Our purpose
The Department of Allergy and Immunology delivers the highest quality clinical care to children and families with allergic and immune disorders and plays a vital role in increasing awareness, understanding and knowledge of allergic and immune disorders in the community and health professionals through education, teaching and training. We play a leadership role in the development and improvement of health care policies and guidelines related to allergic and immune disorders, and also actively identify and pursue research priorities to prevent and improve management of these conditions. We continue to work collaboratively with the Murdoch Children's Research Institute (MCRI) and the University of Melbourne.
We do this by
- Providing multidisciplinary and evidence based secondary, tertiary and quaternary clinical care
- A commitment to excellence in the training and development of allergy immunology specialists, paediatricians, clinical nurse consultants and allied health professionals in the field
- Delivering of community education programs and resources
- Shaping clinical practice by actively participating in national and international expert committees and peak professional bodies
- Driving optimal health policy by providing expert opinion informed by research and clinical knowledge
- Leading internationally recognised research into causative mechanisms, prevention and treatment of allergic and immune disorders
- Collaboration with community, government and professional stakeholders
- Employing a team of passionate and dedicated professionals committed to our purpose
Medical and clinical services
Evaluation and treatment of allergic conditions including asthma, eczema, allergic rhinitis, food, insect, drug, latex allergies and immune disorders.
Diagnostic testing including skin prick tests, intradermal skin prick tests, and inpatient challenges.
Immunotherapy for insect venom such as bee and wasp, aeroallergens such as house dust mites and pollens.
Tests, such as skin prick tests or blood tests and challenge tests may be recommended.
Skin prick testing
Skin prick tests are when a small amount of allergen extract (in the form of a liquid) is pricked into the skin. An allergic reaction appears as a lump (wheal) at the scratch site. An allergy specialist must read the result, as the test needs to be interpreted carefully. A skin prick test takes about 30 minutes.
The test can be performed on babies, but a baby less than 12 months of age has less reactive skin and so the results may be lessened. Registered nurses, who have undergone extensive training in the procedure, perform skin tests and the result is interpreted by medical specialists with experience in allergy diagnosis and management.
Challenges
This is a highly specialised test that is performed in an inpatient setting by experienced allergy specialists and nursing staff in a safe clinical environment. The test takes a minimum of four hours and involves giving a child increasing amounts of an allergen (e.g. food or drug). The child is observed closely after each dose for any clinical allergic response.
Only one food is challenged at a time, and if tolerated, families are given a plan and instructions on how to continue at home.
Thousands of families have learnt through challenges what foods their child can safety introduce back into their diet. Challenges empower families and children to take control of their lives.
Challenges are associated with a risk of severe allergic reaction and should only be performed by allergy specialists experienced in the administration of a challenge and in a setting where resuscitation facilities are available.
Desensitisation/immunotherapy
Desensitisation programs (immunotherapy) are available for insect venom, house dust mite, pollens and other inhalant allergens (eg. cat dander). Immunotherapy for house dust mite, pollens and other inhalant allergens, involves a series of injections with the initial injection given at the hospital then monthly maintenance injections at the patient's local GP for 3 to 5 years. Ultra rush Immunotherapy for bee or wasp venom comprises multiple injections for bee or wasp venom with the initial dose at The Royal Children's Hospital (RCH) followed by monthly maintenance injections at the local GP for 3 to 5 years. The Department Allergist recommends immunotherapy based on skin prick tests, pathology results and the child's history.
Current research projects
The Department is involved in a number of exciting research projects that include:
- The Health Nuts Study - Population prevalence and environmental/genetic predictors of food allergy in an infant cohort
- Probiotic and peanut oral immunotherapy for treatment of peanut allergy (PPOIT 003) – multicentre study in peanut allergy, the commonest cause of anaphylaxis due to food allergy
- Probiotic and prawn allergy for treatment of prawn allergy (PIPA) – multicentre study in prawn allergy, the commonest cause of fatal reactions due to food allergy
- Understanding the immune mechanisms driving acquisition of tolerance in food allergy – whole genome gene expression network analysis
- Investigating intestinal microbial signatures associated with oral tolerance and food allergy
- PEBBLES - A randomised controlled trial to prevent eczema, food allergy and sensitisation using a skin barrier improvement strategy
- Allergy in the Community Trial (ACT) – A new model of care for managing childhood food allergy: a randomised controlled trial
- VITALITY - The role of postnatal vitamin D supplement in infant health – a randomised controlled trial
- Healthy Parents Healthy Kids (HPHK) study - Targeting the perinatal diet for better maternal and child outcomes
- SchoolNuts – Prevalence and predictors of food allergy in adolescents
- Barwon Infant Study (BIS) – investigating early life determinants of microbial composition, immune programming and development of non-communicable diseases including allergic disease, cardiovascular disease, neurodevelopment, and respiratory development.
- Subcutaneous Immunotherapy using allergoid extract for Allergic Rhinitis- evaluation of clinical outcomes
- D-VEX: A randomised controlled trial of Vitamin D for treatment of eczema in children
- Early Nuts- Can early introduction of dietary allergen reduce the prevalence of infant food allergy? A population-based study.
- PrEggNut Study - This research is testing whether the amount of eggs and peanuts a mother eats during pregnancy and breastfeeding has an influence on her baby’s food allergy development.
- Low Dose Multi-nut oral immunotherapy in Pre-schoolers (LMNOP) Trial
- OPTIMUM Study - The OPTIMUM Study is looking to determine whether one dose of ‘whole cell’ pertussis (whooping cough) vaccine given at two months of age instead of the current ‘acellular’ pertussis vaccine can help protect young children against allergic outcomes
- Aravax AVX-201- a Phase 2 study in adolescents and children with peanut allergy
Resources
The Department works closely with the Departments of Nutrition and Food Services (dietetics), Respiratory Medicine, Gastroenterology, Dermatology, and General Paediatrics.
Pre-referral guidelines
Please remember that indefinite referrals are only accepted for chronic medical conditions such as immune deficiency. Patient referrals are triaged based upon the clinical problem detailed in the referral and booked into clinic.
Please access the following Parent Information Sheets by clicking on the sheet or links below:
Useful information for parents
Nip Allergies in the Bub
ASCIA information sheets
https://www.allergy.org.au/patients/information
Covid-19,Vaccines and Allergies FAQ's
RCH information sheets
Professional organisations
Registered training organisation, community groups, charities and not for profit