Death by peanut?

By: Chrissie McKenney

Posted: 9/30/09

Food allergies are responsible for symptoms ranging from hives and swollen lips to anaphylaxis and death. (Anaphylaxis is a sudden, and potentially fatal, allergic reaction involving several different areas or systems of the body at once.)

According to the Food Allergy Action Network, an advocacy group for people with food allergies and their families, food-related anaphylaxis leads to around 50,000 trips to the emergency room and 150 deaths annually. According to the Centers for Disease Control, it is closer to 20,000 emergency room visits and 13 deaths. Either way, deaths represent a small proportion of the total population, so maybe it's not such a big deal-unless, of course, you are one of those people or one of their parents.

The National Center for Health Statistics indicates that the rise in food allergies is most pronounced among children, with the number of children under the age of 18 who suffer from food allergies increasing by 18% percent from 1997 to 2007. From 1998 to 2006, the number of children in that same age group receiving a diagnosis related to food allergies more than tripled, from around 2,600 to approximately 9,500. Because peanut allergies represent the most common cause of anaphylaxis, parents with allergic children have begun pushing for extreme measures in some schools. A number of elementary schools and day care facilities have banned peanuts in any form, while others mandate peanut-free zones, and require students caught eating the offending substance to immediately wash their hands and the area around their mouth with soap. Many parents of non-allergic children feel that, since actual deaths resulting from accidental exposure to peanuts are rare, this is unnecessarily extreme and burdensome. It is not unusual for these parents to sneak peanut butter sandwiches into their kids' lunches.

Maybe parents are overreacting, maybe they are being reasonable. Regardless, even if allergies won't kill you, they can certainly ruin your day. I personally do not have any food allergies, but I have several food sensitivities, which make me sneezy, achy, and tired. It is like constantly having the flu. It won't kill me, but it makes me miserable enough that I avoid the foods in question as strictly as possible. Having swollen lips or being covered in hives is no fun, either.

Allergic reactions occur when the body's immune system overreacts to an otherwise benign substance, responding to an innocent grain of pollen or fragment of peanut as if it were an invading bacterium or virus. Currently there is no cure for food allergies. The only solution is strict avoidance of the food in question. Anaphylaxis can be treated with an injection of epinephrine (adrenaline), and many allergic individuals who have been diagnosed with anaphylaxis carry a syringe of epinephrine with them at all times. In contrast, environmental allergies can be treated with a series of shots that introduce minute but gradually increasing amounts of the allergen into the body in order to desensitize the immune system. Over time, the immune system responds less dramatically, or not at all. Some recent research at Duke University's School of Medicine suggests that it may be possible to treat allergies for peanuts with similarly miniscule sub-lingual (under the tongue) or oral doses of the allergen, rather than injections. The results look promising, but more testing remains to be done.

People who don't have food allergies often regard them as an inconvenience-especially when these people are called upon to accommodate others who do have serious allergies. Perhaps this is because environmental allergies, while unpleasant, are usually easily managed with medication. This may be understandable, if inexcusable. Dietary patterns motivated by food allergies or intolerances are not lifestyle choices like vegetarianism or low-carb/high-protein diets. They're not choices at all. No one tries to force people who are allergic to bee stings to collect honey, or sneaks a bee hive into their car, so why are we so insensitive to people with food allergies? We make accommodations for people with more obvious physical limitations, as we should. Can we at least not actively antagonize people with allergies? I suggest a compromise: don't try to serve us foods that make us sick, and we won't sneak laxatives into your brownies.