Canadian and British allergist societies have issued a statement setting out precautions and patient selection considerations that are important for safety with oral immunotherapy (OIT) or with baked milk or egg introduction.
The statement follows recent news of the anaphylaxis death in May 2021 of 9-year old Canadian girl Brooklyn Secor, who was following a desensitisation protocol – eating a small daily amount of muffin crumbs containing baked milk – with the aim of reducing her sensitivity to milk.
Media reports state the family was following an allergist’s instructions for Brooklyn’s daily doses and the trial had gone well for six months. Her asthma flared up during the night of May 19, 2021, and sadly, after eating her dose of muffin crumbs the following day, Brooklyn suffered a fatal anaphylactic reaction.
The statement issued by the Canadian Society of Allergy & Clinical Immunology (CSACI) and the British Society of Allergy & Clinical Immunology (BSACI) is intended to remind people of the risk for severe food allergy reactions with desensitisation management options.
The guidance covers: initial, supervised allergen introduction and the medical clinic setup for that; informed written consent regarding risks; having a plan for home dosing; and patient selection, with details on asthma control, understanding of adrenaline use, and who is not a good candidate for OIT.
In releasing the statement, President of the BSACI Dr. Graham Roberts also mentioned the potential benefits of desensitisation treatment, through which a child’s diet and quality of life can be greatly improved. He says it is for health-care practitioners to select the right candidates for such an approach and to provide appropriate supervision.