Food Allergy Disaster Prevention

By Emily J. Leader

My daughter Amaya was mildly allergic to chili powder. On taco day, when steam-borne chili powder caused her to develop hives and asthma, we worked out a plan to ensure she was not exposed. She changed her community service project after she got hives from packing spices at the local food bank.

But nothing prepared us for escargot in French class. “No one ever died from trying a snail,” intoned the French teacher. That might not have turned out to be the case for Amaya, one of the students who bit into a garlicky critter that day. Fortunately, a knowledgeable nurse decided she could not wait for an ambulance and rushed Amaya to the hospital. Our daughter’s severe allergic reaction to eating a snail became a bit of family lore, remembered for the swollen sore tongue that affected her speech in the school play and the EpiPen she still carries.

Our story illustrates the wide range of issues schools must consider when addressing food allergies: How common are food allergies in school-age children? How common are life-threatening or severe food allergies? What must schools do to protect students who have allergic reactions to the ingestion of a food or to airborne particles? Do both mild and severe food allergies require the same amount of intervention and planning? Are members of the school staff and those involved in school-sponsored activities sufficiently familiar with food allergy reactions to respond appropriately?

We do know that the number of children with food allergies is higher than previously estimated. In July, Pediatrics published a study, “The Prevalence, Severity, and Distribution of Childhood Food Allergy in the United States.” Researchers surveyed nearly 40,000 households that included a child with food allergies. The study concluded that about 8 percent of children in the U.S. have food allergies, twice the estimate in a 2008 Centers for Disease Control and Prevention study.

Nearly 40 percent of these food-allergic children have a history of reactions characterized by anaphylaxis, low blood pressure, trouble breathing, or a combination of milder symptoms. About 30 percent of children with food allergies have multiple food allergies, and that group is three times more likely than others with food allergies to have a history of severe reactions. Adolescents are the most likely group to experience severe reactions to a food allergen.

Overall, the foods most commonly associated with food allergies are peanuts, milk, and shellfish. Those most associated with severe allergic reactions are tree nuts, peanuts, soy, and fin fish.
