5 September 2022

A new study published in the Journal of Paediatrics and Child Health has found regional and remote Australian hospitals are not adequately equipped to handle the rise of instances of childhood anaphylaxis.

Anaphylaxis is a serious, and potentially fatal, allergic reaction. Symptoms include an itchy rash, swelling of the tongue and/or throat, shortness of breath, vomiting, light-headedness, low blood pressure, and medical shock. Most people who are at risk of anaphylaxis carry a dose of epinephrine – most commonly known as an EpiPen or AnaPen. 

The research, conducted over seven years, shows that childhood anaphylaxis in 0–18-year-olds is largely caused by foods (44%). It further showed a higher-than-normal proportion of anaphylaxis caused by insect bites/stings (21%).  Food allergy is also on the rise, with the proportion of anaphylaxis related to food reactions increasing by 20% over the 7 years. 

Despite this, significant gaps remain in evidence-based anaphylaxis care at regional and remote hospitals, including:

• lack of administration of adrenaline autoinjectors
• workforce shortages
• poor referral patterns to allergy clinics
• lack of anaphylaxis action plans and follow-up allergy tests, compared to metro areas where almost half of anaphylactic children were referred for allergy services
• about a quarter were given adrenaline autoinjectors on discharge
• not easy to access specialist allergy referral services

Dr Heinrich Weber, RACP Fellow and an author of the paper said, “It is pretty concerning that research is showing that almost a third of children in Australia live outside the major cities of Australia and rural and regional centres are generally not adequately equipped to deal with children requiring specialist allergy services. And it's clear rural and regional healthcare isn't resourced for this kind of load.

“There’s a pressing need for improved anaphylaxis recognition, allergy investigations and treatment implementation guidelines in regional areas. 

“If these shortfalls aren’t remedied, they’re likely to result in increased morbidity due to factors such as the remoteness of healthcare services, issues accessing specialist allergy services and critical medications.

“Most anaphylaxis studies only focus on urban areas. We need to focus overdue attention to regional and remote areas, and ensure that children with anaphylaxis and their families can access proper treatment and support.”