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Information updates

New ASCIA Chronic Rhinosinusitis Position Paper

Chronic Rhinosinusitis (CRS) is one of the most common chronic conditions worldwide, with a significant health-economic impact.  CRS is generally subclassified into two dominant subgroups:

  • CRS with Nasal Polyps (CRSwNP), and
  • RS sine (without) NP (CRSsNP).

CRS with Nasal Polyps (CRSwNP) is a Type 2 (T2) inflammatory disorder and has a significant impact on quality of life which is further reduced if other atopic diseases and asthma are also present. Whilst intranasal corticosteroids (INCS) and saline irrigation are safe and effective for long term use in patients, many patients with CRSwNP remain suboptimally controlled and require surgical management.  As new medical therapies are becoming available, a rational approach to appropriate, equitable, and cost-effective treatment is required.

A Position Paper has been developed to provide an overview of CRSwNP and provide a framework for management that includes newer biological therapies. It is available at www.allergy.org.au/hp/papers/crswnp 

This Position Paper was developed by the Australasian Society of Clinical Immunolgy and Allergy (ASCIA) and the Australian Society of Otolaryngology Head & Neck Surgery (ASOHNS) Working Party, comprising: A/Prof Raewyn Campbell, Prof Richard Harvey, Prof Connie Katelaris AM (Chair), Prof Michaela Lucas, Dr Kathryn Patchett, A/Prof Janet Rimmer and Prof Ray Sacks.

This news item was issued on 26 November 2021 by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak professional body for clinical immunology and allergy in Australia and New Zealand.

 

 

Parliamentary Inquiry Report

The Standing Committee on Health, Aged Care and Sport has tabled its report ‘The New Frontier: Delivering better health to all Australians’, following the Parliamentary Inquiry into approval processes for new drugs and novel medical technologies in Australia. 

The three main issues raised in the ASCIA submission to this Parliamentary Inquiry (access to treatments, genomic testing and newborn screening for SCID) that were presented on behalf of ASCIA by Prof Connie Katelaris AM, Prof Jo Douglass and Dr Melanie Wong have been included in the report.

Access to treatments was included in several recommendations and the other issues are specifically mentioned in recommendations 2 (genomic testing) and 21 (newborn screening).  

A link to this report can be found at https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/Newdrugs/Report

The ASCIA submission to this Parliamentary Inquiry was lodged in November 2020 and can be found at https://www.allergy.org.au/ascia-reports#s1

This news item was issued on 26 November 2021 by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak professional body for clinical immunology and allergy in Australia and New Zealand.

New Anaphylaxis Clinical Care Standard

New standard of care to manage anaphylaxis will save lives

A new Acute Anaphylaxis Clinical Care Standard has been developed by the Australian Commission on Safety and Quality in Health Care, in consultation with consumers and healthcare professionals, and is now available online at https://www.safetyandquality.gov.au/standards/clinical-care-standards/acute-anaphylaxis-clinical-care-standard.

The Anaphylaxis Clinical Care Standard was launched today, 24th November, via a live one-hour webcast event. Medical experts, including Dr Preeti Joshi, discussed barriers to prompt recognition of anaphylaxis, appropriate treatment, safe discharge and best practice care after anaphylaxis.  

The National Allergy Strategy, ASCIA and Allergy & Anaphylaxis Australia (A&AA) have been represented on the expert working group run by the Commission, to support the evidence review, development and launch of the Clinical Care Standard, which is consistent with ASCIA Guidelines for Acute Management of Anaphylaxis. To access the ASCIA Guidelines go to www.allergy.org.au/hp/papers/acute-management-of-anaphylaxis-guidelines

Download a copy: Acute Anaphylaxis Clinical Care Standard

Media releaseNational standard of care for anaphylaxis will save lives

This news item was issued on 24 November 2021 by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak professional body for clinical immunology and allergy in Australia and New Zealand.

 

COVID-19 Vaccination Update

COVID-19 vaccination is an important way to reduce the risk of developing COVID-19, which is caused by infection with the SARS-CoV-2 coronavirus. Even if a person does get infected, it is likely to be a milder illness if they have been vaccinated.

Once there is a very high level of COVID-19 vaccination in the population, this can allow travel, work, schools, social activities and in person retail shopping to resume.

From an allergy perspective the only contraindication to COVID-19 vaccination is documented anaphylaxis to a previous COVID-19 vaccine or documented anaphylaxis to one of the components (excipients) contained in COVID-19 vaccines. There is limited use for skin testing to COVID vaccines and their excipients.

Anaphylaxis to vaccines is rare, and almost always occurs within 30 minutes of vaccination. Most people who have anaphylaxis to one type of COVID-19 vaccine will be able to have one of the other types of COVID-19 vaccines.

The seriousness of the COVID-19 pandemic and health consequences mean that medical exemptions under the 'other specified medical condition' category are generally not issued. 

Clinical immunology/allergy specialists are strong advocates for vaccination.  Due to current waiting times of at least six months for appointments to see clinical immunology/allergy specialists, discussions about the numerous benefits and rare risks of COVID-19 vaccination may delay timely vaccination, and people seeking medical exemptions should be aware of the health consequences.

Further information is available from the ASCIA website

https://www.allergy.org.au/patients/covid-19

 

 

Approval for COVID-19 vaccine booster doses

Updated 4 January 2022

Since 11 October 2021, Australians who are severely immunocompromised have been able to receive a third COVID-19 vaccine dose to boost their protection against COVID-19 to the highest level.

Since late October 2021 booster doses of COVID-19 vaccines for individuals 18 years and older have been approved. Whilst the original approval was a third booster dose provided at least six months after the completion of a COVID-19 vaccine primary course of two doses, this has been changed in January 2022 to four months in Australia and New Zealand.

Approval of booster doses means that COVID-19 vaccines have been found safe and effective to boost protection for individuals aged 18 years and older through a third booster dose provided after the completion of a COVID-19 vaccine primary course of two doses. The primary course can be any of the COVID-19 vaccines registered for use in Australia or New Zealand. 

People remain fully vaccinated with two doses of approved COVID-19 vaccines and the commencement of booster doses will provide additional protection and peace of mind for Australians and New Zealanders.

Further information: 

https://www.allergy.org.au/about-ascia/info-updates/third-covid-19-vaccine-shot-recommended-for-people-who-are-severely-immunocompromised

https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/tga-approval-for-pfizer-covid-19-vaccine-booster-dose-0

 

National Allergy Strategy Updates

The National Allergy Strategy is a partnership between ASCIA and Allergy & Anaphylaxis Australia. Several new and updated National Allergy Strategy resources have recently been launched, which are listed below. 

  • NEW Allergy Aware Resource hub
    • This resource hub contains the new National Allergy Strategy Best practice guidelines for anaphylaxis prevention and management in schools and children’s education and care (CEC) services and supporting resources, along with links to A&AA and ASCIA resources for the school and CEC settings.
    • This resource hub is for staff working in schools and children’s education and care services as well as for parents/guardians and students.
  • UPDATED All about Allergens course – food allergen management training for all staff working in food service. This course has been revised to suit staff that work in both front of house and back of house. It is an interactive course that takes about 45 minutes to complete.
  • UPDATED All about Allergens for Cooks and Chefs – this course has been revised to be a single stand-alone course for cooks and chefs. It is an interactive course that takes about 1 hour to complete.
  • NEW All about Allergens Resource hub – This new resource hub provides resources to help those working in food service to provide appropriate food to customers with food allergies. Freely downloadable resources and templates are available for general food service, hospital food service and food service in schools, CEC services and camps.
  • NEW My Health Record and allergy podcasts for health professionals and consumers. The National Allergy Strategy has worked with the Australian Digital Health Agency to develop podcasts for health professionals and consumers about My Health Record and allergy information. The podcasts feature Maria Said, CEO of A&AA along with Dr Dean Tey (paediatric clinical immunology and allergy specialist), Dr Aaron Chambers (GP) and Dr Charlotte Hespe (RACGP) and facilitated by Dr Andrew Rochford.

Stay up to date with NAS projects via their website

Third COVID-19 vaccine dose recommended for people who are severely immunocompromised

The Australian Technical Advisory Group on Immunisation (ATAGI) has released a statement, prepared in consultation with ASCIA, which recommends a third primary dose of COVID-19 vaccine for people who are severely immunocompromised. This includes people with primary immunodeficiencies (PID) disorders, also known as inborn errors of immunity (IEI).

.The ATAGI statement is available at:

https://www.health.gov.au/news/atagi-statement-on-the-use-of-a-3rd-primary-dose-of-covid-19-vaccine-in-individuals-who-are-severely-immunocompromised

The following ASCIA documents have been updated to include the ATAGI recommendations:

The recommended interval for the third dose is two to six months after the second dose of vaccine. People with PID/IEI who had a second dose more than six months ago should receive a third dose whenever this is feasible.

In summary the ATAGI recommendations state that a third primary dose of the COVID-19 vaccine is recommended for people with the following immunocompromising conditions and/or therapies:

  • Primary immunodeficiency (PID) disorders, also known as inborn errors of immunity (IEI),
    including combined immunodeficiency and syndromes, major antibody deficiency (e.g. common variable immune deficiency (CVID) or agammaglobulinemia), defects of innate immunity (including phagocytic cells), defects of immune regulation, complement deficiencies and phenocopies of PID/IEI.
  • Some immunosuppressive therapies.
  • Haematopoietic stem cell transplant (HSCT) or chimeric antigen receptor T-cell (CAR-T) therapy recipients within 2 years of transplantation.
  • Solid organ transplant with immunosuppressive therapy.
  • Active haematological malignancy.
  • Non-haematological malignancy with current active treatment excluding immunotherapy with immune checkpoint inhibitors.
  • Advanced or untreated HIV with CD4 counts <250/μL or those with a higher CD4 count unable to be established on effective antiretroviral therapy.
  • Long term haemodialysis or peritoneal dialysis.

ASCIA will continue to provide advice to ATAGI on the use of COVID-19 vaccines in people who are severely immunocompromised. 

ASCIA will also continue to update ASCIA COVID-19 information as recommendations and restrictions evolve.

In anticipation of lockdowns easing the following updated pictorial checklist has been developed, which is included in the COVID-19 and Immunodeficiency FAQ:

The following ASCIA COVID-19 information has also been recently updated, to include the Moderna Spikevax vaccine:

 

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New allergy guidelines for schools and children's education/care

Best practice guidelines for prevention of severe allergic reactions (anaphylaxis) in schools and children's education/care (CEC) services were launched on Thursday 7 October 2021. The Guidelines were developed by the National Allergy Strategy (NAS), a partnership between ASCIA and Allergy & Anaphylaxis Australia (A&AA).  

The Guidelines are available on a new anaphylaxis resource hub for schools and CEC services https://www.allergyaware.org.au/ and can also be accessed on the ASCIA website https://www.allergy.org.au/schools-childcare

ASCIA and A&AA contributed to the NAS resources and also updated or developed online resources and training courses to include and support the best practice guidelines. This has been a great collaboration and team effort by NAS, ASCIA, A&AA and stakeholders, to achieve nationally accepted best practice guidelines.

The virtual launch was well attended by stakeholders and media. The feedback was extremely positive, and there was significant media coverage, including the following media stories:

Today show – https://www.facebook.com/page/130834060284601/search/?q=nuts
9 News - https://www.9news.com.au/national/nut-ban-could-be-scrapped-at-australian-schools-due-to-new-allergy-guidelines/75a90fff-a5e1-46e0-b690-9ec57d06313d
ABC news - https://www.abc.net.au/news/2021-10-07/food-allergy-guidelines-recommend-education-not-bans/100520428
7 news - https://7news.com.au/lifestyle/health-wellbeing/new-guidelines-say-education-not-bans-the-key-to-managing-food-allergies-c-4174123
SMH - https://www.smh.com.au/national/food-bans-in-schools-discouraged-in-new-allergy-strategy-20211006-p58xmn.html
Daily telegraph - https://www.dailytelegraph.com.au/news/nsw/banning-the-ban-why-nuts-could-be-allowed-back-in-schools/news-story/836d93431ae0112437c453bb76171117

Media Release - New allergy guidelines to protect children from severe allergic reactions in schools and childcare

Food allergy and anaphylaxis is increasing in Australian children, with up to 1 in 20 school aged children having food allergies [1]. Anaphylaxis is the most severe form of allergic reaction, and the incidence of food-induced anaphylaxis in Australia has risen rapidly over the last decade [2]. New guidelines and resources from the National Allergy Strategy aim to equip schools and children’s education and care (CEC) settings to prevent and manage anaphylaxis.

The National Allergy Strategy has launched best practice guidelines for the prevention and management of anaphylaxis in schools and children’s education and care, including out of school hours care. Developed in consultation with key stakeholder organisations, staff working in the sector and parents, the guidelines are important resources in providing evidence-based information and support to reduce the risk of anaphylaxis, while also enabling children to participate in all activities.

“The reality is that severe allergy and the risk of anaphylaxis is common in the school and children’s education and care settings. Children with known allergies that are at risk of anaphylaxis may have severe reactions, but they can also occur in children not previously known to be at risk of anaphylaxis,” stated Maria Said, Co-chair of the National Allergy Strategy and CEO of Allergy & Anaphylaxis Australia (A&AA). “The new guidelines and supporting resources provide much-needed clarity around best practice.”

“Australia is a leader in this area, however a review of school policies and guidelines across Australian states and territories showed inconsistencies in anaphylaxis prevention and emergency treatment, particularly around the amount and frequency of staff training and incident reporting [1]. These variations create confusion and anxiety for parents and educators in schools, and ultimately put children’s safety at risk. While the sectors have a lot of demands on them, no one wants to live with a tragic incident that could have been prevented,” continued Ms Said.

In schools, there is currently no national mandated approach to training staff in the prevention, recognition and emergency treatment of anaphylaxis and significant variations exist in the approach between jurisdictions and government and non-government school sectors.

In children’s education and care services, the minimum requirements are less than what is required in schools and there is greater variation in the type and amount of training being undertaken. Research has shown that 1 in 10 participating services reported no requirement for staff to undertake anaphylaxis training, which is non- compliant with current national regulations [3]. Staff responsible for preparing, serving and supervising meals in children’s education and care services also have a responsibility for food allergy management, yet there is no requirement for them to undertake food service allergen management training.

To support the adoption of the guidelines, the National Allergy Strategy has also developed a new ‘Allergy Aware’ online hub for staff working in schools and CEC, providing free, evidence-based resources including an Implementation Guide, templates and sample documents, plus links to state and territory specific information. The Allergy Aware hub also includes sections for parents and older students.

Dr Preeti Joshi, a paediatric clinical immunology/allergy specialist and Co-chair of the National Allergy Strategy, says the new guidelines and supporting resources outline what is reasonable and what works.

“It is important to embed consistent standards across all of the environments where children receive care so that everyone is informed and knows what is appropriate and reasonable. As an example, the guidelines might give a school the confidence to discuss appropriate allergy management with a concerned parent, or help a parent discuss what reasonable strategies a school or childcare service should have in place,” said Dr Joshi.

“Trying to completely ban food allergens in these settings simply does not work and is near impossible to enforce. It is not safe or practical to rely on people to not bring food allergens, of which there are many, into a certain environment. A consistent allergy aware approach with age-appropriate strategies is preferred. This includes ensuring staff are adequately trained, especially in the prompt recognition and treatment of an allergic reaction including anaphylaxis,” continued Dr Joshi.

“In addition, a range of appropriate risk minimisation strategies alongside good supervision and open communication is important. Things such as timely administration of adrenaline and correct positioning of the person experiencing anaphylaxis are key factors that can potentially save lives. Standardised reporting of incidents is also critical so we can learn where the gaps are and then work to increase safety. We are prevented from learning and improving after incidents because currently it is not mandatory to report them in schools and childcare services across Australia.”

The guidelines can also be used by overarching education and children’s education and care bodies, when reviewing and updating state and territory legislation, guidelines, policies and procedures to improve standardisation of anaphylaxis management across Australia.

Dr Katie Allen MP, food allergy expert and Member for Higgins – “Australia does not take a back seat when it comes to safety from anaphylaxis in schools and children’s education and care. These guidelines ensure that best practice is standardised across each state and territory. I welcome the work of the National Allergy Strategy in making these guidelines a reality”

The new guidelines and supporting resources are available at www.allergyaware.org.au.

pdfNAS Best practice guidlenes media release226.19 KB

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About the National Allergy Strategy
The National Allergy Strategy (NAS) aims to improve the health and quality of life of Australians with allergic diseases and minimise the burden of allergic diseases on individuals, carers, healthcare services and the community. The NAS is a partnership between the Australasian Society of Clinical Immunology and Allergy (ASCIA) and Allergy & Anaphylaxis Australia, the leading medical and patient organisations for allergy in Australia. For more information about the NAS go to: www.nationalallergystrategy.org.au

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