COLLEGE OF MEDICINE AND HEALTH
Medicine, Nursing and Allied Health Professions

Bill Vennells, GP, talks about Stepping up to Paediatric and Adult Allergy 2017 in our blog

"Hello, is everybody awake?" asked the facilitator of our workshop after lunch. Actually everyone was quite alert and ready to get on, probably because the workshops were an opportunity for discussion amongst the multi-disciplinary group.

The various disciplines all had a different angle on the subject. It is worthwhile to know how other community and hospital departments operate. Sharing my GP perspective with the perspectives of a consultant paediatric dermatologist, a community nurse, and a paediatric allergy consultant, was helpful. I think we learned what our colleagues do, and perhaps as valuable, what they cannot do.

The first few sessions were in the main lecture theatre. They took us back to scientific first principles rather than presenting us with bullet points of received wisdom, the more usual format for knowledge updates. A bit more challenging, some furrowed brows, but well worthwhile, a focus on understanding as well as recall of information.

We learned about T helper cells recognising allergens on re-exposure after sensitisation, for example. There was time to question speakers who were also approachable during coffee breaks and lunch, when we could also interact with colleagues from different backgrounds. I encountered a GP from a rural practice in Cornwall and a consultant paediatrician.

One simple practical nugget of information - allergy to fish and shellfish are quite distinct conditions, so we do not have to condemn our patients to a lifetime without both. My grandson is now six years old, and I recall my daughter's determination to breast feed exclusively for at least six months, so it was with some chagrin that I learned that the absence of an oral antigen challenge is likely to encourage allergy, especially if there is an inflammatory skin condition that is associated with breaks in the skin and exposure to the allergen through that route rather than the oral one. Similarly inhaled allergens rather than oral exposure fosters sensitivity. Present good practice is to expose the infant to peanut butter and dairy products at an early age, to prevent sensitisation - the advice is still to continue breast feeding while doing so. We learned that maternal diet has little effect on the development of infant allergy, but can cause symptoms in the presence of allergy or food intolerance. There is a worldwide increase in allergic reactions.

The campus was spacious with surrounding grass and shrubbery, it was good to have these encounters outside. The format of a lecture theatre at the end of a corridor with smaller seminar rooms off to either side seemed to work very well. We would break up into workshops, then return to the lecture theatre at intervals. The campus is an attractive green environment which also helped to keep us engaged.