Allergists, immunologists and health care professionals from around the world convened at the American College of Allergy, Asthma & Immunology (ACAAI) annual meeting Nov. 6-10 in Atlanta, addressing recent allergy and asthma research while branching out into related disease states such as eczema, urticaria, COPD and hereditary angioedema.
The annual meeting opened with the news that Allergy & Asthma Network is partnering with ACAAI to help patients manage their chronic condition while updating health care professionals, pharmacies and government officials on advocacy issues and current best practices.
The collaboration agreement includes educational activities and resources tailored to patients, allergists, convenient care clinics, pediatricians and pharmacies.
On Nov. 8, Allergy & Asthma Network and ACAAI hosted free asthma screenings prior to the New York Knicks-Atlanta Hawks basketball game at Philips Arena in Atlanta. More than 180 children and adults underwent spirometry and FeNO breathing tests for asthma and consulted with allergists.
Volunteers from Atlanta Allergy & Asthma Clinic, Georgia Pediatric Pulmonology Associates and Not One More Life, an advocacy organization that provides asthma education for inner city residents, helped conduct the screenings.
ACAAI’s annual meeting included a new study revealing the encouraging news that emergency supplies of epinephrine in schools save lives. The study took place in Chicago Public Schools, the first large urban school district in the United States to implement a stock epinephrine policy.
Researchers discovered that 38 school-aged kids and adults in Chicago Public Schools were given epinephrine during the 2012-13 school year. More than half of the reactions were first-time incidents and many of the students were not aware they had a severe allergy.
“Many children are trying foods for the first time at school and therefore it is critical that schools are prepared for a possible anaphylactic reaction,” says Ruchi Gupta, MD, MPH, lead study author and associate professor of pediatrics at Northwestern Feinberg School of Medicine’s Center for Healthcare Studies.
Illinois is one of 45 U.S. states to require or allow schools to stock emergency supplies of epinephrine auto-injectors and allow school nurses or designated personnel to administer epinephrine to students experiencing anaphylaxis. Epinephrine is the first line of treatment for anaphylaxis, a severe allergic reaction to food, insect venom, latex or medications. If there’s a delay in administering epinephrine, the risk of fatality greatly increases.
Find out where your state stands with stock epinephrine legislation.
ACAAI’s meeting also included a daylong session on allergic skin conditions including eczema, urticaria, atopic dermatitis and contact dermatitis.
Allergists and dermatologists discussed different causes of eczema and when it may be a sign of a more serious problem. They compared treatment options and reviewed ways to advise patients to avoid allergens and ensure compliance with the treatment plan, such as offering lists of products that are safe to use.
Another study presented at the conference addressed allergic responses that occur to various asthma and allergy medications as well as adverse reactions to topical skin preparations.
Allergy to a topical corticosteroid may not be evident right away because the allergic reaction may mimic symptoms it is supposed to treat, says allergist Luz Fonacier, MD, of Winthrop University Hospital in Mineola, N.Y. “Patients should suspect an allergy to medication if the rash does not respond, gets worse with medication, or improves initially and then flares,” she adds.
Other topical medications that can cause allergic reactions are antibiotics such as bacitracin and neomycin, topical anesthetics and antifungals.
The most common medication allergy involves penicillin – but it’s not as common as people think. People who believe they have a penicillin allergy should consult an allergist and undergo skin testing.
Studies revealed more than 94 percent of people who think they are allergic to penicillin tested negative for the allergy, meaning they have been limiting their antibiotic choices and using alternatives that may be less effective and more expensive.
“When you are told you have an allergy to something, it’s important to be seen and tested by an allergist, who has the specialized training needed for accurate diagnosis and treatment,” says allergist James Sublett, ACAAI president. “If you’re truly allergic to a medication, your allergist will counsel you on an appropriate substitute.”
Several ACAAI sessions addressed the difficulty in diagnosing COPD (chronic obstructive pulmonary disease) and how it differs from asthma despite many overlapping symptoms such as coughing, wheezing and shortness of breath. Patients with severe COPD experience more respiratory complications than patients with asthma.
Cigarette smoking is regarded as the leading cause of COPD in the United States and symptoms most often begin after the age of 40.
“In every patient, but in older patients in particular, we need to take a thorough medical history and perform a physical examination, as well as measurements of lung functions,” says William Busse, MD, professor in the Division of Allergy and Immunology at the University of Wisconsin School of Medicine and Public Health. “In patients with COPD and asthma, the changes in lung function may be severe, and it is not often readily apparent. Treatment will differ depending on diagnosis.”