Ask Bonnie

• Food allergy occurs in 6 percent to 8 percent of children under the age of 4 and in 4 percent of adults. The risk is greatest for a child born to parents who are both allergic.

• Peanuts and nuts that grow on trees cause most cases of severe food allergy reactions.

• Proteins in peanuts and a few other foods can produce an abnormal immune response in susceptible people. The person generates an antibody that stands ready to interact on the molecular level with the specific protein. When it is present in the body, cells are activated in sites such as the nose, throat, lungs, skin and gastrointestinal tract. The cells release chemicals such as histamine that cause the reaction.

• Reactions to food substances trigger roughly 30,000 episodes annually of anaphylaxis, a condition that can include itching, fainting and even death.

I am a mother of two children with food allergies. One who is severely allergic to peanuts and tree nuts. He is almost six years old and goes to day camp and they say they are a “Peanut-Free” camp.

I have been on pins and needles each and every day that he is there. It has been a big challenge to make sure that my son is completely safe when eating and participating as a camper even with Epi-pens stationed with the Head counselor and with the nurse—I always worry.

I have discovered that the administration and counselors don’t really have great procedures in place and lack communication between staff members.

They just seem unaware of the consequences of such an allergy. I have caught many slip-ups with procedures and they have thanked me afterwards for pointing things out.

This camp is on its 10th year and you would think they would have everything under control when it comes to severe food allergies.

We need to come together to educate these camps and bring awareness to the people that work there about these severe food conditions.

Please write in your comments if you are a parent of a child with a severe food allergy, and let me know if your child’s camp experience has been a positive or a negative one.

A food allergy is an immune system response to a food that the body mistakenly believes is harmful. Once the immune system decides that a particular food is harmful, it creates specific antibodies to it. The next time the individual eats that food, the immune system releases massive amounts of chemicals, including histamine, in order to protect the body. These chemicals trigger a cascade of allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin, or cardiovascular system. Scientists estimate that approximately 12 million Americans suffer from true food allergies.

What are the common symptoms of a reaction?
Symptoms range from a tingling sensation in the mouth, swelling of the tongue and the throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, drop in blood pressure, and loss of consciousness to death. Symptoms typically appear within minutes to two hours after the person has eaten the food to which he or she is allergic.

What is the best treatment for food allergy?
Strict avoidance of the allergy-causing food is the only way to avoid a reaction. Reading ingredient labels for all foods is the key to maintaining control over the allergy. If a product doesn’t have a label, allergic individuals should not eat that food. If a label contains unfamiliar terms, shoppers must call the manufacturer and ask for a definition or avoid eating that food.

Is there a cure for food allergies?
Currently, there are no medications that cure food allergies. Strict avoidance is the only way to prevent a reaction. Most people outgrow their food allergies, although peanuts, nuts, fish, and shellfish are often considered lifelong allergies. Some research is being done in this area and it looks promising. Click here for research information.

Should I stop eating foods that I think I’m allergic to?
Randomly taking food out of your diet can leave you with an unbalanced diet that can cause other health problems. Additionally, you may become frustrated because you reach a point where you believe that everything you eat is causing a reaction. Seek the help of a doctor before making significant changes in your diet.

What is the best treatment for a food allergy reaction?
Epinephrine, also called “adrenaline,” is the medication of choice for controlling a severe reaction. It is available by prescription as a self-injectable device (EpiPen® or Twinject®).

What is the difference between food allergy and food intolerance?
Many people think the terms food allergy and food intolerance mean the same thing; however, they do not. A “food intolerance” is an adverse food-induced reaction that does not involve the immune system. Lactose intolerance is one example of a food intolerance. A person with lactose intolerance lacks an enzyme that is needed to digest milk sugar. When the person eats milk products, symptoms such as gas, bloating, and abdominal pain may occur.

A “food allergy” occurs when the immune system reacts to a certain food. The most common form of an immune system reaction occurs when the body creates immunoglobulin E (IgE) antibodies to the food. When these IgE antibodies react with the food, histamine and other chemicals (called “mediators”) cause hives, asthma, or other symptoms of an allergic reaction.

What information should I provide my doctor?
Keep a food diary, for 1 to 2 weeks, of everything you eat, what symptoms you experience, and how long after eating they occur. This information, combined with a physical examination and lab tests, will help the doctor determine what, if any, food is causing your symptoms.

What is the difference between a prick skin test and a blood test or RAST test?
The prick skin test or a blood test, such as the RAST (or radioallergosorbent test), is commonly used to begin to determine if an allergy exists. The RAST can sometimes be called the CAP-RAST or ImmunoCap test.

A prick skin test is usually cheaper and can be done in the doctor’s office. The doctor places a drop of the substance being tested on the patients’ forearm or back and pricks the skin with a needle, allowing a tiny amount to enter the skin. If the patient is allergic to the substance, a wheal (mosquito bite-like bump) will form at the site within about 15 minutes.

A RAST test requires a blood sample. The sample is sent to a medical laboratory where tests are done with specific foods to determine whether the patient has IgE antibodies to that food. The results are usually received within one week.

Which test is better?
Although both tests are reliable, there are instances where one is better than the other. Many doctors use a RAST for young children or patients who have eczema or other skin problems that would make if difficult to read the results of a prick skin test. The results of either test are combined with other information, such as a history of symptoms and a food challenge, to determine whether a food allergy exists.

visit:
www.foodallergy.org
for more information

As a wife and mom of two children, ages two and five, there are so many joys that we face. However, sometimes we may encounter some bumps along the way.

When my son, “Matt” was 23 months old he had an anaphylactic reaction from ingesting a tiny piece of a peanut butter cracker. Anaphylaxis is a sudden, severe, potentially fatal systemic allergic reaction that can involve various areas of the body (such as skin, respiratory tract, gastrointestinal tract, and cardiovascular system). Symptoms occur within minutes to two hours after contact. An anaphylactic reaction can be mild to life threatening.

Common symptoms includes a tingling sensation in the mouth, swelling of the tongue and throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, drop in blood pressure, loss of consciousness, to death. Jett had some of the above symptoms and had to be rushed to the emergency room and was given a shot of epinephrine (adrenaline) to stop the reaction. It could have affected his breathing. We were very lucky that he was fine after he was treated. However, it could happen again and worse if we are not careful.

A few days later a blood test was given by an allergist; we found out that “Matt” was indeed allergic to not only peanuts, but also cashews.

How can this be? We wondered…No one in our family is allergic to any foods. You just never know—-it can happen to anyone at anytime.

Now our lives had to change—- food shopping, the food we kept at home, restaurants, going to friends’ homes, birthday parties, carrying Epi-pens (epinephrine) and Benadryl, and school responsibilities. My husband and I had to be trained in how to administer an Epi-pen in case there was an emergency and we had to train others. The doctor said he had to refrain from eating not only peanuts (legumes) and cashews (tree nuts) but all other nuts and seeds in case of cross-contamination.

We had to learn how to read food labels and learn what ingredients he can and cannot have. It is now a law that all manufacturers label their packages with any food allergens it may contain. For example, under the ingredients on a package of cookies it may state, “allergy information- may contain traces of peanuts or tree nuts” or it may state, “manufactured on equipment that processes tree nuts, sesame, peanuts.” “Matt” has to stay away from all of that. Other highly allergic foods that people might be allergic to are eggs, milk, soy, wheat which would also be written on different foods if they contained those ingredients.

There is no cure right now for food allergies. The best treatment is strict avoidance of the allergy-causing food. If a product doesn’t have a label, allergic individuals should not eat that food. There is so much information on food allergies. I could go on for hours.

In regards to school, we just want to mention how wonderful the teachers and administration were at Congregation B’nai Israel(CBI) in Boca Raton, Florida in regards to “Matt’s” allergy. When he began the two’s I was so nervous to leave him because he was my first, but also to leave him with a deadly food allergy. As the days and years went on at CBI my trust and confidence with the teachers and office staff grew tremendously. “Matt’s” classrooms became peanut-free, his teacher’s wore fanny packs with his emergency medications wherever they went with him. Eventually, CBI did away with offering peanut butter sandwiches as a substitute for lunch. Everyone was so understanding and accommodating to us.

We want to personally thank Linda Harris (Director) and Rebeca Rosenblatt and all of “Matt’s” teachers and the staff members who came in contact with him daily. Thank you for keeping him safe and for putting our minds at ease for the past four years.

Now “Matt” is off to Kindergarten in a brand new school with new faces. We have to start all over again to gain trust, but at least we can say we started off with a great first experience at CBI.

If anyone has any further questions about food allergies you can contact The Food Allergy and Anaphylaxis Network at 800-929-4040 or visit their website at www.foodallergy.org.