Introduction

In June 2014, notable medical professionals Jacques Gayraud, MD, and Dionysis Giannakopoulos, MD, along with delegates from 26 countries, convened to discuss the current state and future of allergology in Europe. This summary highlights key findings and statistics from the meeting, reflecting the collaborative efforts and diversity of practices across the continent.

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Countries Involved

The initiative saw participation from the following countries:

• Greece
• Portugal
• Lithuania
• Slovenia
• Denmark
• Hungary
• Italy
• France
• Germany
• Finland
• Spain
• Czech Republic
• Netherlands
• Austria
• Cyprus
• Belgium
• Turkey
• Switzerland
• Sweden
• Estonia
• Romania
• United Kingdom
• Ireland
• Poland
• Slovakia
• Bulgaria

Allergology as a Specialty  

• Countries Recognising Allergology: 14 countries recognise allergology as a specialty, including Italy, Portugal, Spain, Greece, Croatia, the Czech Republic, Lithuania, Luxembourg, Cyprus, the Netherlands, Switzerland, Romania, UK, and Sweden.
• Countries Not Recognising Allergology: 5 countries do not recognise it, including Denmark, Slovenia, Austria, Belgium, and Ireland.

Allergology in Medical Schools  

• Countries with Allergology Departments: 19 countries, including Finland, Croatia, Italy, the Czech Republic, Lithuania, Spain, Portugal, the Netherlands, France, Germany, Denmark, Austria, Switzerland, Turkey, Sweden, Belgium, Romania, UK, and Slovakia, have allergology departments in their medical schools.
• Countries without Allergology Departments: 5 countries, including Greece, Hungary, Slovenia, Cyprus, and Estonia.

Training in Allergology

• Duration of Training: The duration of allergology training varies by country, ranging from 2 to 5 years. For instance, Spain requires 4 years, Portugal 5 years, Netherlands 4+2 years, and Germany 18 months.
• Training Centers and Trainees: The number of training centers and trainees also varies significantly. Spain has 34 centers with 55 trainees per year, whereas Germany has between 50-100 trainees annually

Pediatric Allergy Specialty

• Countries with Pediatric Allergy Specialty: Bulgaria and the UK have a recognised specialty in pediatric allergy, with France having it as a competence.
• Countries without Pediatric Allergy Specialty: Several countries, including Austria, Spain, Lithuania, Slovakia, Poland, Greece, and Romania, do not have this specialty.

Complementary Allergy Training  

Some countries provide complementary allergy training for general practitioners and other specialists. Notably, Spain, Lithuania, Poland, Greece, UK, Germany, and France offer such training.

University/Pregraduate Level Training  

Hours dedicated to allergy training at the university level range from 0 to 30 hours in countries like Spain, Lithuania, Poland, and Bulgaria.  

Diseases Managed by Allergologists

• Common diseases treated by allergologists in Europe include asthma, rhinitis conjunctivitis, food allergy, drug allergy, venom allergy, anaphylactic shock, immunotherapy, urticaria angioedema, and eczema.
• Less common conditions include skin allergy, contact dermatitis, occupational asthma, primary immunodeficiencies, AIDS, and transplantation.

Prices of Allergy Services  

The cost of allergy services varies widely across Europe. For instance, initial consultations cost between €16.28 and €285, with follow-up consultations ranging from €7.75 and €285. Prices for specific tests, such as IDR and patch tests, also vary.

Immunotherapy Practices   

All European countries practice immunotherapy in various forms, including SIT, SCIT, SLIT, and tablets.  

Specialists Prescribing Immunotherapy   

In most countries, allergists prescribe immunotherapy. However, in some, other specialists like pulmonologists and ENT doctors can also prescribe.

Anaphylaxis Guidelines

Anaphylaxis guidelines exist in half of the European countries, including Hungary, France, UK, Germany, Slovenia, Finland, Czech Republic, Sweden, Spain, Switzerland, Netherlands, Greece, and Romania. Denmark, Portugal, and Italy are still working on developing guidelines.

Continuing Medical Education (CME)  

CME is mandatory in 14 countries and beneficial in 8. Countries with mandatory CME include France, Hungary, Italy, Austria, Spain, the Netherlands, Slovenia, Lithuania, Germany, Czech Republic, Switzerland, Turkey, Belgium, Romania, Greece, UK, Cyprus, and Ireland.  

Allergologist to Population Ratio  

The ratio of allergologists to the population varies greatly. Germany has the best ratio, while Ireland has the worst. Other notable ratios include Italy, Czech Republic, Lithuania, Netherlands, Portugal, Spain, Finland, Denmark, Greece, Sweden, Romania, France, Hungary, and Slovenia.  

Distribution of Allergologists   

The distribution of allergologists by status (public, private, or both) varies by country. For example, Austria has 15 allergologists, with 400 specialists, while Spain has 700 allergologists, 550 in public hospitals, and 150 in private practice.

Scientific Societies and Patient Associations

Most countries have scientific societies and patient associations representing allergologists, with 19 countries having such structures.  

Conclusion  

The collaborative efforts across these 26 countries reflect a robust and diverse landscape of allergology practices in Europe. The shared knowledge and unified approach aim to enhance allergology training, patient care, and research, ultimately benefiting patients across the continent.