrs Yeates said, "Joshua (7) never eats restaurant food, he has a drink and we pack some special food treats for him to take. We now rarely eat at a restaurant for this reason, we prefer to do something else that is fun (like sport, picnic) for the whole family. At birthday parties Josh takes his own lunch box and does not eat the food at the birthday party. We have only travelled overseas once when he was 2½ years old. We ask specifically (with Dr’s letters, etc.) for a special diet for airline food, but we found we could not trust them. Luckily we took lots of our own food We also took a box of his favourite soya milk, which we were glad of because the US soya milk tasted very different."
- Mrs Evans said, "At restaurants we ask the waiter to ask the chef if egg and nuts are in the order that we have made for Jake. When we are shopping we have to watch Jake at all times."
- Ms Neville said that she "Always carries a mobile phone with a medication bag everywhere I go. At restaurants, I talk to chef before hand. W always our carry own snacks, etc.. We never rely on food on aeroplane. We do not go on holidays where medical services are not available or acceptable, e.g. Bali, Fiji, etc.."
- Ms Wurth said "We only order what we consider safe food - no experimentation. We would not trust waiter and chefs to fully understand the situation. Regarding overseas flights - we had a nasty incident on a flight from New Zealand. Lucy was given a container of food marked ‘no egg and nut’ (at our earlier request). Clearly the airline had thought we were just being neurotic. A snickers bar was included. Lucy ate a gingerbread (we thought it would be OK). However, she had a gastric attack."
- Dr Yang said "The ingredients of all food we eat outside the home must be given our satisfaction before Alexander (8) can eat them. If the ingredients cannot be known, then he cannot eat that food."
- Mrs Sew Hoy said, "When we travel, we always carry our Medical Bag with us, which contains her Nebuliser, and all the medication that is required for anaphylaxis, food intolerance, asthma, eczema. If we spend a day out, e.g. a Fun Park, we will take the Medical Bag with us. If we are going somewhere local, then we travel lightly - her Ventolin spray and a bottle of Phenergen. When she (Tiffany, 9) is out an about on her own, e.g. at gymnastics, she always carries her Ventolin and Phenergen. We find Chinese restaurants are the best restaurants to go to, as they rarely use dairy products, although they occasionally use peanuts or peanut oil - we usually ask before hand. We avoid Italian and Mexican foods where cheese is used a lot. We found a visit to a Dairy Farm and watching the cows being milked, produced an anaphylactic response. She will be going on her first Camp soon - a Band Camp! That will be a very nerve-wracking experience for us. She is so looking forward to going, we don’t want to stop her. Although I have advised the Teacher-in-Charge, I am sure I will have to follow this up very very thoroughly. Previously, when we went to the Department of Sport and Recreation Family Camps, the Catering Staff were very helpful. Although I brought her own special food along, e.g. her own dairy-free margarine, her own bottle of vegemite (so it is not contaminated with other people’s knives after touching butter, etc.), we found she could more or less eat the food provided. She was given special permission to always be served first so that the food would not be cross contaminated. I would say, she leads a very full life, and there is nothing she can’t do, provided the necessary precautions are taken."
Here are some suggestions as to ways in which we can raise community Awareness about anaphylaxis (suggestions compiled from results of survey):
- Mrs Yeates, Vice President of F.A.C.T.S. suggested that we could raise community awareness, "By speaking to all we come across in the wider community. By being frank and positive and connecting schools, Groups, etc., with others existing successfully. By using the media. F.A.C.T.S. did this approx. 3 years ago and has grown considerably since. (Originally we were 8 families on the Northern Beaches and now 75 families Australia wide). By speaking to food manufacturing companies when you call to check the ingredients - many are not aware of the potential hazards they pose to anaphylactics by not listing all components of a product’s ingredients."
- Ms Ruth Dwyer suggested that, "Obstetricians should make pregnant women who have a history of food allergies in their, or their husbands family aware that they must not eat peanuts during pregnancy to avoid their baby having a food allergy in particular a peanut allergy which is one they probably won’t grow out of."
- Ms Donnellan suggested that we should, "Lobby for food manufacturers to make them label items better (i.e. label all ingredients, even if they are in trace amounts). Lobby for retailers of takeaway food, hotels, and restaurants to provide ingredient lists of all food items. Lobby for government to have an anaphylactic awareness week to raise community awareness."
- Ms Rosemary Dwyer suggested that we should, "Find a high profile person who has a child with anaphylaxis and raise the community’s awareness on anaphylaxis, through interviewing them through the media. Continue having small articles published in papers as has happened in the past. Continue distributing information to child health sisters, nutritionists, GPs, and specialists."
- Mr Teghini suggested that, "Better food labelling by companies to make sure there are no dairy products in the food. Even the slightest amount of something should be labelled, just in case."
- Ms Tebble suggested, "Education in the schools where affected children attend, and in the workplaces of allergic adults."
- Ms Clements said, "It would be helpful if Workshops or in-house trainers could be available for Day- care/Pre-school/Occasional Care Centres, to inform staff about allergies and what to do in emergency situations - i.e. how to inject an EpiPen."
- Ms Hoppenbrouwer suggested that, "A brochure, short and simple should be available at pharmacies, doctors surgeries, possibly food outlets. This brochure should advise people that anaphylaxis is life-threatening and to warn people not to offer food to children without first checking with parents. One of my biggest worries/concerns are nice people who offer my child chocolate or biscuit (or whatever) because he’s cute or as a promotion."
- Ms Millward said that we can raise community awareness by using, "Newspaper articles and television programmes. However anaphylaxis is not a 'hot topic' and so there is little interest by others. We feel that awareness is raised when people have to deal directly with anaphylaxis. E.g. schools and pre-schools. Teachers and students are forced to learn more about allergies when a sufferer is left in their care or share a playground. We have found that some relatives and friends are keen to learn more about anaphylaxis, where as others treat it as a normal allergy and their attitude is 'they’ll grow out of it'. They are unwilling to accept the severity of these allergies."
- Mrs Sew Hoy suggests that "the cost of the EpiPen be lowered as to have it be more affordable, so parents of anaphylactic sufferers can use this as an emergency aid. At $100.00 per injection, with its use-by date of a few months (in most cases, a little less than a year), and the importance of at least carrying one with the sufferer at all times, PLUS have one at School, it often means at least $200.00 a year spent as a precautionary measure. Over the number of years in a sufferer’s life, this is a very costly exercise, although a very necessary one. However, if there could be some way of making it more affordable, then it would not cause such an economic strain on the parents who already have committed a lot of their time, care and expense on the sufferer."
Books
Brostoff, J., and Gamlin, L., (1989), The Complete Guide to Food Allergy and Intolerance, Bloomsbury publishing Limited.
Hibberd, J., (1995), The Great Allergy Detective Book, Bookman Press.
Mumby, K., (1993), The Complete Guide to Food Allergies and Environmental Illness, An Imprint of Harper Collins Publishers.
Rothfeld, G., and Levert, S., (1997), Natural Medicine for Allergies, Rodale Press, Inc.
Riches, H.R.C., (1990), Allergies, The UCB Institute of Allergy.
Smith, M., (1994), Allergies, Kyle Cathie Limited.
Steel, M., (1986), Understanding Allergies, Consumers’ Association and Hodder & Stoughton.
Pamphlets
Muñoz-Furlong, A., (1992), Just One Little Bit Can Hurt! Important Facts About Anaphylaxis, The Food Allergy Network.
Wood, R., and Muñoz-Furlong, A., (1993), Learning to Live With Food Allergies: Tips for Parents and Teens. Parent’s Guide, The Food Allergy Network.
Wood, R., (1993), Learning to Live With Food Allergies: Tips for Parents and Teens. Teen’s Guide, The Food Allergy Network.
I would like to thank the following people for taking the time to fill out my survey:
Mr Rudi Bartl,
Ms Eileen Burke,
Mrs Noreen Clarke,
Ms Kate Clements,
Ms Lisa Donnellan,
Ms Rosemary Dwyer,
Ms Ruth Dwyer,
Mrs Kim Evans,
Ms Jennifer Hoppenbrouwer,
Ms Leah McKenzie,
Ms Leeanne Millward,
Ms Margaret Neville,
Ms Dawn Pusey,
Mrs Maria Sew Hoy,
Ms Roslyn Teblle,
Alessandro Teghini,
James Uden,
Ms Barbara Whitaker,
Ms Megan Wurth,
Mr Hung Yang,
Mrs Julianne Yeates, Vice President of F.A.C.T.S. Assos. Inc.
I would also like to especially thank Mrs Julianne Yeates, Vice President of F.A.C.T.S. Assos. Inc., who referred many of the above people to me, and gave me information, such as pamphlets and papers about anaphylaxis.
If you have any comments or questions please 
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What is Anaphylaxis?