CURRENT ALLERGY & CLINICAL IMMUNOLOGY JOURNAL OF THE ALLERGY SOCIETY OF SOUTH AFRICA
Vol 34, No 1 June 2021
- The insta-diet
Social media for healthcare professionals
- Pearls and pitfalls of using social media in allergy
- Allergy to Cannabis Sativa: an unusual type of ‘weed’ allergy
- The value (or otherwise) of social media to the medical professional
- The viral spreading of pseudoscientific and quackery health messages on Twitter
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Authors: S Karabus
Abstract: There’s no doubt that we will look back on this time as the period during which it became mandatory to start every email with ‘I hope you are safe and well in these difficult times ….’
Who would ever have imagined how the world could change, and how rapidly? Medicine in the era of COVID-19 has had to suddenly change tack and evolve very quickly in order to continue to provide for the healthcare needs of entire populations.This global pandemic has emerged in and wreaked havoc on wholly unprepared societies in both the developed and the developing world. It has had an arguably unprecedented impact across the globe: widespread social disruption and isolation, general hardship and economic loss have visited devastation upon many levels of society, and that is certainly the case in South Africa. To adapt the words of the poet James Shirley, we could call this phenomenon ‘COVID the Leveller’, because that it has certainly been: few are immune to it, and in its dust all will be equal made.
SOCIAL MEDIA FOR HEALTHCARE PROFESSIONALS: NEW ETHICAL GUIDELINES
Authors: Brandon Ferlito, Selaelo Mametja
Abstract: The popularity and use of social media have grown at exponential rates over the past few years. Many healthcare professionals (HCPs) consider the use of social media in their daily prctice as a positive, rather than a negative. However, concern is growing that HCPs may expose themselves unwittingly to ethical dilemmas when using social media. Although HCPs should not be discouraged from using the benefits of social media, they still need to be aware of any potential ethical pitfalls, even if such consequences of using social media are unintended. As a result, the Health Professions Council of South Africa (HPCSA) published the booklet: ‘Ethical Guidelines on Social Media’, which aims to help HCPs understand their ethical responsibilities when making use of social media.
Keywords: new ethical guidelines, social media, healthcare professionals
AMERICAN COLLEGE OF ALLERGY, ASTHMA & IMMUNOLOGY POSITION PAPER ON THE USE OF TELEMEDICINE FOR ALLERGISTS
Authors: Tania Elliott, Jennifer Shih, Chitra Dinakar, Jay Portnoy, Stanley Fineman
The integration of telecommunications and information systems in health care first began four decades ago with 500 patient consultations performed via interactive television. The use of telemedicine services and technology to deliver health care at a distance is increasing exponentially. Concomitant with this rapid expansion is the exciting ability to provide enhancements in quality and safety of care. Telemedicine enables increased access to care, improvement in health outcomes, reduction in medical costs, better resource use, expanded educational opportunities, and enhanced collaboration between patients and physicians. These potential benefits should be weighed against the risks and challenges of using telemedicine. The American College of Allergy, Asthma and Immunology advocates for incorporation of meaningful and sustained use of telemedicine in allergy and immunology practice. This article serves to offer policy and position statements of the use of telemedicine pertinent to the allergy and immunology subspecialty.
Republished with permission from Elsevier Inc. Ann Allergy Asthma Immunol 2017;119:512–517.
THE VIRAL SPREADING OF PSEUDOSCIENTIFIC AND QUACKERY HEALTH MESSAGES ON TWITTER – FINDING A COMMUNICATION VACCINE
Authors: George Claassen
Abstract: One of the most serious problems for both scientists and journalists reporting on scientific findings and research is the growing online presence of quackery, pseudoscience and alternative ‘facts’ in the health field. The focus on this phenomenon sharpened in the wake of the Ebola outbreak of 2013–2016 and has now come under the spotlight even more intensely during the COVID-19 pandemic. This viral spread of pseudoscience and quackery has reached communities at large, often leading to the adoption of conspiracy theories about vaccines and to pseudoscientific advice on medication against the viruses being heeded. This study investigates the presence and power of pseudoscientific messages about health matters on Twitter and how some scientists are trying to use the social media platform to counteract quackery.
Keywords: viral spreading, pseudoscientific messages, Twitter
THE VALUE (OR OTHERWISE) OF SOCIAL MEDIA TO THE MEDICAL PROFESSIONAL: SOME PERSONAL REFLECTIONS
Authors: Timothy D Noakes
Abstract: Between June 2015 and June 2018, I was engaged in a 28-day hearing conducted by lawyers representing the Health Professions Council of South Africa (HPCSA). I faced a charge of unprofessional conduct for a seven-word Tweet that I typed in February 2014. The charge of unprofessional conduct was based essentially on the accusation that by answering a request for information on Twitter I had automatically entered a doctor–patient relationship; I had given medical advice that was incorrect because it was ‘unconventional’ and not ‘evidence-based’; I had not fulfilled my duty of care to the patient; and that I had potentially put the lives and health of ‘millions’ of infants at risk. It was not difficult to disprove all these concocted charges even though it took 28 days in court at a total cost to both parties combined that probably exceeded R15 million. My legal team and I were able to show that: (i) I had not entered a doctor–patient relationship on Twitter; (ii) I had provided medical information not medical advice in response to a ‘we’ question; (iii) the information I had provided was 100% compatible with the South African and World Health Organization Dietary Guidelines for complementary infant feeding; and (iv) in the broader picture, the general dietary advice that I favour – the low-carbohydrate high-healthy-fat diet – is neither ‘unconventional’ nor ‘not evidence-based’. While on the surface the trial was ostensibly about the ‘dangers’ of a seven-word Tweet, there were a number of covert agendas acting out behind the scenes. It was surprising, for example, that so many of the key witnesses for the prosecution had links to a shadowy international front organisation, the International Life Sciences Institute (ILSI), whose established goal is to control national dietary and exercise policies on a global scale and ‘to marginalise unfavourable positions’, mine included. Or perhaps an undisclosed aim was to restrict the future freedom of speech of practitioners registered with the HPCSA. For had I lost the case, registered practitioners would no longer be absolutely certain that any information they shared when either lecturing, writing, speaking in public or interacting on social media on any medical topic whether dealing with individuals (medical advice) or groups (medical information), might not result in their being charged as was I. By winning this matter, this danger has been averted. I expand the article by explaining why I believe that, if used properly, social media tools such as Twitter have enormous educational potential for scientists and students especially, but also for clinicians.
Keywords: social media, medical professional, value
Authors: Lindsay Archibald-Durham
Abstract: Consumers are becoming more mindful of their lifestyle choices, finding new avenues for learning about food and nutrition via the internet. In this era of instant information, health messages, whether factually correct or not, are at our fingertips. Social media usage in South Africa is increasing, giving health professionals an opportunity to disseminate public-health messages. But inaccurate and potentially dangerous information also has a wider reach. Social media gives everyone an equal voice, affording an unqualified individual, a celebrity or a healthcare professional the opportunity to communicate directly with the public to influence their behaviour. While most social media platforms have community guidelines to attempt to regulate content, the very nature of these platforms allows anyone to create and publish content. Social media can be used for inspiration and creative ideas; however, it should never take the place of sound medical advice. The popularity and impact of social media in the context of nutrition should ideally require influencers to meet accepted scientifically or medically justified criteria.
Keywords: nutrition, social media, medical advice, influencers, instant information
PEARLS AND PITFALLS OF USING SOCIAL MEDIA IN ALLERGY
Authors: Carina Venter, David R Stukus
Abstract: Social media provide a user-friendly format for healthcare professionals to engage with a large audience and provide much-needed reliable information. In addition, healthcare professionals may want to engage on social media to network and obtain information or increase their own education. Many different social media platforms are in use, each with its own positive and negative aspects. They include Blogs, Facebook, Twitter, Instagram, Snapchat, Pinterest, LinkedIn, Reddit and Tiktok. Prior to engaging in social media, it is recommended to consider, 1) the audience one wants to reach, 2) the messages one wants to convey and 3) which platform is best suited to achieving goals. As with any other healthcarerelated encounter, patient confidentiality should always be the first priority. In a world where travel is becoming less commonplace and food-allergy research is ever-evolving, engagement with social media provides the ideal opportunity to educate others and be educated.
Keywords: social media, allergy, pitfalls
ALLERGY TO CANNABIS SATIVA: AN UNUSUAL TYPE OF ‘WEED’ ALLERGY
Authors: Sarah Karabus
Introduction: Cannabis sativa is a herb indigenous to Central Asia and the Indian subcontinent but it can be found growing worldwide. Ancient archaeological evidence dating back to the Neolithic period, shows that cannabis is one of the world’s oldest cultivated crops widely used for food, rope and fabric, as well as recreational, medicinal and religious purposes. In recent years, many governments have debated the illegal status of Cannabis sativa. As a result, many countries, including South Africa, have legalised or decriminalised its used. The United Nation’s World Drug Report estimates that 4% of the global population use cannabis recreationally, and this seems to be steadily increasing.1 Cannabis sativa allergy is of particular relevance given the growing popular interest in the potential health benefits that might be derived from cannabis in the form of hemp, hemp seeds, cannabis oil and other forms.
Keywords: Cannabis sativa, weed allergy, cannabis-fruit/vegetable syndrome
ALLERGEN SENSITISATION OF PATIENTS WITH ALLERGIC RHINITIS AT A PRIVATE EAR, NOSE AND THROAT PRACTICE IN THE NORTHERN CAPE
Authors: Werner Hoek, Gina Joubert, Riaz Y Seedat
Introduction: Allergic rhinitis occurs as a result of an IgE-mediated hypersensitivity response in the nose. There are no reported data from patients with allergic rhinitis from the Northern Cape to guide the panel of aeroallergens used for allergy testing. The aim of the study was to describe the aeroallergen sensitivity profile of patients diagnosed with allergic rhinitis at a private ear, nose and throat practice in the Northern Cape.
Methods: This was a retrospective descriptive study of patients diagnosed with allergic rhinitis who underwent testing for aeroallergen sensitisation by skin-prick testing or detection of allergen-specific IgE over a six-year period at a private ear, nose and throat practice in the Northern Cape.
Results: Grass pollens were the most common sensitising allergen, with 84.6% of patients tested being sensitised to one or more grass pollen. Of the patients tested, sensitisation to weed pollens was present in 46.4%, to tree pollens in 27.6%, to moulds in 48.6% and to dust mites in 41.0%.
Conclusion: Knowledge of the allergen sensitisations of patients with allergic respiratory diseases, together with pollen calendars can assist with allergen avoidance by these patients. Further studies are required to determine sensitisation to prevalent airborne pollens identified by pollen monitoring.
Keywords: allergen sensitisation, allergic rhinitis, Northern Cape
PERSISTENT ORAL CANDIDIASIS AND DISSEMINATED BCGosis AS MANIFESTATIONS OF A POSSIBLE INBORN ERROR OF IMMUNITY
Authors: Anne Barasa, Ismail Ahmed, Jamilla Rajab, Edwin Walong
Abstract: Inborn Errors of Immunity (IEI) are inherited disorders characterised by a defect in one or more components of the immune system, leading to increased susceptibility to infections. We present the case of a five-month-old boy with persistent oral thrush and disseminated BCG infection following vaccination at birth, due to a possible underlying IEI.
Keywords: inborn errors of immunity, oral candidiasis, disseminated BCGosis
TUBERCULOSIS REACTIVATION – A CONSEQUENCE OF COVID-19 ACQUIRED IMMUNODEFICIENCY?
Authors: Sipho D Ntshalintshali, Riezaah Abrahams, Tholakele Sabela, Jacques Rood, Sumanth Karamchand, Nelius du Plessis, Songezo Ceki
Abstract: COVID-19 has been associated with lymphopaenia secondary to direct effects of SARS-CoV-2 virus on lymphocytes. We report on a case of an elderly patient with previous pulmonary tuberculosis (TB), recently diagnosed with COVID-19 complicated by lymphopaenia and TB reactivation. Our intention is to raise the awareness of clinicians to be alert to the high level of suspected TB infections during the COVID-19 pandemic, especially in TB-endemic regions such as South Africa. We further review the mechanism by which SARS-CoV-2 infection may lead to TB reactivation.
Keywords: pulmonary tuberculosis, tuberculosis reactivation, COVID-19, acquired immunodeficiency