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Venom immunotherapy in children

Information:

Please come accompanied to your appointments, have a good breakfast and take one of your usual antihistamine tablets on the morning of your appointment.

If you have any queries, please telephone Medical Day Care on 0114 305 3473 or 0114 305 3427.

What is venom immunotherapy?

Most allergies are due to an over reaction of the immune system to foreign material, such as bee or wasp venom, pollens, or animal dander. Venom immunotherapy (also known as desensitization) is a treatment in which increasing doses venom are given in order to improve the body’s tolerance in case the individual has another sting.

What does the treatment involve?

Carefully calculated amounts of venom are given by injection just below the surface of the skin (subcutaneously).

To start with we build up your tolerance by giving increasing amounts of allergen over a specific period according to your schedule.

Afterwards we give a maintenance dose as a 4 to 8 weekly injection for up to 3 years.

These injections are timed at specific intervals and it is extremely important that you or your child attend each visit unless they are unwell. At each visit the doctor will record details of your preceding injection and symptoms you may have had. After each injection you must be observed in the clinic for at least 60 minutes. If you feel unwell after the injection you may be asked to stay a little longer until the doctor is happy for you to leave.

What is the response to the treatment?

The vast majority of people undergoing venom immunotherapy will be completely protected from future stings for up to 10 to 20 years. However, there is still a small chance (about 1 in 20) of developing an allergic reaction when next stung, particularly if the person is stung by multiple stinging insects at the same time. Patients with bee or wasp sting allergies should continue to carry their adrenaline auto-injector (such as Epipen, Jext or Emerade) all the time.

Are there any adverse reactions to the treatment?

After the injection a small local reaction will sometimes appear in the form of a swelling with redness. In some cases the swelling may be quite large and may even be accompanied by nose or chest symptoms. These will usually settle on their own or with an antihistamine (if you are not already taking them) but if you are concerned you should not hesitate to contact the paediatric allergy consultant.

Local reactions are not a reason to discontinue the treatment, but some adjustment will be made to the dosage. Rarely, small nodules may appear under the skin at the site of the injection. These are nothing serious and do not mean treatment needs to be stopped.

Serious reactions to immunotherapy are very rare but can occur during the first 30 to 60 minutes following your injection. In the past, rare deaths have occurred due to serious systemic reactions that were not treated promptly. This is why we ask you to stay for 60 minutes after each injection. The medical staff in the clinic are experienced in treating this sort of reaction and will deal with them if necessary.

Is there anything that I should not do after my injection?

During the 24 hours following the injection, you must avoid any form of strenuous physical exercise, prolonged hot bathing, and alcohol. These activities are thought to increase the risk of delayed reactions.

Can I have this treatment if I am pregnant?

We will not start immunotherapy if you are already pregnant or if you are trying to conceive. However, if you become pregnant whilst you are already on a well established maintenance regime, treatment can be continued. You should discuss this with your doctor since there is still a small but real risk of having a severe allergic reaction during treatment and this might affect the baby’s health.

What should I do if I develop a new illness or am put on a new drug?

You should inform the paediatric allergy consultant if you have a new illness or if you have started a new medication. This may sometimes mean the treatment needs to be stopped.

Injections should not be given at the same time as vaccinations. We usually recommend leaving 2 weeks between vaccinations and immunotherapy injections. Injections are also not recommended during ‘colds’ or chest infections. If in doubt, please speak to the nurse or the doctor at the immunotherapy clinic.

Information:

Please discuss with the doctor at the clinic if you have any queries or questions.

Further information, help and support

Paediatric allergy consultant secretary: call 0114 305 3897 or 0114 271 7585.

Medical day ward: call 0114 305 3473 or 0114 305 3427.

Allergy nurses: call 0114 226 7872 or email scn-tr.allergy@nhs.net

Allergy secretaries: call 0114 271 7585 (an answer machine is available out of hours)

Allergy UK: call 01322 619898 or visit www.allergyuk.org

Asthma UK: call 01322 619898 or visit www.asthma.org.uk

The Anaphylaxis Campaign: 01252 542029 or visit www.anaphylaxis.org.uk

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Disclaimer

Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

Resource number: ALG13

Resource Type: Article

NHS

Western Bank
Sheffield
S10 2TH

United Kingdom

Switchboard: 0114 271 7000

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