Food Allergies in the School Setting

66 Pages·2014·2.2 MB·English

VOLUNTARY GUIDELINES FOR MANAGING FOOD
ALLERGIES IN SCHOOLS AND EARLY CARE AND
EDUCATION PROGRAMS

WHAT THE PEDIATRICIAN NEEDS TO KNOW

Scott H. Sicherer MD, FAAP, MD, FAAP Lani Wheeler, MD, FAAP
THIS WEBINAR WAS PRODUCED UNDER A
COOPERATIVE AGREEMENT BETWEEN THE
AMERICAN ACADEMY OF PEDIATRICS AND THE
CENTERS FOR DISEASE CONTROL AND
PREVENTION (CDC).
CME for this activity
The American Academy of Pediatrics (AAP) is accredited by the Accreditation Council for Continuing

Medical Education (ACCME) to provide continuing medical education for physicians.

The AAP designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™.

Physicians should claim only the credit commensurate with the extent of their participation in the
activity.

This activity is acceptable for a maximum of 1.00 AAP credits. These credits can be applied toward the

AAP CME/CPD Award available to Fellows and Candidate Members of the American Academy of
Pediatrics.

The American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational

activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME. Physician
assistants may receive a maximum of 1.00 hours of Category 1 credit for completing this program.

This program is accredited for 1.00 NAPNAP CE contact hours of which 0 contain pharmacology (Rx)

content, (0 related to psychopharmacology), per the National Association of Pediatric Nurse Practitioners
(NAPNAP) Continuing Education Guidelines.
CLAIMING CME CREDIT
In order to claim CME for this webinar,
you must complete the survey that will
be sent after the webinar to all
registrants and receive a passing score
of 70%.
Disclosure of Financial Relationships and Resolution of Conflicts of Interest for AAP CME Activities Grid
The AAP CME program aims to develop, maintain, and improve the competence, skills, and professional performance of pediatricians and pediatric healthcare professionals by providing quality, relevant,
accessible, and effective educational experiences that address gaps in professional practice. The AAP CME program strives to meet participants' educational needs and support their life-long learning with a goal
of improving care for children and families. (AAP CME Program Mission Statement, January 2013).

The AAP recognizes that there are a variety of financial relationships between individuals and commercial interests that require review to identify possible conflicts of interest in a CME activity. The “AAP
Policy on Disclosure of Financial Relationships and Resolution of Conflicts of Interest for AAP CME Activities” is designed to ensure quality, objective, balanced, and scientifically rigorous AAP sponsored or
joint sponsored Continuing Medical Education (CME) activities by identifying and resolving all potential conflicts of interest prior to the confirmation of service of those in a position to influence and/or control
CME content.

All AAP CME activities will strictly adhere to the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support: Standards to Ensure the Independence of CME
Activities. In accordance with these Standards, the following decisions will be made free of the control of a commercial interest: identification of CME needs, determination of educational objectives, selection
and presentation of content, selection of all persons and organizations that will be in a position to control the content, selection of educational methods, and evaluation of the CME activity (ACCME Standard
1.1).

The purpose of this policy is to ensure all potential conflicts of interest are identified and mechanisms to resolve them prior to the CME activity are implemented in ways that are consistent with the public good.
Name/Role Relevant Financial Relationship Name of Commercial Interest(s)* Disclosure of Off-Label
(Please list name(s) of entity) (Unapproved)/Investigational Uses of
(Please indicate Yes, or No)
AND Products
Nature of Relevant Financial Relationship(s) AAP CME faculty are required to disclose
(Please list: Research Grant, Speaker’s Bureau, to the AAP and to learners when they plan
Stock/Bonds excluding mutual funds, to discuss or demonstrate pharmaceuticals
Consultant, Other - identify) and/or medical devices that are not
approved by the FDA and/or medical or
surgical procedures that involve an
unapproved or “off-label” use of an
approved device or pharmaceutical.

(Do intend to discuss or Do not intend to
discuss)
Scott Sicherer, MD, Yes Food Allergy Research and Education (FARE)- Do not intend to discuss
Consultant and Grant
FAAP/ Faculty
Novartis- Consultant
NIH/NIAD- Grants

Lani Wheeler, MD, No Do not intend to discuss
FAAP/ Faculty
Florence Stevens MPH/ No Do not intend to discuss
Staff
Disclosures (Sicherer)
Consultant, Food Allergy Research and Education

(FARE); Novartis
Boards and Organizations: AAP Section on Allergy

and Immunology Immed Past Chair; Chair, Board of
Allergy and Immunology
Royalties: Johns Hopkins University Press, CRC

Press, UpToDate
Grants: NIAID/NIH; FARE

I do not intend to discuss off label use of

medications
Learning Objectives
Understand the general approaches, practical issues, and best

practice for the pediatrician regarding children with food
allergies.
Be able to provide schools with the necessary documentation

and advice for individual children with food allergies as
requested by the CDC Voluntary Guidelines for Managing Food
Allergies in Schools and Early Care and Education Centers.
Understand the role of a school based physician with regard to

the CDC Voluntary Guidelines for Managing Food Allergies in
Schools and Early Care and Education Centers.
Importance of the Problem
Food allergy affects up to 8% of children.

The prevalence appears to have increased.

16-18% of children with food allergies have a

reaction in school.
About 25% of food-induced anaphylactic reactions

in schools occurred in a child without a prior
diagnosis.
References: Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol 2011; 127(3):594-602. Branum AM, Lukacs SL. Food
allergy among u.s. Children: trends in prevalence and hospitalizations. NCHS Data Brief 2008;(10):1-8. McIntyre CL, Sheetz AH, Carroll
CR, Young MC. Administration of epinephrine for life-threatening allergic reactions in school settings. Pediatrics 2005; 116(5):1134-40.
Nowak-Wegrzyn A, Conover-Walker MK, Wood RA. Food-allergic reactions in schools and preschools. Arch Pediatr Adolesc Med 2001;
155(7):790-5.
CDC’s Voluntary Guidelines
Result of 2011 FDA Food Safety Modernization Act.

To support implementation of food allergy

management and prevention.
Multiple consultants/contributors.

Addresses: Parental obligations (relates to

physician diagnosis and plans), individualized plans,
communication strategies, risk reduction,
education of stakeholders, response to
anaphylaxis, etc.
Definitions
Food Allergy: an adverse health effect arising from

a specific immune response that occurs
reproducibly on exposure to a given food.
Focus on IgE mediated

Anaphylaxis: a severe allergic reaction that is rapid

in onset and may cause death.
References: Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA et al. Guidelines for the diagnosis and management of
food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol 2010; 126(6 Suppl):S1-58.
Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF, Jr., Bock SA, Branum A et al. Second symposium on the definition and
management of anaphylaxis: Summary report-Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis
Network symposium. J Allergy Clin Immunol 2006; 117(2):391-7.