Clinical Allergy

COVID-19/Coronavirus

This is a fast moving situation and we will try and update this website with relevant new information as it becomes available. All non-urgent outpatient clinics and much day-case activity (e.g. Omalizumab injections/allergy desensitisation/allergy challenges) have been cancelled due to the coronavirus pandemic. Depending on the availability of staff due to redeployment to other departments and sickness, we may be able to provide a limited service. This will generally be over the phone, video call or in exceptional circumstances in person. If patients have had an appointment cancelled then patients can expect to receive a new appointment after normal services resume. Patients should please contact the department on 0117 4148392 or 0117 4148393, or at allergyandimmunology@nbt.nhs.uk if they feel that their medical problem is urgent.

Information on allergies/COVID-19 is available from a patient organisation called Allergy UK at https://www.allergyuk.org/. The BSACI (British Society for Allergy and Clinical Immunology) have made recommendations for modifications to adult allergy services during the COVID-19 pandemic which is accessible at https://www.bsaci.org/announcements/modifications-for-adult-allergy-services-during-covid-19-pandemic and our actions in relation to our service are in keeping with this advice. Information for patients on Omalizumab from the British Association of Dermatologists may be found at https://www.bad.org.uk/shared/get-file.ashx?itemtype=document&id=6659.

Please access the government coronavirus website for general information and recommendations on coronavirus at https://www.gov.uk/coronavirus.

Clinical Allergy Service

We run regular Adult Allergy (and Immunology/Immunodeficiency) clinics on Tuesday mornings, Thursday afternoons, and all day Friday seeing patients referred (see Patient Referral Pathways) to our service with suspected or confirmed allergic disease. Criteria and advice for whom to refer can be found on the Remedy website at https://remedy.bnssgccg.nhs.uk/media/1337/immunology-referral-guidance.pdf. We see patients in our Adult Allergy service with the following conditions:

  • Anaphylaxis
  • Uncontrolled rhinitis (e.g. hayfever)
  • Bee or wasp allergy
  • Drug and anaesthetic allergy
  • Food allergy
  • Urticaria and/or angioedema
  • C1 esterase inhibitor deficiency (Hereditary Angioedema)

Please note we do not see patients for:

  1. “Patch testing” (e.g. for eczema, contact hypersensitivity) – please refer to Dermatology.
  2. Lactose or food “intolerance” as we do not have expertise in these conditions.
  3. Myalgic encephalomyelitis (ME), chronic fatigue, or fibromyalgia as we do not have expertise in these conditions.
  4. Mast cell activation disorders as we do not have expertise in the management of these conditions.

Our service also performs:

  • Sublingual and subcutaneous desensitisation
  • Omalizumab injections for chronic spontaneous urticaria
  • Drug and food allergy challenges
  • Drug desensitisation

Alert: Emerade autoinjectors recall

The below message is relevant to patients and for carers of patients who carry an Emerade adrenaline autoinjector. We have also written to all GP practices we have on our database and patients for whom we have a record of having prescribed an adrenaline autoinjector in approximately the last 5 years.

This alert refers to three drug alerts which have been raised by the Medicines and Healthcare products Regulatory Agency (MHRA) on 4th March 2020, 7th April 2020 and 18th May 2020 recalling all Emerade adrenaline autoinjector pens. These alerts can be viewed at:

Testing of all strengths of Emerade autoinjectors (150, 300 and 500 mcg doses) indicate that approximately 13% of pens need higher than normal force to activate, implying a higher risk of activation failure than was previously understood. This has led to sequential withdrawal of each strength of Emerade autoinjector and a recommendation of replacement with an alternative adrenaline autoinjector brand (e.g. Jext or Epipen). Patients should contact the prescriber of their Emerade autoinjector to arrange this. GPs should inform patients of this alert and arrange for replacement of their Emerade adrenaline autoinjectors. Appropriate training in alternative adrenaline autoinjectors should be provided (in person, with product instructions leaflet, or online (on the manufacturer’s website)). Obtaining a ‘trainer pen’ free of charge from the manufacturer website is encouraged. Old Emerade autoinjectors should be returned to pharmacies after obtaining alternatives, but patients should not break self-isolation to do so.

 

Last updated 30/06/2020