Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Guidance may perpetuate the problem
- David M Lewis (7 September 2006)
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Peanut allergy - Prevention?
- Mangala M Pai, Manohar Pai, Rekha Pai and Latha Prabhu (9 September 2006)
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Avoiding Adjuvants & Excipients Can Avoid Allergies
- Clifford G. Miller (10 September 2006)
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Preventing patients having knowledge of allergic reactions
- Lisa C Blakemore-Brown (10 September 2006)
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Overlooking (ignoring?) the obvious
- Alan Rees (10 September 2006)
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David M Lewis, General Practioner Watford, UK WD24 7PH
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Dear Madam Prof Sheikh has produced a timely guide, but perpetuates the peanut avoidance advice in early childhood which may be plain wrong if Prof Gideon Lack's [Professor of Clinical Immunology at Guys & St Thomas'] observations (outlined at a recent lecture I attended in London) of peanut allergy rates in Israel and Sub-saharan Africa are considered. There is no peanut allergy in these places which are linked by there early introduction of peanut based substances in babyhood - in Africa 'peanut' soup is the main source of protein for these kids; in Israel 'bamba' is given to babies because it is wheat free and a tasty weaning food. Prof Sheikh's advice perpetuates (Western) cultural myths about nutrition and food allergy. If we wish to see reductions in food (peanut) allergy, the dietary advice to mothers concerning the use of peanut based products in their baby's diets needs urgent review! Yours sincerely David Lewis Competing interests: None declared |
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Mangala M Pai, assistant professor Center for basic sciences, KMC, Mangalore, Bejai, 575004, Manohar Pai, Rekha Pai and Latha Prabhu
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Peanuts are cheap sources of dietary protein and predominantly ingested. In India it is known as "poor man's nut" and forms the chief ingredient of baby weaning food products which is introduced as early as 6 months. Peanut allergy is not known in this part of the world or possibly the symptoms of the reaction (if any) is not attributed to peanut. The symptoms may vary from apprehension to chills to coma and death. A reaction to peanut may be induced by consuming peanut or food labelled as hydrolysed vegetable protein or even eating from plate containing residues of peanut products.Most exposures are accidental. A peanut sensitive child may undergo lot of peer pressure and therefore psychological counselling should be given utmost importance. Competing interests: None declared |
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Clifford G. Miller, Commercial lawyer, graduate physicist, former university lecturer in law BR3 3LA
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Dear Sirs, Preventing development of allergic disorders in children BMJ 2006;333:485 (2 September), Regarding their ten minute consultation, it might assist Chantelle Anandan, research fellow and Aziz Sheikh, professor of primary care research and development, University of Edinburgh to investigate what causes the body to be in a condition in which it responds with a reaction to allergens. It is trite that allergens are not allergens if the body did not react to them. It is also trite that avoidance of the causes of sensitisation will avoid sensitisation. Whilst there is very a little in the evidence-based literature, it is well-known in manufacturing circles that adjuvants cause allergies. As biotech company Biovant's CEO, Steve Simes said on the launch of their new adjuvant:- "The problem with most adjuvants is that they can cause allergies," said Simes. "Ours might not be as potent as others, but it is safer."Further, some excipients are also known to cause sensitisation reactions and hypersensitivity is a contraindication [2] If, in preparation for the ten minute consultation, Chantelle Anandan and Aziz Sheikh would research the evidence base on the risk of serious adverse effects with the risks of avoidance of adjuvants and excipients as one of the causes of sensitisation, the decision on best practice is a simple one. Regrettably, their search will be difficult and tenacity is needed as I have found when reseaching these issues. As Dr Tom Jefferson said when head of the vaccine division of the Cochrane Collaboration and board member of the European Programme for Improved Vaccine Safety Surveillance Jefferson said [1] "There is some good research, but it is overwhelmed by the bad. …. there was a "dearth" of sound studies on the risks and benefits.” www.cliffordmiller.com. [1] Vaccines expert warns studies are useless The Telegraph (London, England - Filed: 27/10/2002 - Lorraine Fraser - Accessed 10 Sept 2006) [2] SPC & PL Wording for Use of Thiomersal in Medicinal Products With Regard to Sensitisation As Agreed by the Chmp in February 2006 - Committee for Medicinal Products for Human Use (CHMP) CPMP/2612/99 Competing interests: None declared |
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Lisa C Blakemore-Brown, Psychologist UK
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It is disconcerting that Anandan and Sheikh tell professionals to " Reassure (her) that routine immunisations do not increase the risk of babies developing allergic disorders and are safe to give to babies with food allergies, eczema, or asthma ", when, as Clifford Miller has pointed out, there is clear evidence that allergic reactions are associated with products put into vaccines. One example he gives is Thiomersal, and in the CHMP 2006 position statement which he provides, it is clearly stated that those receiving the vaccine should be made aware of the risks of allergic reactions to Thiomersal. In a reply to an FOI request to the Department of Health I was told "As advised by the Committee on the Safety of Medicine, the Department's only concerns about the inclusion of thiomersal in vaccines were of possible hypersensitivity reactions". Their reply is available to anyone who would like to read it. Product inserts list contraindications and warn those who may have a history of allergic reactions, such as anaphylaxis to tell their doctor before having vaccinations. Unless I have missed something, parents who take their children for vaccination are not routinely given the product insert sheet for contraindications to vaccines or the CHMP position statement when Thiomersal has been in the vaccines, or indeed any information which may make them less confident in the vaccine programme. With the rate of allergies soaring to epidemic proportions and factual information being kept back from parents about allergic reactions to vaccines, how confident can we be about the desire to prevent allergic reactions? Competing interests: Specialist in disorders which can be caused by vaccine and are often blamed on parents |
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Alan Rees, Translator Words AB
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Since peanut oil is commonly used as an adjuvant in vaccines, the source of the problem should be obvious. However, since it appears to be crimethink even to suggest such a thing, I remain confident that the medical profession will continue to overlook or deliberately(?) ignore the obvious. Competing interests: Father of a vaccine-injured child. Currently taking legal action on his behalf. |
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