Every day, thousands of parents pack a peanut butter and jelly sandwich for their children and send them off to school. While the favorite lunchtime standby is great for some kids, it can be downright deadly for others.
According to the American Academy of Allergy, Asthma & Immunology, one in every 13 children has some kind of food allergy ranging from peanuts, egg, tree nuts, wheat, soy and milk to fish and shellfish. That's about two children in each classroom. In addition, the Centers for Disease Control and Prevention estimates 25 percent of children with undiagnosed food allergies have severe life threatening attacks while in school.
National author and founder of Educating for Food Allergies, Jan Hanson, wants Utah parents and educators to be more aware of the growing problem. A book, Food Allergies: A Recipe for Success at School, provides information and recommendations for families and school personnel.
"My oldest son was diagnosed with a milk allergy as an infant in 1987," Hanson said. "He outgrew this allergy by the time he turned one. He later developed a walnut allergy at the age of 18 shortly before he left for college. He is now 26 and in the past few years has developed an allergy to kiwi. He now carries and EpiPen wherever he goes."
Hanson's youngest son was diagnosed with life-threatening allergies to peanuts, tree nuts, shellfish, penicillin and sulpha antibiotics in 1992. He has even had reactions from inhaling peanut and tree nut proteins that have become airborne.
"I became involved with food allergy education because in 1992 there was a lack of information, resources and understanding about this health issue," she said. "There was also a profound lack of school policies and management. To help insure my son's safety at school, I became educated about food allergies and its management and started working with personnel at my son's school."
Hanson said food allergy exposure, especially in the school setting is complicated. She said most often, a child will have an allergic reaction after being exposed to a food that contains a hidden ingredient in the child's food allergen. For example, she said, this past summer, a 13 year-old girl in California with a peanut allergy ate a Rice Krispie snack she thought was safe, but actually contained peanut products. The girl was treated with epinephrine but it didn't work and she died. In January, a first grade Virginia student with a peanut allergy ate a cookie she thought was safe. It too contained peanut products. The child also died from complications.
Hanson said children can also become sick when they have skin contact with their food allergen.
"I worked with a family who's tree nut allergic son in preschool had anaphylaxis after touching a book that he and his teacher were using," she said. "It seems the teacher ate a snack containing nuts in a separate room from the child but didn't wash her hands before going back to work with the child. The child touched the book ... and suffered a severe allergic reaction because of this exposure."
Dr. Douglas Jones, a physician at Rocky Mountain Asthma, Allergy and Immunization, said even kissing a person with a food allergy can become deadly. That's because a person's saliva may excrete the allergen after the food has been absorbed into the body, even up to several hours after eating. The wrong food can leave the person being kissed covered in hives or even fighting for their life.
"Work with the school to establish a peanut-free lunch table and advocate for policies that prohibit children from sharing food there and in other settings where kids aren't supervised," Jones said.
In addition, teachers, nurses and the child should all know how to use the injectable epinephrine.
Hanson said food is also used as part of the curriculum, such as art projects.
"Food plays a big role at school for students. Snacks, lunch, birthday and holiday celebration, pizza parties, ice cream socials and for the curriculum, which means there are many opportunities for exposure," she said.
Signs and symptoms of food allergies depend on which part of the body has been exposed. The child may have hives, swelling of the lips, tongue and eyelids and an itchy red rash. They could have cramps, nausea, vomiting and diarrhea or itchy, watery eyes, coughing, sneezing, wheezing, shortness of breath, difficulty swallowing and changes in the sound of the voice. Other serious symptoms include dizziness, confusion, feeling faint, pale skin, chest pain and a drop in blood pressure.
Hanson said parents need to be an advocate for their children and learn as much as they can and then follow up with teachers, nurses and other administration.
"School personnel have a duty to care for all of their students, including children with food allergies," she said. "These children are entitled to a safe school experience."
FOOD ALLERGY FACTS
* Only an infinitesimal amount of a food is capable of causing an allergic reaction. For example, only 2 mg., or 1/250th of a peanut, can cause an allergic reaction.
* Annually, 77,000 children are seen in U.S. emergency rooms for food-induced allergic reactions.
* There is no way to predict how a reaction will develop symptoms may progress from mild to severe in only a few minutes.
* Peanut allergy has tripled in the U.S. since 1997.
* Children with both food allergies and asthma are at a higher risk for experiencing fatal anaphylaxis.
* Most food-allergic reactions occur from eating an unexpected or hidden ingredient, or from unknowingly ingesting the food allergen.
* Hand sanitizers are not effective in removing food proteins from the hands. Using soap and water or wet wipes are the most productive way to remove food residue from the hands.
SIGNS AND SYMPTOMS
Skin - hives, swelling, often of the lips, tongue and eyelids, and an itchy, red rash.
Gastrointestinal - cramps, nausea, vomiting, diarrhea.
Respiratory - Itchy, watery eyes, coughing, sneezing, wheezing, shortness of breath, difficulty swallowing, change in the sound of the voice.
Cardiovascular - dizziness, confusion, feeling faint, pale skin, chest pain, drop in blood pressure.
Source: Jan Hanson, author of "Food Allerges: A Recipe for Success Aat School"