After just one bite, someone with a food allergy can go into life-threatening anaphylaxis where the airway passages can constrict and cut off the ability to breathe. On February 7, a child at Holiday Hills Elementary School in the Southside neighborhood of Jacksonville took two bites of a cookie that was provided by a special education aide in her classroom and went into an allergic reaction, ending up in the emergency room.
This child had a diagnosed peanut allergy. School personnel were aware of her allergy and her class was designated “peanut-free.” A sign on the door stated, “Please do not bring any peanuts or products containing peanuts into this classroom.” However, the special education aide, Mary Baxley, brought in a container of peanut butter cookies and sugar cookies. She told investigators that she thought “peanut-free” meant that peanuts could not be loose in the classroom.
This unfortunate incident can be turned into an opportunity for education. Those people coming in contact with our children in the school system, after-care programs, daycares, summer camps, sports leagues, and playdates must not delay in learning about the prevalence and treatment of food allergies. Urgency exists because approximately one in every 13 children in the U.S. has a food allergy, according to Food Allergy Research & Education (FARE). That is one to two children in each classroom. And the number is likely to increase. The Center for Disease Control and Prevention (CDC) reported in 2013 that a 50% increase in children with food allergies occurred between 1997 and 2011. This problem is not going away anytime soon.
Children spend a majority of their waking hours in school and school personnel bear the responsibility of keeping them safe – including teachers, aides, cafeteria assistants, librarians, paraprofessionals, bus drivers, coaches and others. Adults in these positions of authority are trusted by students. Given this level of trust, we cannot afford for these individuals to be ignorant or miseducated. If we tolerate it, a fatality can occur such as in a Virginia school with 7-year old Anmaria Johnson.
When a child is having a food allergy reaction, there is no time to delay in assessing the symptoms and administering proper treatment. Symptoms can affect a variety of the body’s systems and range from hives (skin) to vomiting (stomach) to constricted breathing (throat) to swelling of the lips (mouth) to dizziness (heart) to wheezing (lung). Itching can occur in the throat, mouth, and skin. Mylan (maker of ephinephrine auto-injector Epi-Pen) reports that a life-threatening anaphylaxis could be occurring if two or more of the body’s systems are affected (see image).
Source: Mylan Epi-Pen Auto Injectors brochure, 2012
Epinephrine is the only way to treat life-threatening anaphylaxis (the main ingredient is adrenaline, a naturally occurring hormone in our bodies). Antihistamines can treat other allergy symptoms, such as itchiness, but does nothing for anaphylaxis. The CDC reported that 25% of anaphylactic reactions occurring in schools happened in children that were not previously diagnosed with a food allergy. These 25% would not have a prescription for epinephrine. The School Access to Epinephrine law signed by President Obama in 2013 allows schools to place epinephrine auto-injectors in schools for children that do not have one designated and prescribed to them (much like the automated external defibrillators in public buildings).
To learn more, visit FARE, Allergy Home, CDC, and American Academy of Allergy, Asthma and Immunology.