Allergies affect most of the population daily; whether it be from the environment, food, medications or other substances. While most of us are lucky enough not to experience severe allergic reactions, complications and even death due to anaphylaxis from allergies are a genuine threat for one out of every thousand people according to the 2022 Critical Allergy Stats.

So I was truly surprised when I found out that you can’t buy EpiPens in China. Even if you don’t suffer from allergies yourself, I’m sure you’ve heard of EpiPens. An EpiPen is a hypodermic device that administers a dose of epinephrine, used for the emergency treatment of an acute allergic reaction.

To find out more about why EpiPens aren’t available here, and what alternatives there are, jingkids spoke to Dr Kim John Ly from Beijing United Family Hospital.

Dr. Ly is a licensed general practitioner/family physician and pharmacist from the United Kingdom with over 20 years of healthcare experience in both the private and public sector. He received his Master of Pharmacy Degree from the UCL School of Pharmacy, his MBChB from the University of Leicester, and is a member of the Royal College of General Practitioners and the Royal Pharmaceutical Society of Great Britain. He also holds a diploma in sexual health and reproductive healthcare (DFSRH) from the Royal College of Obstetricians and Gynecologists. He became a fellow of the Royal Society for the Promotion of Health in 2007.

Q: I understand that epi-pens are not allowed in China? Why is that?

Dr Ly: EpiPen (licensed by Mylan) is one of many branded epinephrine/adrenaline auto-injector (AAI) devices on the global market for treating anaphylaxis. Currently, there are no AAIs registered in mainland China, so they are not available due to exclusive licensing rights.  However, last year a Denmark based allergy company, ALK, planned to launch its AAI called Jext in China via a collaboration with Chinese company Grandpharma, who paid for the right to sell Jext. This is expected to be the first AAI to market in China.

If patient is to carry their own AAI from abroad, a prescription or medical certificate from the prescriber will be necessary to prove that it is for patient’s own medical use.

Note: Adrenaline (is the British approved name in UK) and epinephrine (is the WHO’s recommended international non-proprietary name and USA adopted name) are both the same active pharmaceutical ingredient. USA use the term epinephrine instead of adrenaline because Parke, Davis and Co marketed the extract under the proprietary/brand name Adrenalin, and so epinephrine became the generic name in America.

Q: What are the available alternatives here?

At Beijing United Family Healthcare we have an epinephrine anaphylactic kit available for our patients with a history of anaphylaxis. The kit consists of epinephrine 1mg/ml ampoules, ampoule cutter, syringe and alcohol swabs. Our experienced pharmacists teach the patient and their parents/guardians how to open the ampoules, draw up the appropriate dose of the medication and administer it correctly when dispensing the medication. Adrenaline is a prescription only medication and cannot be purchased over the counter.

Q: What is your advice on dealing with allergies, especially in kids, in Beijing? 

Allergy is an abnormal hypersensitive reaction mediated by our own immune system in response to a substance, which we call the allergen. It consists of a spectrum of symptoms of varying severity. At the severe end of the allergy spectrum we have anaphylaxis, which is a medical emergency, and defined as a “severe, life-threatening, generalised or systemic hypersensitivity reaction characterised by rapidly developing life threatening airway and/or breathing and/or circulation problems usually associated with skin and mucosal changes” following exposure to an allergen.

Children with suspected anaphylaxis should be referred to an allergy specialist, and prescribed an epinephrine/adrenaline kit by their family medicine doctor or ER doctor as an interim measure before their allergy specialist appointment. Patients can make an appointment to see one of our clinical allergist at Beijing United Family Healthcare.

Indications for prescribing an AAI include:

• People with a severe allergic reaction involving the airway and/or low blood pressure
• People whose reaction is triggered by an unavoidable allergen
• People with a localized reaction (not involving the airway) in a person who is considered high risk (e.g. people with asthma)
• Likely repeated exposure to allergen
• Lack of access to emergency care

On the less severe end of the spectrum, allergy symptoms can present as sneezing, watery eyes, irritated nose, itchy rash and more. These symptoms are annoying and often make it hard to focus, concentrate and sometimes hard to get a restful night.

At United Family Healthcare our family medicine doctor can prescribe allergy tests to explore potential allergens including, but not limited to, cat dander, dog dander, tree pollen mixture, grass pollen mixture, mould mixture, egg, nut mixture, fruit mixtures, wheat, sesame, crab, shrimp, milk, penicillin and more.

Measures to reduce or minimise exposure (e.g using air purifier, wearing face mask, keeping windows shut when pollen count is high), or avoiding the known allergen (e.g. not eating foods that trigger the allergy) can help limit the symptoms experienced. Also medications such as antihistamines, allergy eye drops, allergy nasal sprays and nasal douches can be prescribed by a family medicine doctor to provide symptomatic relief.

There is evidence that vitamin D deficiency is positively correlated with an increased prevalence for allergies. Vitamin D is also an important hormone for child growth due to its effect on calcium homeostasis and bone mineralization, but also for the proper functioning of the immune system.

In view autumn is here and winter is approaching soon, less sunshine and increased indoor activity means our exposure to sunshine is decreased and our ability to generate vitamin D is reduced. To maintain an adequate level of vitamin D, foods rich in vitamin D such as eggs, salmon fish, fortified cereals and fortified milk, or vitamin D supplementation is recommended.

KEEP READING: Navigating Allergies in Beijing’s International Schools

Images: Pexels, Beijing United Family

There’s few things scarier than having a medical emergency in a foreign country. But what if it happens outside of regular working hours when most of the city has already turned off their lights? That’s why we thought it prudent to share with concerned parents this list of 24-hour emergency phone numbers of hospitals that specialise in treating children. The list was originally put out in Chinese by 树图星球 (Shù tú xīngqiú) and has been translated into English for your convenience.

This list has been considerately segmented into various types of emergencies ranging from fever to broken bones; injuries that require stitches; burns and scalds, as well as ear, nose, throat infections. It is always recommended to call ahead to ensure that the medical staff at the hospital is ready to receive you.

In the original post, there were some notes included at the bottom that we have also translated for your reference:

– Pediatric resources are very scarce, and pediatric clinics in some hospitals are restricted or pediatric emergencies are suspended.
– Under epidemic conditions, it has become very difficult for children under the age of 14 to see a doctor when they have a fever.
– Both the international community and the China-Japanese friendship do not receive infants and young children Under the age of 14 in emergency cases of trauma injury.
– Compared with the public hospitals, private hospitals can deal with the disease in time to reduce cross-infection as soon as possible.
– Some private hospitals can invite experts to fly for consultation at additional cost. It is true that you can buy resources with money.
– Private medical insurance coverage can assist in getting medical appointments in a timely manner.

While we hope you’ll never have to use these numbers, it’s always better to be safe than sorry. So keep these numbers handy just in case of an emergency!

KEEP READING: Is Your Medical Insurance Covering Your Family the Way It Should?

Images: Pexels, Jingkids

Urgent action is needed to change the way both doctors and consumers use antibiotics, to avoid a post-antibiotics era where these drugs no longer work at all, the World Health Organization (WHO) in China announced during the first ever World Antibiotic Awareness Week, from now through November 22.

“Antibiotics are a crucial part of modern medicine, but they have become victims of their own success. As a result of over-use and misuse of antibiotics by both doctors and patients, antibiotic resistance is a now a gravely serious global health problem – including here in China,” said Dr. Bernhard Schwartländer, WHO representative in China.

“Antibiotic resistance affects us all. It means infections which were once easily cured are becoming harder to treat, and common surgical procedures such as caesarian sections and appendix removals could become life-threatening due to the risk of untreatable infections,” Dr. Schwartländer explained.

Beyond the health system, the economic costs of antibiotic resistance are formidable – in China, one prediction estimates the loss of up to a million lives a year by 2050 – and if left unchecked, antibiotic resistance could wipe out up to 3.5 percent of global GDP by 2050.

In China, use of antibiotics is very high: over the past decade, more than half of outpatients in China have been prescribed antibiotics – far above the level recommended by WHO (less than 30 percent).

A new survey commissioned by the WHO for World Antibiotic Awareness Week also shows that public awareness in China about antibiotics and their use is low:

• 61 percent of survey respondents in China thought antibiotics were effective against colds and flu, despite the fact that antibiotics have no impact on viruses;
• 53 percent of survey respondents in China  thought it was okay to stop once taking antibiotics once they felt better, rather than completing the prescribed course of treatment; and
• 35 percent of survey respondents in China thought antibiotics were effective against headaches, which is not the case.

China has taken important steps over the last few years to address antibiotic resistance: for instance, in 2011, the Chinese government launched a nationwide campaign to improve the use of antibiotics by health workers and institutions, which has led to significant reductions in rates of antibiotic prescriptions.  

However, more needs to be done – both by health care professionals and patients.

“The WHO’s message for patients is this: don’t demand antibiotics from your doctor when you may not need them. Only take antibiotics when they are prescribed for you by a certified health professional. Always take the full course, even if you are feeling better. Never use leftover antibiotics, and never share your antibiotics with others,” said Dr Schwartländer.

“The magnitude of the problem of antibiotic resistance is enormous, and all of us have a role to play in addressing it. If everyone plays their part, we can ensure that these crucial drugs are still able to save lives in the years to come,” Dr Schwartländer concluded.

This post first appeared on thebeijinger.com on November 18, 2015.