Does Hong Kong have enough expertise to treat peanut allergies for some 21,000 people?
Expert says city would need about 70 allergists for a population of 7.34 million; it currently has fewer than 10
Hongkongers with peanut allergies will be unlikely to benefit from a new probiotics study because there is a “lack of expertise” to test the treatment locally, one of the city’s top allergists has said.
Dr Lee Tak-hong, director of the Allergy Centre at the Hong Kong Sanatorium and Hospital, said the city’s estimated 21,000 peanut allergy sufferers continued to be neglected by the city’s health system.
He said the number of allergists had increased slightly since 2014, from one per 1.46 million people to one per 1.17 million. But he said Hong Kong would need about 70 allergists for a population of 7.34 million to cope with the needs of sufferers, he said. There are currently fewer than 10 allergists in the city.
Lee made the comments in relation to a new Australian study by scientists at Melbourne’s Murdoch Children’s Research Institute. They gave children with peanut allergies a probiotic, along with small doses of a peanut protein for an 18-month clinical trial starting in 2013.
Four years on, 70 per cent of the children in the trial could eat peanuts without suffering an adverse reaction, according to research published in medical journal The Lancet last month.
Doctors say probiotics can promote the expansion of suppressor T cell populations which inhibit immunological mechanisms that can result in allergies.
Lee said although he thought the study represented significant progress, he remained pessimistic about how it could benefit Hongkongers without greater financial investment from the government.
“This study is exciting and an important advance in the management of peanut allergy if it can be confirmed by other centres,” he said. “Unfortunately there are also very few specialists in Hong Kong that can conduct oral desensitisation to peanuts or any other foods.
“Hong Kong has a severely unmet need in allergy service provision. The lack of expertise in Hong Kong regrettably impedes its ability to take advantage of advances in allergy prevention and treatment.”
Some scientists have suggested peanut allergies are marginally less prevalent in Asian countries than in the West, which they speculate could be due to Asian eating habits.
Hongkongers will typically be introduced from infancy to foods which contain peanuts, such as congee and soup, perhaps making them less likely to become allergic to them.
Peanuts are among the top five food allergens for Hongkongers. The others are shellfish, eggs, dairy products and fruits.
Less than 5 per cent of the population have food allergies, according to the Hong Kong Sanatorium, but doctors suggest the numbers have been increasing as Hongkongers’ diets change.
In the last decade, Hong Kong allergists have carried out desensitisation trials on patients, but these can be costly, time-consuming and still come with a considerable degree of risk for the patients themselves, with many not completing the treatment.
The allergy sector is also severely under-resourced. This year finally saw the recruitment of Hong Kong’s first trainee allergist in 20 years.
Peanut allergy sufferers here face difficulties in trying to avoid peanuts in local restaurants, which often use peanut oil for wok-based cooking.
When they do inadvertently suffer from peanut-induced anaphylaxis, their main option is to self-administer adrenaline to neutralise their reaction.
Lee expressed caution about Hongkongers trying to administer probiotic drugs themselves in a bid to cure their allergy.
“Before everyone goes out and buys just any probiotic for self-administration, it should be emphasised that it is not known whether all probiotics have this beneficial effect, how long they have to be given or what is the best dose,” he said.