10 practical priorities to prevent and manage serious allergic reactions: GA²LEN ANACare and EFA Anaphylaxis Manifesto

Antonella Muraro¹, Debra de Silva², Marcia Podesta³, Aikaterini Anagnostou^{4

5}, Victoria Cardona⁶, Susanne Halken⁷, Pete Smith⁸, Luciana Kase Tanno⁹, Paul Turner¹⁰, Margitta Worm¹¹, Montserrat Alvaro-Lozano¹², Stefania Arasi¹³, Anna Asarnoj¹⁴, Simona Barni¹⁵, Kirsten Beyer^{11

16}, Lucy A Bilaver¹⁷, Andrew Bird¹⁸, Roberta Bonaguro¹, Helen A Brough¹⁹, R Sharon Chinthrajah²⁰, Emma E Cook²¹, Céline Demoulin²², Antoine Deschildre²³, Timothy E Dribin²⁴, Motohiro Ebisawa²⁵, Montserrat Fernandez-Rivas²⁶, Alessandro Fiocchi²⁷, David M Fleischer²⁸, Eleanor Garrow²⁹, Jennifer Gerdts³⁰, Mattia Giovannini^{15

31}, Kirsi M Järvinen³², Mary Kelly³³, Edward F Knol³⁴, Gideon Lack¹⁹, Francesca Lazzarotto¹, Thuy-My Le³⁵, Stephanie Leonard³⁶, Jay Lieberman³⁷, Michael Makris³⁸, Lianne Mandelbaum³⁹, Mary Jane Marchisotto⁴⁰, Gustavo Andres Marino⁴¹, Francesca Mori¹⁵, Caroline Nilsson^{42

43}, Anna Nowak-Wegrzyn^{44

45}, Mikaela Odemyr⁴⁶, H N G Oude Elberink⁴⁷, Kati Palosuo⁴⁸, Nandinee Patel¹⁰, Jennifer Pier⁴⁹, Sung Poblete⁵⁰, Rima Rachid⁵¹, Pablo Rodríguez Del Río⁵², Maria Said⁵³, Hugh A Sampson⁵⁴, Angel Sánchez Sanz⁵⁵, Sabine Schnadt⁵⁶, Fallon Schultz⁵⁷, Alice Toniolo¹, Julia E M Upton⁵⁸, Carina Venter⁵⁹, Brian P Vickery⁶⁰, Berber Vlieg-Boerstra⁶¹, Julie Wang⁵⁴, Graham Roberts^{62

63

64

65}, Torsten Zuberbier^{11

66}; GA2LEN ANACare Centres and EFA

Affiliations

¹ Padua University Hospital, Padua, Italy.
² The Evidence Centre, London, UK.
³ European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium.
⁴ Children's Hospital, Houston, Texas, USA.
⁵ Baylor College of Medicine, Houston, Texas, USA.
⁶ Hospital Universitari Vall d'Hebron, Barcelona, Spain.
⁷ Hans Christian Andersen Children's Hospital and University of Southern Denmark, Odense, Denmark.
⁸ Griffith University, Southport, Queensland, Australia.
⁹ Hôpital Arnaud de Villeneuve - University Hospital of Montpellier, Montpellier, France.
¹⁰ Imperial College London, London, UK.
¹¹ Charite Univeritätsmedizin Berlin, Berlin, Germany.
¹² Hospital Sant Joan de Déu, Barcelona, Spain.
¹³ Bambino Gesù Children's Hospital, Rome, Italy.
¹⁴ Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
¹⁵ Meyer Children's Hospital IRCCS, Florence, Italy.
¹⁶ German Center for Child and Adolescent Health Partner Site Berlin, Berlin, Germany.
¹⁷ Northwestern University, Evanston, Illinois, USA.
¹⁸ University of Texas Southwestern University, Dallas, Texas, USA.
¹⁹ Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.
²⁰ Stanford University, Stanford, California, USA.
²¹ ATOPICCO Network for Children of the Earth, Tokyo, Japan.
²² AFPRAL, Paris, France.
²³ Université de Lille, Lille, France.
²⁴ Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio, USA.
²⁵ NHO Sagamihara National Hospital, Sagamihara, Japan.
²⁶ Hospital Clinico San Carlos, Universidad Complutense IdISSC, Madrid, Spain.
²⁷ Pediatric Hospital Bambino Gesù, Rome, Italy.
²⁸ University of Colorado and Children's Hospital Colorado, Aurora, Colorado, USA.
²⁹ Food Allergy and Anaphylaxis Connection Team, West Chester, Ohio, USA.
³⁰ Food Allergy Canada, North York, Ontario, Canada.
³¹ University of Florence, Florence, Italy.
³² University of Rochester, New York, New York, USA.
³³ Anaphylaxis UK, Farnborough, UK.
³⁴ University Medical Center Utrecht, Utrecht, The Netherlands.
³⁵ University Utrecht, Utrecht, The Netherlands.
³⁶ University of California, San Diego, La Jolla, California, USA.
³⁷ University of Tennessee Health Science Center and LeBonheur Children's Hospital, Memphis, Tennessee, USA.
³⁸ National and Kapodistrian University of Athens, Athens, Greece.
³⁹ No Nut Traveler Inc, Livingston, New Jersey, USA.
⁴⁰ MJM Advisory LLC, New York, New York, USA.
⁴¹ Hospital Universitario Austral and Fundación SOS Alergia, Pilar, Argentina.
⁴² Karolinska Institutet, Stockholm, Sweden.
⁴³ Sachs' Children and Youth Hospital, Stockholm, Sweden.
⁴⁴ New York University, New York, New York, USA.
⁴⁵ University of Warmia and Mazury, Olsztyn, Poland.
⁴⁶ Astma- och Allergiförbundet, Stockholm, Sweden.
⁴⁷ University of Groningen, Groningen, The Netherlands.
⁴⁸ Helsinki University Hospital, Helsinki, Finland.
⁴⁹ University of Rochester, Rochester, New York, USA.
⁵⁰ Food Allergy Research & Education (FARE), McLean, Virginia, USA.
⁵¹ Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁵² Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
⁵³ Allergy & Anaphylaxis Australia, Sydney, New South Wales, Australia.
⁵⁴ Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁵⁵ AEPNAA Spanish Association of People with Food and Latex Allergy, Madrid, Spain.
⁵⁶ Deutscher Allergie- und Asthmabund, Berlin, North Rhine-Westphalia, Germany.
⁵⁷ International FPIES Association, Quincy, Massachusetts, USA.
⁵⁸ University of Toronto, Toronto, Ontario, Canada.
⁵⁹ University of Colorado, Denver, Colorado, USA.
⁶⁰ Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
⁶¹ OLVG Hospital, Amsterdam, The Netherlands.
⁶² University of Southampton, Southampton, UK.
⁶³ St Mary's Hospital, Southampton, UK.
⁶⁴ NIHR Biomedical Research Centre, Southampton, UK.
⁶⁵ University Hospital Southampton NHS Foundation Trust, Southampton, UK.
⁶⁶ Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

PMID: 39614094
PMCID: PMC11606857
DOI: 10.1002/clt2.70009

Review

10 practical priorities to prevent and manage serious allergic reactions: GA²LEN ANACare and EFA Anaphylaxis Manifesto

Antonella Muraro et al. Clin Transl Allergy. 2024 Dec.

. 2024 Dec;14(12):e70009.

doi: 10.1002/clt2.70009.

Authors

Affiliations

¹ Padua University Hospital, Padua, Italy.
² The Evidence Centre, London, UK.
³ European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium.
⁴ Children's Hospital, Houston, Texas, USA.
⁵ Baylor College of Medicine, Houston, Texas, USA.
⁶ Hospital Universitari Vall d'Hebron, Barcelona, Spain.
⁷ Hans Christian Andersen Children's Hospital and University of Southern Denmark, Odense, Denmark.
⁸ Griffith University, Southport, Queensland, Australia.
⁹ Hôpital Arnaud de Villeneuve - University Hospital of Montpellier, Montpellier, France.
¹⁰ Imperial College London, London, UK.
¹¹ Charite Univeritätsmedizin Berlin, Berlin, Germany.
¹² Hospital Sant Joan de Déu, Barcelona, Spain.
¹³ Bambino Gesù Children's Hospital, Rome, Italy.
¹⁴ Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
¹⁵ Meyer Children's Hospital IRCCS, Florence, Italy.
¹⁶ German Center for Child and Adolescent Health Partner Site Berlin, Berlin, Germany.
¹⁷ Northwestern University, Evanston, Illinois, USA.
¹⁸ University of Texas Southwestern University, Dallas, Texas, USA.
¹⁹ Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.
²⁰ Stanford University, Stanford, California, USA.
²¹ ATOPICCO Network for Children of the Earth, Tokyo, Japan.
²² AFPRAL, Paris, France.
²³ Université de Lille, Lille, France.
²⁴ Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio, USA.
²⁵ NHO Sagamihara National Hospital, Sagamihara, Japan.
²⁶ Hospital Clinico San Carlos, Universidad Complutense IdISSC, Madrid, Spain.
²⁷ Pediatric Hospital Bambino Gesù, Rome, Italy.
²⁸ University of Colorado and Children's Hospital Colorado, Aurora, Colorado, USA.
²⁹ Food Allergy and Anaphylaxis Connection Team, West Chester, Ohio, USA.
³⁰ Food Allergy Canada, North York, Ontario, Canada.
³¹ University of Florence, Florence, Italy.
³² University of Rochester, New York, New York, USA.
³³ Anaphylaxis UK, Farnborough, UK.
³⁴ University Medical Center Utrecht, Utrecht, The Netherlands.
³⁵ University Utrecht, Utrecht, The Netherlands.
³⁶ University of California, San Diego, La Jolla, California, USA.
³⁷ University of Tennessee Health Science Center and LeBonheur Children's Hospital, Memphis, Tennessee, USA.
³⁸ National and Kapodistrian University of Athens, Athens, Greece.
³⁹ No Nut Traveler Inc, Livingston, New Jersey, USA.
⁴⁰ MJM Advisory LLC, New York, New York, USA.
⁴¹ Hospital Universitario Austral and Fundación SOS Alergia, Pilar, Argentina.
⁴² Karolinska Institutet, Stockholm, Sweden.
⁴³ Sachs' Children and Youth Hospital, Stockholm, Sweden.
⁴⁴ New York University, New York, New York, USA.
⁴⁵ University of Warmia and Mazury, Olsztyn, Poland.
⁴⁶ Astma- och Allergiförbundet, Stockholm, Sweden.
⁴⁷ University of Groningen, Groningen, The Netherlands.
⁴⁸ Helsinki University Hospital, Helsinki, Finland.
⁴⁹ University of Rochester, Rochester, New York, USA.
⁵⁰ Food Allergy Research & Education (FARE), McLean, Virginia, USA.
⁵¹ Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁵² Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
⁵³ Allergy & Anaphylaxis Australia, Sydney, New South Wales, Australia.
⁵⁴ Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁵⁵ AEPNAA Spanish Association of People with Food and Latex Allergy, Madrid, Spain.
⁵⁶ Deutscher Allergie- und Asthmabund, Berlin, North Rhine-Westphalia, Germany.
⁵⁷ International FPIES Association, Quincy, Massachusetts, USA.
⁵⁸ University of Toronto, Toronto, Ontario, Canada.
⁵⁹ University of Colorado, Denver, Colorado, USA.
⁶⁰ Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
⁶¹ OLVG Hospital, Amsterdam, The Netherlands.
⁶² University of Southampton, Southampton, UK.
⁶³ St Mary's Hospital, Southampton, UK.
⁶⁴ NIHR Biomedical Research Centre, Southampton, UK.
⁶⁵ University Hospital Southampton NHS Foundation Trust, Southampton, UK.
⁶⁶ Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

PMID: 39614094
PMCID: PMC11606857
DOI: 10.1002/clt2.70009

Abstract

This Anaphylaxis Manifesto calls on communities to prioritise 10 practical actions to improve the lives of people at risk of serious allergic reactions. The Global Allergy and Asthma European Network and the European Federation of Allergy and Airways Diseases Patients' Associations (EFA) compiled patient-centric priorities. We used qualitative consensus methods, research evidence and feedback from over 200 patient groups, stakeholder organisations and healthcare professionals. We encourage healthcare, education and food organisations to collaborate with people at risk of serious allergic reactions to tackle safety, anxiety and financial burdens for individuals and societies. Key priorities for prevention include awareness-raising campaigns for the public and professionals, school and workplace initiatives and mandatory precautionary allergen labels on food. Priorities for improving immediate and long-term management include educating healthcare professionals, patients and schools about when and how to use adrenaline, funding two approved adrenaline devices for everyone at risk, and facilitating access to allergy specialists. Integrated care pathways should include clinical and non-clinical management options such as individualised risk assessment and quality of life assessment, self-management plans, dietetic and psychosocial support and peer support. Organisations around the world are committing to work together towards these priorities.

Keywords: adrenaline; allergy; anaphylaxis; hypersensitivity.

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Conflict of interest statement

A separate file has been provided listing all potential interests of the authors.

References

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10 practical priorities to prevent and manage serious allergic reactions: GA²LEN ANACare and EFA Anaphylaxis Manifesto

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10 practical priorities to prevent and manage serious allergic reactions: GA²LEN ANACare and EFA Anaphylaxis Manifesto

Authors

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Abstract

Conflict of interest statement

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