The EAACI community is deeply affected by the recent media reports of the death of a young child undergoing an oral food challenge (OFC) in the United States. Firstly, we wish to express our sincere condolences to Alastair Watson's family.

This is the first fatality reported in relation to OFC's and we await the full facts surrounding Alastair's death. While we wait for further details, this statement hopes to reassure the wider allergy community and to highlight procedures that should be followed by those performing OFC's; the gold standard test for food allergy diagnosis. In this regard EAACI has delivered the Guidelines for Food Allergy Diagnosis and Management in 2014 that should serve as best practice of care.

Food challenges are essential for the effective diagnosis and progress management of food allergies and currently cannot be replaced by skin prick or blood IgE, component or basophil activation testing or allergy testing alone. Patients and families should be informed about the potential risks and appropriate consent should be obtained. The OFC has been used safely for decades Life-threatening and fatal anaphylaxis at OFC's are exceptional if proper process and equipment are put in place by the health care professionals involved in oral food challenges. Reviewing internal procedures, setting, staffing and supervision should be performed on regular basis and on individual basis when needed. Ensuring patient’s safety is paramount. Protocols should be in place following some international guidance such as PRACTALL summarized in the EAACI Guidelines for Clinical practice on Food Allergy and Anaphylaxis, available for download here.

EAACI Pediatric Section

Last updated 21 November 2017