In the autumn of 1984, about thirty years after the founding of European Academy of Allergology and Clinical Immunology (EAACI) in Rome, Professor Luisa Businco (Fig. 1) of Rome gathered a number of Southern European pediatric allergists, proposing the founding of a Working Group on Pediatric Allergy and Clinical Immunology (WGPACI) within the European Society for Pediatric Research (ESPR). A month later, Sten Dreborg, at that time Medical Director at Pharmacia Diagnostics, was in Rome. He was invited to see Luisa Businco while in Rome discussing clinical trials. The question was would Pharmacia Diagnostics Italy fund a part-time secretary for one year to help start a European Society on Pediatric Allergy? The answer was yes, and Sten Dreborg was invited to the founding meeting.
A Working Group on Pediatric Allergology was formed in 1984, which rapidly developed to become the European Society on Pediatric Allergology and Clinical Immunology (ESPACI) in 1988 with its own journal, Pediatric Allergology and Immunology. ESPACI worked together with the European Academy of Allergology and Clinical Immunology (EAACI) to form a Section of Pediatrics within EAACI (SP-EAACI) in 1996. The ESPACI and the SP-EAACI formally merged in 2001. Within the EAACI organization, the Pediatric Section has continued to grow. The Pediatric Section is working to develop pediatric allergology across Europe, focusing on postgraduate education, facilitating the research agenda and advocating for children and adolescents with allergies.
The working group on pediatric allergy within ESPR
The founding meeting of the Working Group took place in Porto in November 1984. Annual meetings were held during the ESPR annual meetings in Munich 1985, Groningen 1986, and Padua 1987. The Working Group was administered by a secretary, initially Luisa Businco and from 1986 Jean-Luc Menardo (Fig. 2). There was no membership fee, but a register of interested people was kept by the secretary.
In 1985, during the meeting in Munich, it was decided to start two trials, one on diagnosis and one on immunotherapy. The latter was proposed by Sten Dreborg, and two years later, it was taken over and run by ALK as the Preventive Allergy Treatment study (PAT) [1-3].
The founding of European Society of Pediatric Allergy and Clinical Immunology, ESPACI
In 1988, the annual meeting of the Working Group was organized by the secretary Jean-Luc Menardo during the IVth International Food Allergy Symposium, in the Pope's Palace in Avignon (Fig. 3). In the monastery of the Pope's Palace, a group of members decided to form a European Society of Pediatric Allergy and Clinical Immunology, later abbreviated to European Society on Pediatric Allergology and Clinical Immunology (ESPACI). Running a society was very different in the 1980s, with the relatively primitive communication resources available at that time. Fax machines were only beginning to be introduced, and so communication was mainly by letters. This was often problematical, as the postal system across European countries did not function well. In Rome, enormous mountains of post sacks were stored outdoors at the Leonardo da Vinci airport, so Luisa Businco's letters arrived at monthly intervals by DHL. Something to think about when sending yet another e-mail by iPhone!
In 1988, during the World Allergy Organization (WAO) congress in Montreux, Sten Dreborg met with Peter Hartmann, director of Munksgaard International Publishers, Copenhagen. Sten Dreborg proposed a new journal on Pediatric Allergy and Clinical Immunology. Peter Hartmann agreed on the idea. Later, Bengt Björkstén was proposed by Sten Dreborg as the first editor. At that time, the Working Group had 300 registered but non-paying members.
In 1990, the new journal, Pediatric Allergy and Immunology (PAI)  (Clinical was removed by the editor to make it broader and more ‘sophisticated’) was appointed the official organ of ESPACI, and the symposia held during the annual meetings started to be published as supplements to PAI.
The formation of the society
During the congress of EAACI in Berlin in 1989, a few days prior to the opening of the Berlin Wall, a board of ESPACI was formed. Ulrich Wahn was elected president, Luisa Businco treasurer and Sten Dreborg secretary (Fig. 4). As a first step to open communication with the Eastern part of Europe, Václav Špičák from Prague, Czechoslovakia, was included as board member. The first board functioned for four years until the statutes of the society were set up. During this set-up period, annual meetings were still organized during the annual meetings of ESPR, in Vienna 1990 , Zürich 1991, and Uppsala 1992 . The program was mainly organized by the board but with increasing participation of local pediatric allergists. New meeting formats were tried, for example, in Vienna, the main symposium was on eczema with 30-min presentations and 30-min discussions following each presentation. The discussions were lively, and we miss them during today's congresses with the limited time for discussion. Such discussion can increase the participation in a scientific society.
In 1990, EAACI had its annual meeting in Glasgow. During that meeting, there was only one symposium devoted to pediatrics. ESPACI approached the President and Secretary General of EAACI and proposed to organize a Section on pediatrics within EAACI. Unfortunately, this proposal was not accepted, and so the board of ESPACI focused on strengthening ESPACI as an independent society.
ESPACI as an independent society with its own congresses
The first independent ESPACI congress was organized by Ulrich Wahn in Potsdam in 1993 to increase the profile of the society and make it the main meeting point for pediatric allergists in Europe. The Potsdam Congress was a success, and during the meeting, Luisa Businco was elected as the second president.
In 1993, ESPACI also published in PAI its first position paper on hydrolyzed cow's milk formulae, the work was a joint effort by many European and North American pediatric allergists .
The next year, Hermann Neijens organized a pediatric allergy session during the Pediatric Week in Rotterdam. The Pediatric Week was an initiative to bring pediatricians from different sub-specialities together. That initiative faded rapidly. Today, it has been replaced by the European Academy of Pediatrics (EAP)  and its congresses together with other sub-specialities, the European Academy of Pediatric Societies  every second year, most recently in Istanbul, Turkey in October 2012.
The society increased in membership and active participants. When Luisa Businco organized a congress in 1995 in Rome, approximately 900–1000 pediatric allergists participated. In Rome, Arne Høst was elected as the third president of ESPACI.
Negotiations between ESPACI and EAACI
Perhaps due to the success of the Potsdam and Rome meetings, the President of EAACI, Gunnar Johansson, approached Sten Dreborg in January 1996, asking ESPACI to organize the first section within EAACI, the Section on Pediatrics (SP-EAACI) . Arne Høst, as president, and Sten Dreborg negotiated the contract for the collaboration between ESPACI on the one side and the new section  and EAACI  on the other side. According to the agreement, the council of ESPACI would at the same time function as board of SP-EAACI. This arrangement would assure complete alignment between SP-EAACI and the leadership of ESPACI.
Collaboration with the Pediatric Assembly within ERS
In 1996, Arne Høst (Fig. 5) organized the congress in Odense, Denmark, as the first joint meeting with the Pediatric Assembly of European Respiratory Society (ERS-PA) (Fig. 6). During that meeting, it was agreed to continue the collaboration, with ERS-PA organizing joint meetings every third year. As usual, the main symposium was published as a supplement to PAI  (Fig. 7). Such meetings were later organized in Berlin in 1999, in Valencia in 2002, Prague 2005, and Lisbon 2007.
Formation of the Education and Training Committee, Pediatric Allergy
During the Odense Congress in 1996, Arne Høst and José Lopes dos Santos (Fig. 8) initiated the European Training Committee on Pediatric Allergy (ETC-PA) as part of the Union on European Medical Specialists (UEMS) . This is the European society that organizes all medical specialist societies in Europe. Their rules for the education of European specialists and standards for European training centers were then applied to pediatric allergy. There had been many problems in some European countries with adult allergists treating children without having any pediatric training. The Committee held the view that trainee pediatric allergists should have ‘the common trunk’ of pediatric training, supplemented by an education in the subspecialty of pediatric allergy.
The first European Training Syllabus  in Pediatric Allergy was approved by UEMS in 1999 and revised in 2003 and, most recently, in 2011. Furthermore, the ETC-PA has set up rules  for the formation of European training centers within pediatric allergy .
Slow transformation from independent Society to an EAACI Section
According to the agreement with EAACI, ESPACI was allowed to continue its activities with PAI as the official organ of the society and also organizes its own congresses. However, we had problems with finding dates for meetings. EAACI congresses were in June; thus, we tried different solutions during the autumn and winter. In 1997, José Cesar Ramos and colleagues organized the ESPACI congress in Lisbon, and the board of the section organized pediatric sessions during the congresses of EAACI in Rhodes in 1997, Birmingham 1998, Brussels 1999, Lisbon 2000, and Berlin 2001.
In 1998, ESPACI sponsored the Portuguese Pediatric Allergy meeting in the Azores. That year, however, ESPACI refrained from organizing any independent congress to facilitate the negotiations with EAACI on merging ESPACI with the SP-EAACI. To facilitate the merger negotiations, further very successful ESPACI congresses were organized in Berlin in 1999, Venice 2000, and Padua 2001.
After some years of negotiations, a preliminary agreement on the merger of ESPACI with the SP-EAACI was signed by the presidents and secretaries of EAACI and ESPACI in March 2001 . In May 2001, the agreement was confirmed at the annual meetings of both societies during the EAACI Congress in Berlin.
The agreement contained a number of clauses to allow the successful ESPACI activities to continue within EAACI. SP-EAACI would continue to have PAI as the official Journal of the Section, and the members should continue to receive the journal in addition to Allergy. The Section was allowed to arrange meetings on their own or in collaboration with other pediatric societies (e.g., ERS-PA), while keeping the executive committee of EAACI informed. Furthermore, it was stated that ‘the Section on Pediatrics may seek independent sponsors for pediatric activities. Approaches to sponsors for financial support should be discussed with the EAACI President’. The Section was also given the right to set up working groups (task forces) on the subjects of special pediatric interest. Finally, ESPACI safeguarded for future problems by inserting ‘In the event of unbridgeable difficulties, members of the Section on Pediatrics may choose to demerge and reform ESPACI as an independent entity’. It is hoped that, this clause will never be used!
At the merger with SP-EAACI in May 2001, ESPACI had about 400 members. The business plan when presenting the idea of PAI to Peter Hartman planned for an increase from 300 members in 1988–700 paying members within three years after the first issue of PAI. However, it took 15 years to get 700 members, that is, in 2004, 2 years after the merger in 2001.
Publications by the Working Group, ESPACI and SP-EAACI until the merger
Already during the first annual meeting in 1985, as previously mentioned, the Working Group decided upon common activities in the form of two trials.
When ESPACI and PAI had been established, workshops held during the annual meetings and later congresses of ESPACI were published as supplements to PAI. Additionally, the society published two position papers: one on hydrolyzed cow's milk formulas  in collaboration with American colleagues and one together with the European Society on Pediatric Gastroenterology and Nutrition, ESPGAN . Based on the Padua meeting in 2002, three position papers on ‘dietary prevention of food allergy’ were published in PAI in 2004 [19-21] with a follow-up in 2008 .
European Society on Pediatric Allergology and Clinical Immunology members contributed to several EAACI position papers during the 1990s, for example, allergen standardization and skin tests , and the use of adrenaline autoinjectors . ESPACI contributed, together with EAACI and other organizations, to the publication of international position papers on immunotherapy  and local immunotherapy  and also contributed to the work on a new nomenclature for hypersensitivity, allergy and atopy, an activity that started before the merger with SP-EAACI .
The section on pediatrics finds its form
Because the SP-EAACI had been working for several years before the merger in 2001, the activities during the first years followed the plans of ESPACI with annual autumn meetings in Venice in 2001, Valencia 2002 in collaboration with ERS Pediatric Assembly, in Geneva 2003, Prague 2005, and Estoril 2007.
As a result of the merger, the section and council were adapted to the bylaws of EAACI , the chairman was now a full and permanent member of the Executive Committee of EAACI, and other members appointed members of different committees. With the merger, the number of members of the section grew dramatically (Fig. 10).
ETC-PA continued activities
The aims of ETC-PA are to promote and harmonize the training program in pediatric allergology in all European countries by implementing its curriculum and work for the establishment of European Training Centers in Pediatric Allergology. After the merger, this activity has continued.
Education and Training Committee, Pediatric Allergology has facilitated individual accreditation of pediatricians in pediatric allergology based on individual applications directly to ETC-PA or acceptance of previous specialization according to national rules. Furthermore, a few adult allergology specialists have been approved based on long-term experience and/or scientific activities. So far, 373 pediatric allergologists have received their European Accreditation. The certification has no juridical impact. Actually, the authorities within EU have decided that specialization in one EU country should be accepted in other EU countries and have left to UEMS (European Union of Medical Specialists) the setting-up of common rules for specialization. Therefore, the accreditation as European Specialist by ETC-PA helps authorities in the evaluation of applicants from other EU countries. It is also a personal quality mark and increases the status of the institution.
Visitation and approval of training centers (according to UEMS rules) have been conducted by inspection teams. In 2008, five centers were inspected and approved in Spain and six further centers in Sweden in 2011 . The driving force behind these activities has been the secretary of ETC-PA, José Lopes dos Santos.
Pediatric Allergy for Primary Care Physicians
Because the number of trained pediatric allergologists is not sufficient to provide good care to all children suffering from allergies, EAACI has launched activities with the aim to increase the knowledge of allergies among practicing general pediatricians and general practitioners . Additionally, the Pediatric Allergy for Primary Care Physicians (PAPRICA)  activity was launched for primary care physicians, to improve awareness of early signs and symptoms of allergy. The campaign has confirmed the strong demand by primary care physicians for education in pediatric allergology. The PAPRICA symposia were initiated by Philippe Eigenmann (Fig. 11), the then chairman of SP-EAACI, who has continued to coordinate the PAPRICA Committee with its EAACI and SP-EAACI members.
To fulfill the aims of PAPRICA, it was decided to go local, organizing one-day symposia for primary care physicians (general practitioners, pediatricians). The first series of PAPRICA symposia took place in Ireland in 2004 and raised interest. The organization of these symposia has involved national/local allergy or pediatric allergy societies in collaboration with general practitioners and pediatric societies. The symposia have involved international speakers identified as experts in their fields, and the presentations have addressed mainstream topics of pediatric allergology/general allergology such as respiratory diseases, skin problems, and food allergies. The presentations have focused on current guidelines on diagnosis and treatment. The PAPRICA symposia have been a very popular and successful educational initiative for general practitioners in many European countries.
Clemens von pirquet foundation
According to the agreement between ESPACI and EAACI, the surplus assets from annual meetings arranged by ESPACI belonged to SP-EAACI. In 2007, these assets formed the basis for a SP-EAACI foundation, Clemens von Pirquet Foundation . The foundation is independent and acts in collaboration with SP-EAACI. Besides scientific activities, the foundation has continuously supported the educational activities of ETC-PA.
International Pediatric Allergology and Asthma Consortium
In 2007, the international Pediatric Allergy and Asthma Consortium (iPAC)  was founded as a joint initiative of SP-EAACI, American Academy of Asthma, Allergy and Immunology (AAAAI), and Clemens von Pirquet Foundation. The Foundation was set up to promote the education and research in pediatric allergy in collaboration with SP-EAACI. One of the aims of iPAC is to foster research within the European research programs, and it has published a series of editorials summarizing research needs across the breadth of pediatric allergology [32-37]. The iPAC foundation has initiated meetings mainly in collaboration with the SP-EAACI. Recently iPAC and SP-EAACI supported a workshop in Berlin resulting in a EAACI position paper on perspectives of specific immunotherapy in children .
Within EAACI, the Section on Pediatrics has taken the initiative for several task forces of special interest to pediatricians, for example, anaphylaxis in children , allergy schools , and more recently pediatric rhinitis and food allergy practice guidelines.
Collaboration with ERS-PA, ESPGHAN, dermatology section, interest groups on food allergy and immunotherapy
The section has continued its collaboration with the ERS Pediatric Assembly with joint meetings in Valencia in 2002, Prague 2005, and Estoril 2007. These meetings evolved into the Pediatric Asthma and Allergy Meeting (PAAM), which was first held in Venice, 2009. Furthermore, the collaboration with the Interest Group (IG) on Food Allergy, ESPGHAN and the Section on Dermatology has resulted in Food Allergy and Anaphylaxis meetings, Food Allergy and Anaphylaxis meeting (FAAM), in Venice in 2011 and several task forces. Furthermore, the Section has been actively involved in several task forces and position papers in collaboration with other sections and IGs.
Inclusion and promotion of junior members
Already before the merger in 2001, junior membership had been offered to pediatric allergologists and researchers less than 35 years of age. In 1999, Katarina Blümchen of Berlin was included in the ESPACI/Section on Pediatrics council/board. Since then, junior members have had an increasing role in the work of the section board. The Junior Members and Affiliates-Sections, JMA [41, 42], have promoted and participated in many different activities of the section, particularly the taskforces, PAAM meetings , and collaboration with PAI [44, 45].
In collaboration with the Executive Committee and the Junior Members IG (JMA), the Section has promoted the new program JMA Mentorship Program, beginning in 2012 . Junior members are offered contact with established researchers within EAACI offering their time and will to support. Based on a short c.v. of the mentor, the mentee chooses a mentor to discuss his/her future research. Many members of the Section participate as mentors.
For more than a decade, EAACI has organized Allergy Schools to spread knowledge, especially to junior members, in different parts of Europe. The Pediatric Section has been engaged especially in Allergy Schools for pediatric allergology, asthma, and food allergy. The most recent one focused on food allergy and was held in August 2012, Vienna, Austria, in collaboration with the IG on food allergy and allied health .
Pediatric Allergology and Asthma Meetings
The first joint meeting between ESPACI and Pediatric Assembly of European Respiratory Society (ERS-PA) was held in 1996  and was followed by joint meetings between the two societies every second/third year. That initiative was renamed PAAM run by EAACI with meetings in Venice in 2009 chaired by Antonella Muraro (Fig. 12) and in Barcelona in 2011 chaired by Susanne Halken (Fig. 13). Both meetings were very successful with around 900 and 700 participants, respectively.
Current and future EAACI pediatric section activities
Within EAACI, the Pediatrics Section has continued to grow such that it now has over 1300 members (Fig. 10). The Pediatric Section Board provides leadership for the Section (Fig. 14, Table 1). The current priorities for the Section are to promote training and education in pediatric allergology, develop the speciality, promote research to address the key gaps in understanding of pediatric allergy, and to advocate for children and young people with allergies and their families.
|Year||President/Chairman||Honorary Secretary||Honorary Treasurer||Annual Meeting||President of the annual meeting|
|2000–2001||Sten Dreborg||Bodo Niggemann||Bodo Niggemann||Venice||Sten Dreborg|
|1999–2000||Sten Dreborg||Bodo Niggemann||Bodo Niggemann||Berlin (ERS-PA)||Ulrich Wahn|
|1997–1999||Sten Dreborg||Bodo Niggemann||Bodo Niggemann|
|1997–1998||Sten Dreborg||Bodo Niggemann||Bodo Niggemann||Lisbon||José Cesar Ramos|
|1996–1997||Arne Høst||Bodo Niggemann||Bodo Niggemann||Odense (ERS-PA)||Arne Høst|
|1995–1996||Arne Høst||Bodo Niggemann||Bodo Niggemann||Rome||Luisa Businco|
|1994–1995||Luisa Businco||Sten Dreborg||Sten Dreborg||Rotterdam||Hermann Neijens|
|1993–1994||Luisa Businco||Sten Dreborg||Sten Dreborg||Potsdam||Ulrich Wahn|
|1992–1993||Ulrich Wahn||Sten Dreborg||Sten Dreborg||Uppsala||Tony Foucard|
|1991–1992||Ulrich Wahn||Sten Dreborg||Luisa Businco||Zürich||Council|
|1990–1991||Ulrich Wahn||Sten Dreborg||Luisa Businco||Vienna||Council|
|1989–1990||Ulrich Wahn||Sten Dreborg||Luisa Businco||EAACI Berlin|
|1995–1997||Arne Høst||Bodo Niggemann||2003–2007||Philippe Eigenmann||Antonella Muraro|
|1997–1999||Sten Dreborg||Bodo Niggemann||2007–2009||Antonella Muraro||Susanne Halken|
|1999–2001||Sten Dreborg||Bodo Niggemann||2009–2011||Susanne Halken||Graham Roberts|
|2001–2003||Arne Høst||Bodo Niggemann||2011–2013||Graham Roberts||Susanne Lau|
The Pediatric Section has an active program of ongoing and future activities. The next PAAM meeting will take place in Athens, Greece, October 17–19, 2013 . More PAPRICA Symposia are planned in 2013 . There continues to be huge research needs in allergy, particularly in the pediatric age groups with the lack of good quality trial data in many areas [33, 49]. The current EAACI campaign is the Food Allergy and Anaphylaxis Initiative. The Pediatric Section is playing a key central role in this activity, contributing to many of the guidelines groups, in particular updating the pediatric anaphylaxis position paper  as a full anaphylaxis guideline, updating the prevention position paper  as a guideline, and upgrading the allergy in school position paper  as a community guideline. The Food Allergy and Anaphylaxis Meeting, FAAM,  will be a central part of this campaign, being held in Nice, February 7–9, 2013. The Pediatric Section is organizing this meeting together with the Food Allergy and Allied Health IGs. It will be an opportunity to showcase cutting-edge food allergy science of relevance both to practicing allergologists and scientists. As part of this campaign, we have also actively involved patient groups in the guidelines activity, developing and delivering the FAAM meeting and in the future outputs from the campaign. Advocacy for children and young people with allergies and their family is a key part of the strategy for the Pediatric Section.
And finally, we must acknowledge all our colleagues and friends
Sten Dreborg and Arne Høst would like to thank all those who devoted part of their professional and private life to Working Group and ESPACI. Without all their activities over the 17 years that the Working Group and ESPACI existed, a platform for the development of European Pediatric Allergy could not have been built up. They also want to thank all those who have been engaged in the build-up of the Section on Pediatrics from 1996 to the present and especially Bodo Niggemann, secretary 1996–2003 (Fig. 9). They finally wish to forward sincere thanks to the companies who sponsored our activities during those years.
Graham Roberts, Susanne Lau, Susanne Halken, and Alexandra Santos would like to thank everyone who is contributing to the Section's current activities and Antonella Muraro for her continued mentorship of the current Board. We are all sure that our EAACI Pediatric Section will continue to be as successful in future years with its engaged and active membership. Section chairmen and secretaries are listed in Table 2.