The month of November saw too many deaths. Two teen-aged boys, an elderly woman and a little boy all lost their lives after being exposed to foods they were fatally allergic to. Nineteen year old Chandler Swink and seven year old Joseph DeNicola didn’t even ingest the foods to which they were allergic. It’s suspected that both boys were victims of cross contamination. Sixteen year old Jamie Mendoza ate a peanut butter cookie that he thought was a chocolate chip. He fought for his life for over a month before being removed from life support. Sixty-eight year old Dora Coburn was fed a dessert containing bananas, that an intake nurse failed to note as an allergy on her chart. She died six hours later. The lives of those with food allergies are full of almost constant fear, especially around holidays when food is the central part of many family celebrations and relatives aren’t cognizant of the severity and gravity of those allergies.
The last decade has seen a huge increase in the prevalence of food allergies in U.S. children. Today, roughly 50% more children are suffering from true food allergies than were afflicted at the turn of the current century. A 2009 amendment to the Americans with Disabilities Act made it possible for severe food allergies to be considered a disability and allowing children, teens, and adults certain protections under the federal law. Walking into schools nowadays is a very different experience that it was ten or twenty years ago. Signage in the cafeterias and on classroom doors declaring food allergies are replacing student art décor as roughly 1 in every 13 (around 6 million) children are afflicted with a food allergy. Approximately 300,000 of those children wind up in an Emergency Department or other healthcare setting for treatment after exposure to their particular allergen- costing about $25 billion dollars per year. Because of widely available emergency medical care, deaths from anaphylaxis related to food allergies are not common but they do happen, especially in scenarios where epinephrine treatments are delayed or not administered to individuals with known allergies and a prescription for the drugs.
Food allergies cover a broad spectrum, which leads to a lot of confusion. Many people conflate food allergies with respiratory allergies or food intolerances. All three of these are very different problems. Generally, respiratory allergies are reactions that are limited to airborne substances such as pet dander, pollen, mold, pollutants, and the like. These types of allergies can generally be controlled with an antihistamine (oral, nasal, ocular), and the symptoms (sneezing, nasal congestion, coughing, watery eyes) while debilitating, are almost never very severe. Food intolerances are digestive system responses to food the person’s body is unable to break down. These symptoms can include any variety of peptic upset (pain, nausea, vomiting, diarrhea, heartburn, gas or bloating etc.), headaches and mood swings, but do not involve an actual immune system response. Many people believe that having diarrhea after consuming dairy means that they are allergic to milk, when in actuality, they are more likely lactose intolerant. True food allergies are an immune response to food proteins called anaphylaxis. This is a whole body, or systemic, reaction involving the respiratory, gastrointestinal, cutaneous (skin) and/or cardiovascular systems. Proteins in certain foods (milk, eggs, peanuts, tree nuts [ex: almonds, walnuts, pecans], wheat, soy, fish and shellfish account for 90% of all food allergies) can cause all of the symptoms of respiratory allergies and food intolerances, and tack on some others that are very scary and can lead to death by asphyxiation and/or cardiac arrest. These additional symptoms include: chest pain, rash, hives, itchy skin, shortness of breath, and most serious, cardiac arrhythmias (irregular heartbeats) and swelling of the throat and airways to the lungs. In an allergic individual, the body responds to these proteins as if they were a toxin, in a case of “mistaken identity,” and launches an all-out assault which results in the allergic reaction. The acuity of the reaction can vary, even in the same individual, but it is generally accepted that the faster the symptoms present, the more severe the reaction will be. Even “mild” anaphylactic reactions can be terrifying as tissues swell, breathing becomes restricted, heart rate changes, and confusion sets in. While some allergic reactions can be headed off with medications such as Benadryl, severe anaphylactic reactions can quickly progress to anaphylactic shock and death. Much of the anxiety surrounding food allergic children and their parents is the inability to know how quickly the reaction will progress and if treatment will be able to be provided in a timely manner. Anaphylaxis is always an emergency for this reason. Injection of epinephrine will not necessarily arrest the onset of anaphylaxis. It is the first line of defense, but medical observation is always necessary after administration as the reaction can last more than 24 hours and can also reoccur after resolving initially. Severe reactions may require additional dosages of injected medications, intravenous drugs, nebulized breathing treatments, intubation and sometimes surgical interventions.
Food allergy deaths are preventable. Raising awareness is helping. As reported by the Inquisitr, FARE launched the Teal Pumpkin Project in earnest this year as a way to include allergic kids while keeping them safe. Many families are pushing for better labeling by manufacturers of possible cross contamination issues in their production facilities. Being mindful these allergies and adapting family recipes to keep loved ones safe is imperative during family gatherings.
Image source: http://nateam.org/