A severe allergy, however, is a dramatic and violent error of the immune system. "An allergy is a reaction of the immune system, therefore it is completely different from an intolerance," Barata clarifies. Here, the body's defense forces mistake a harmless substance - a protein in a peanut, a molecule in shellfish, or enzymes in bee venom - for a deadly invader. The immune system then launches a disproportionate, full-scale attack on the body itself. This extreme reaction, known as anaphylaxis, is a rapid, whole-body shock. "The body tries to protect itself so much that it closes the airways, enters into internal collapse, and the resulting anaphylactic shock can be fatal," Barata states, describing the terrifying physiological cascade. The symptoms are acute and dramatic: the throat and tongue can swell to the point of suffocation; breathing becomes a desperate struggle; a catastrophic drop in blood pressure causes dizziness and loss of consciousness.
Faced with this, the response must be immediate and precise. "This is a race against time that requires immediate treatment with an auto-injector of epinephrine," Barata emphasizes. The epinephrine acts as a powerful countermeasure. In layman's terms, Barata explains, "it will jolt the body a little to breathe, to enter into a counter-cycle with the hypersensitivity." This must be instantly followed by an urgent call to emergency services, specifically requesting advanced medical support.
Behind this stark medical reality lies a burgeoning public health crisis, particularly in Luxembourg, where the systems of support are struggling to keep pace with the rising tide of cases. Pedro Barata provides a sobering assessment of the landscape. "In the last 10 years, the number of allergy cases has doubled and the number of hospitalizations due to allergies has increased sevenfold," he reveals, pointing to an alarming trend that shows no sign of abating. This surge is occurring in a context where specialized medical care is scarce. Allergology as an independent specialty is relatively new in Luxembourg, and the country falls short of World Health Organization recommendations for specialist coverage. The consequence for families is direct and painful. "Children who discover they are carriers of severe allergies currently have a waiting list of one to one and a half years," Barata notes, a delay that can feel like an eternity for a parent managing a life-threatening condition.
Into this breach steps the Luxembourg Allergy Network. Founded in 2015, LAN was born from a recognition of a critical void in the system. "When someone exercises the right of free association, it is saying that there is a void in the services that are provided by the State," Barata observes. "We are not trying to say that the State is at fault, but what we say is that there is a void between what is being done and what can be done." The association's work is fundamentally community-based and pragmatic. "Typically, when allergies enter the life of a family, the family knows nothing about the subject," he says. "They don't know how to handle the children, how to deal with the creches, the school, the dietary restrictions." LAN’s role is not to provide formal medical advice but to foster a network of mutual aid. "What we do is try to help people with the experiences of other people. Share best practices, what worked in this case, what worked in that case... there is above all a mutual help between the different members of the community."
From this frontline perspective, LAN identifies two particularly acute systemic failures. The first is the arduous and emotionally draining path to diagnosis. Barata describes the plight of families, and especially non-verbal infants, who navigate a labyrinth of specialists. "We see children with severe allergies taking a year, a year and a half to be detected because the pediatrician who sees the child could not identify or alert to this possibility," he says. He gives a poignant example: "A mother who is breastfeeding her child and the child is allergic to milk. The mother, unwillingly, is hurting the child. And she feels frustrated because she feels the lack of well-being of the child and tries a thousand things and nothing is working." The solution, he argues, lies in bolstering frontline medicine. "The first point is more training for pediatric doctors, training, information actions on the subject of allergies to pediatricians, to family doctors."
The second crisis point erupts when a child reaches school age. "From the moment the children are in school age, the parents are transferring the responsibility to the teachers. And then sometimes the drama of the parents begins," Barata describes. The situation in Luxembourg is a complex mosaic of different policies and preparedness levels. While he praises the proactive steps of some private schools and communes like Luxembourg City, he notes that success is often fragile. "There are other cases that we consider successful, but that are linked to one or two people... but there are many cases in which manifestly the schools are not prepared and here we are not going to say that it is due to ill will."
He points to a deeper, legal ambiguity that complicates matters. "In the Luxembourgish Civil Code, what is called the 'prise en charge' is not defined in an unambiguous way... there are gaps in terms of responsibility." This contrasts with countries like Australia, Canada, or the UK, where such responsibilities are clearer. To address this patchwork system, LAN advocates for "processes well defined and universal to be used in the entire country."
This advocacy has now crystallized into a formal proposal. Inspired by the successful creation of a national cancer plan in collaboration with the Luxembourg Institute of Health (LIH), LAN has co- signed a document submitted to the Ministry of Health. "We requested the creation of a multidisciplinary working group... that in the period of 18 months creates a base of work for the implementation of the National Plan for the Management of Allergic Diseases," Barata announces. This push for a coordinated, state-level strategy underscores a firm belief that "without political participation, without a commitment from the local authorities, only with community effort we will not manage to do everything in time."
For the general public, Barata offers clear, actionable guidance. He explains that emergency protocols typically have two components. For a mild, single-symptom reaction, an antihistamine may suffice. However, the rule of thumb is critical: "More than one symptom is because the person is going to escalate, is not going to improve. Therefore, then it is to go directly to the question of epinephrine." He offers a crucial reassurance to those who may hesitate: "Giving an injection of epinephrine to someone who after all did not need it is not harmful." His advice in moments of doubt is simple and powerful: "I think that in case of doubt it is better to help more than to not help." The emergency protocol is also clear about the next step: "In case of a severe reaction, call the SAMU immediately... and say: 'I have a person in a potential anaphylactic attack, I am going to administer an epinephrine pen, come to the location."
Ultimately, the rising wave of allergic diseases is a call for a societal shift - from perception to policy. It demands that we move beyond viewing allergies as a trivial inconvenience and recognize them as the serious, chronic, and potentially fatal conditions they can be. It calls for empathy, a word Barata himself highlights. "Because we do not know what we do not know, give a vote of confidence to others, be open to learning new things." As Luxembourg, and indeed the world, grapples with this growing challenge, the work of associations like LAN and the lessons they offer provide not just a path to better management, but a blueprint for building a more informed, prepared, and compassionate society for all.
JS Gomes
Radio Latina Universo Associativo
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