Peanut Allergies in Children
How to Cope with Life-Threatening Anaphylaxis
There are 1.5 million children and adults suffering from severe peanut allergies in the USA. This article discusses how to live safely with a peanut allergy.
According to the Food Allergy and Anaphylaxis Network, there are over 1.5 million adults and children in the United States with significant peanut and tree nut allergies. The number of individuals affected has steadily increased over the past two decades, for reasons that are unclear. As the number of children with potentially life threatening food allergies increases, there is a need for increased public awareness to help affected children avoid life threatening anaphylactic reactions.
What is a peanut allergy?
Peanut allergies involve an overly aggressive response of the body’s immune system to ingestion of foods containing peanut protein. When a peanut-allergic person is exposed to the allergen, specialized immune cells, known as mast cells, release a chemical called histamine, which circulates through the body, causing several adverse effects:
- Constriction of the airways in the lungs, causing shortness of breath and decreased blood oxygen levels.
- Dilation of blood vessels, causing a dangerous drop in blood pressure.
- Release of fluid in the skin, resulting in hives.
- Abnormal fluid (edema) in the nose, mouth and tongue, restricting swallowing and breathing.
Mild reactions may involve less severe symptoms such as hives or sneezing. More severe reactions, known as anaphylactic reactions, can result in more severe symptoms, such as shortness of breath, cardiovascular collapse, and even death.
How should an allergic reaction be treated?
The most effective treatment for severe allergic reactions is an injection of adrenaline (a.k.a. epinephrine), immediately after the onset of symptoms. Individuals who are known to have severe peanut allergies should always have one or two doses of adrenaline on hand (not in the car, or in the basement, or in the medicine cabinet, but in a pocket, a backpack or a purse) in case they have an allergic reaction. Adrenaline kits shaped like pens, with an automatic injection trigger, are available by prescription for allergy patients, and should be carried at all times. Antihistamines (such as Benadryl) may also help stop mild allergic reactions. Antihistamines should be used in conjunction with adrenaline, but not as a substitute.
After injecting epinephrine, Emergency medical services should be contacted, and the individual transported to a hospital for observation. This is because, despite prompt treatment with epinephrine, the patient may experience a second wave of symptoms, and should therefore be observed in a medical facility for up to eight hours for further treatment if needed.
Is there a cure?
No. Although children may grow out of some food allergies (such as milk, soy or egg allergies), this isn’t true for peanut allergies. These allergies are a lifelong issue for affected individuals. Therefore children and adults with peanut allergies must be forever vigilant, and carefully avoid ingesting nuts, as well as products that may contain hidden traces of nuts. Traces of unexpected peanuts may be present in many products on grocery store shelves, either by design (as a flavor enhancer) or by cross-contamination during processing. For example, the following items may contain small (but significant) amounts of peanuts, and should be avoided:
- Chinese, Indonesian, Japanese, Mexican, and Vietnamese dishes (which often contain peanuts or are contaminated with peanuts during meal preparation).
- Pesto sauce (an Italian sauce made with nuts).
- Marzipan (paste made from ground almonds and sugar).
- Health food bars (many may be “cross contaminated” by peanuts during the manufacturing process).
- All cakes and pastries with unknown ingredients, particularly carrot cake, pumpkin cake or pie, and fruit and nut rolls.
- Bouillon and Worcestershire sauce.
- Praline and nougat.
- Muesli and fruited breakfast cereals.
- Vegetarian dishes.
- Salads and salad dressings.
Fortunately, as the food industry becomes more responsive to food allergic individuals, labeling of products for potential allergens has improved, allowing suffers to remain healthy, and free of anaphylactic reactions.
References:
Food Allergy and Anaphylaxis Network www.foodallergy.org
Asthma and Allergy Foundation of America www.aafa.org.
