Starship Paediatric Immunology and Allergy provides both inpatient and outpatient services for two main groups of patients:

• children with primary immune deficiency disorders where the immune system does not function properly. Many of these children will have multiple hospital admissions and they will also be seen in outpatients.  Some will require ongoing immunoglobulin replacement therapy for which Auckland children will be seen in the Day Stay Unit at Starship. The service is involved in the care of immune deficient children from around New Zealand, in liaison with the child's local paediatrician.
• children with allergic disorders.  Allergy is extremely common, and most children with allergy will be looked after by their general practitioner, sometimes with the assistance of a general paediatrician. Only a minority of children with allergy will need to be seen by the Starship Immunology and Allergy service. Examples of allergy problems that may need to be seen by the Starship Immunology and Allergy service include very severe allergic reactions / anaphylaxis, complicated food allergy, or severe insect sting reactions. Most allergy patients will be seen only in outpatients.

The Starship Paediatric Immunology and Allergy service receives more referrals than it is possible to see. Many of these referrals will be forwarded to general paediatric services. Referrals from paediatricians or other specialists will always be accepted. Some referrals will be returned to the GP with advice if, from the details in the referral, an appointment is not needed.

The waiting time for an appointment depends on the nature of the referral. Referrals for possible immune deficiency will be seen urgently. Referrals for severe allergic reaction will generally be seen within 6 weeks, while referrals for less urgent allergy problems may wait longer to be seen. 

At the clinic your child will be seen by a Consultant Immunologist or an Immunology Registrar (who will discuss each case with the consultant). The doctor will take a detailed history of symptoms and ask about previous illnesses and medications.  The history is the crucial part of the consultation.  There will be other questions about general health designed to add helpful information to diagnose what is causing your child's symptoms.  The doctor will then examine your child.  They will explain to you as they go the reasons for the examination and then what tests or treatments are coming.  It is helpful to bring your child’s well child book to the appointment, particularly if there are concerns about growth or food allergy. 

If relevant, the doctor may ask for skin tests to be performed, either on the first clinic appointment or at a subsequent appointment.  Certain skin tests may take some time to perform (e.g. up to 2 hours for some antibiotic allergy tests). 

Your child may be started on medications or asked to undergo further testing (e.g. blood tests) before being seen again in the clinic or may be discharged back to your GP for ongoing management. A letter will be sent to your GP (with a copy to the family) with treatment recommendations as well as the results of any tests that are undertaken.

Some patients will need other procedures arranged such as food or drug challenge, or venom immunotherapy.  Wait times for these procedures vary considerably depending on clinical urgency. 

www.allergy.org.au

Website of the Australasian Society of Clinical Immunology and Allergy. Links to:

• anaphylaxis resources including action plans and EpiPen teaching resources
• patient information on a variety of allergic conditions (food allergy, allergy prevention, dust mite avoidance etc)
• eczema management information (including on "finger tip units" to guide on use of topical steroids).

 www.idfnz.org.nz/

Website of the Immune Deficiencies Foundation of New Zealand, a community support organisation for children and families affected by immune deficiency.

http://www.allergy.org.nz/

Website of Allergy New Zealand, a community support organisation for children and families affected by allergy.  Allergy NZ have many useful resources about specific food allergy, education of preschools and schools, and a cook book produced with food allergies in mind.