How long will the needs last?

Allergy and anaphylaxis Duration Guidance

This guidance covers -:

Food Allergy with a risk of anaphylaxis where a moderate functional restriction is identified or a severe functional restriction is identified because the child has more than 2 specific food allergies

The risk of anaphylaxis continues for many years, often into adulthood. Children at risk of anaphylaxis aged 3 to 8 will require extra care and supervision to avoid anaphylaxis until they are 8. At age 8 they can be expected to avoid allergens and communicate reliably with adults about their allergy. Constant supervision or care from another person will probably not prevent reactions beyond this age even where multiple food allergies are present. The child could be expected to understand their condition, cooperate with avoidance measures and can always choose to be safe by not eating.

Time limited awards are recommended to age 8 in moderate functional restriction. Extension of care needs beyond age 8 will be unusual. Such needs are only likely when the child has developed more severe allergy and now has a severe functional restriction or because the child has learning or behavioural difficulties that prevent them from practicing allergen avoidance for themselves.

Time limited awards are recommended to age 8 in severe functional restriction caused by multiple food allergies. This is because the child can be expected to cooperate with avoidance measures taken by their carers and practice avoidance themselves by age 8. Extension of care needs beyond age 8 will be unusual. Such needs are only likely when the child has developed more severe allergy and now has a severe functional restriction for another reason other than multiple food allergies or because the child has learning or behavioural difficulties that prevent them from practicing allergen avoidance for themselves.

Food Allergy with a risk of anaphylaxis where a severe functional restriction is identified due to the co-existence of severe asthma, previous PICU admission or reactions to environmental food allergens.

Children who react to environmental contamination with anaphylaxis may require care or supervision beyond age eight. These are children with severe functional restrictions. How much care is required can be determined from medical evidence from the treating specialist or the school. If continuing needs are identified, a renewal should be conducted at the 12th birthday. This is because at 12 many children who are at risk due to severe asthma will have much improved; those that have not improved could be expected to substantially manage their own asthma and their own Epipen in most cases. Children who still have anaphylaxis related to environmental contamination may still require help or supervision beyond this age because they have behavioural or learning difficulties or may require someone to accompany them outside the home because of their allergy – there should be medical evidence available to confirm that this is necessary.

Idiopathic (of no known cause) anaphylaxis

Medical evidence from the treating hospital consultant will confirm the diagnosis, frequency and severity of anaphylaxis and care needs. Some children will be unable to use their adrenaline autoinjector in time because of the rapid onset of their reactions. Others will be able to do this for themselves from the age of 12. Duration of award should reflect the medical evidence from the treating doctor.

Latex allergy

Severe latex allergy with anaphylaxis from environmental latex is now rare in children. Anaphylaxis due to latex allergy is most likely to occur, in the current generation of children, during hospital or dental treatment. The diagnosis and the severity should always be confirmed by seeking medical evidence from the treating consultant. Awards are recommended until age 12 and should be guided by the medical evidence from the treating doctor.

Insect venom allergy bee sting/wasp sting

Although this type of allergy carries a risk of anaphylaxis there are no additional care or mobility needs associated with it. This is because contact with insects is not an unavoidable part of every day life. Carrying the adrenaline autoinjector out of doors and providing emergency treatment in the unlikely event of an insect sting will not be onerous or time consuming.

Pet dander

Anaphylaxis to pet dander is very rare. Pet dander can be avoided.

Drug allergy

Some drugs cause allergic reactions ranging from a rash to anaphylaxis. Many more people think that they are allergic to penicillins than actually have the allergy. Assessment by an allergy specialist will clarify this. Although this type of allergy carries a risk of anaphylaxis there are no additional care or mobility needs associated with it. This is because the drug in question can be avoided. Carrying an adrenaline autoinjector is not necessary.

Hay fever or allergic rhinitis

Hay fever is caused by an allergic reaction to airborne plant allergens such as grass or tree pollen. Symptoms include sore itchy, red watering eyes and similar nasal symptoms. These symptoms are annoying but there is no risk of anaphylaxis. Extra care and supervision is not required.

Oral allergy syndrome

Oral allergy syndrome is a condition that only occurs in people with bad hay fever. It is a mild form of allergy. People with this condition develop allergic reactions to certain fruits during the hay fever season. The reaction to fruits includes lip swelling from eating the fruit or touching it to their lips. These symptoms are annoying but there is no risk of anaphylaxis. Extra care and supervision is not required.

Other conditions that may be claimed under allergy and anaphylaxis

All information must be taken into account when considering the duration of care and mobility needs. The duration of care and mobility needs must be based on the particular circumstances of the child.