An occasional article in the press will detail how a person stung by a bee or who has consumed peanuts in one form or another experienced anaphylaxis. This is a potentially life-threatening disorder that can affect people of all ages, although young people are at an increased risk of anaphylaxis deaths. Reasons cited for these fatalities often include a failure to perform long-term management skills. A better understanding of the factors that contribute to the lack of this performance, in turn, could reduce the impact of anaphylaxis. Akeson and coworkers conducted a study to explore: (a) the psychosocial impact of living with anaphylaxis on adolescents and their parents; (b) management of the condition; and (c) perceptions of health care for the condition. In-depth interviews were conducted with 15 participants, including seven adolescents aged 13 and 16 years with a history of clinician-diagnosed anaphylaxis and eight of their parents. Responses suggested that the adolescents perceived anaphylaxis as 'no big deal' and described a low impact on their day-to-day life when compared with their parents. Perhaps this was explained by the fact that most adolescents could not remember an anaphylactic reaction. Obstacles to effective long-term self-management included inadequate knowledge to support risk assessment enhanced by a lack of confidence to make further enquiries about the ingredients of meals when with peers. Parents reported anxiety about 'handing over' the main responsibility for avoidance and emergency management to their children. Medical support for these families was limited, with primary care teams in some cases actively hindering effective self-management.

VALUE OF STUDY TO READER: The authors concluded that having a child with anaphylaxis might have a long-term effect on parents; their anxiety, in turn, may be transferred from parents to their children. It was suggested more long-term self-management training for adolescents, along with better access to appropriate medical care, might reduce the impact of anaphylaxis. These seem reasonable suggestions. Fortunately, it appears as if a greater effort to identify patients, particularly children, who could experience anaphylaxis has occurred in the United States in the past two decades. These efforts have also included more education on how to treat anaphylaxis by self-administered shots when needed. A considerable amount of information on anaphylaxis and its prevention can be found at the Food Allergy and Anaphylaxis Network.

N. Akeson et al. The psychosocial impact of anaphylaxis on young people and their parent. Clinical and Experimental Allergy, 2007;37:1213-1220.