Allergic diseases in Australia are the most common group of chronic childhood disorders. Approximately 4.1 million Australians have at least one allergy.
It is not fully understood why the incidence of allergic disease is rising rapidly in Australia, but if current trends continue, there will be a 70% increase in the number of Australians with one or more allergic disorders from 4.1 million currently to 7.7 million by 2050. With the rising community prevalence and incidence, demand for allergy services is increasing. Hospital admissions for food anaphylaxis in Australia have doubled over the last 10 years and increased by five-fold in children aged 0 – 4 years.
Primary immune deficiency diseases (PIDs) are potentially serious disorders where inherited defects in the immune system result in an increased susceptibility to infection. There are currently more than 150 primary immune deficiency diseases. Research has led to improved therapy for people with PIDs, including antibiotic therapy for prevention and early management of infections, immunomodulation, immunoglobulin. The Sydney Children’s Hospitals Network (SCHN) Allergy and Immunology Services provide multidisciplinary clinical, diagnostic and educational services for allergic and immunological conditions. Patient cohorts range from those with general allergy conditions to those with chronic and complex rare diseases and patients with complex allergies.
Two tertiary referral units operate from Sydney Children’s Hospital Randwick and The Children’s Hospital at Westmead.
Allergy services diagnose and manage patients with multiple allergies, anaphylactic-type food allergies, drug allergies, stinging insect allergies and severe atopic disease. Educational information is provided to patients, parents and other health professionals. Services include multidisciplinary clinics, allergen skin prick testing and food and other challenges. The Children's Hospital at Westmead accepts only tertiary referrals and Sydney Children's Hospital accepts referrals from general practitioners and specialists. Both services triage referrals for appropriateness prior to accepting a patient for assessment. Clinical services provided to patients by the Immunology service include diagnosis and management of patients with rare diseases requiring tertiary level care, such as primary immunodeficiency disorders, complex autoimmune diseases like systemic lupus erythematosis (SLE) and autoinflammatory disorders (which include familial Mediterranean fever).
Clinical immunology pathology and laboratory
The Immunology Laboratory at The Children’s Hospital at Westmead provides diagnostic testing of immune function, immunogenetics, and allergy. The tests are specialised, technically demanding and often not available in other pathology laboratories. The Immunology Laboratory has developed tests tailored to individual patients or conditions such as Autoimmune Lymphoproliferative Syndrome, Veno-occlusive disease and Papillon-Lefevre syndrome. The Immunology Laboratory is the NSW State Reference laboratory for tests of neutrophil function. Sydney Children’s Hospital refers all diagnostic tests to the SEALS Immunology Lab located at Sutherland Hospital. Most sllergy and immunology services are provided on an outpatient basis through multidisciplinary clinics which include:
- Allergy and Immunology clinics
- Food Challenge Clinics (low risk)
- Immunotherapy clinics
- Immunodeficiency clinics
- Immunisation Adverse Events Clinic (in conjunction with NCIRS)
- Immunogenetics clinics (in development at SCH)
- Severe eczema clinics (CHW)
- Vascular birthmarks clinics (CHW)
- The Departments of Infectious Diseases and Microbiology at both hospitals