Peanut Allergies in a Nutshell

In the last column, we discussed some important aspects of peanut allergy. Today, we will concentrate on prevention, immediate management and where to find more information on this important subject.

As in the last column, we will use information provided by Dr. Hugh Sampson, paediatrician, Mount Sinai School of Medicine, New York, in his article published in the New England Journal of Medicine.

Sharon Pudwell, a local parent of a child with peanut allergy, has also given me information to share with you.

Dr. Sampson says that children with peanut allergy, their parents and caregivers, must be educated to:

-to avoid accidentally ingesting peanuts
-learn to recognize early signs of an allergic reaction
-learn to give medication as soon as symptoms develop.

Parents and children should check all food labels. They should avoid high-risk situations such as foods served in buffets and ice-cream parlours and unlabeled candies and deserts.

Symptoms of allergic reaction can appear within few minutes to few hours. Pudwell says that some of the early symptoms are: itchy eyes, nose, and face; flushing of face and body; swelling of eyes, face, lips, tongue and throat; hives, vomiting, diarrhoea, wheezing, a feeling of fear and apprehension; weakness and dizziness; inability to breathe and eventually loss of consciousness. The condition may end in shock and death.

Treatment of acute reaction (anaphylaxis) by patient and family members include injection of epinephrine (depending on patient’s history and symptoms) with EpiPen Autoinjector and oral liquid diphenhydramine (an anti-allergic medication). Patient should be transported to hospital emergency immediately. Let emergency physician take over the care. Patients should be observed in the emergency department for at least four hours after they have recovered.

Dr. Sampson says that considerable amount of education material is available from the Food Allergy and Anaphylaxis Network (telephone number, 1-800-929-4040; web site www.foodallergy.org). This web site contains written emergency plan (every allergic child should carry one) and appropriate doses of liquid diphenhydramine and self-injectable epinephrine

Locally, Pudwell had started a support group. She says, “My support group no longer meets. I do not know personally how many people in this area suffer from peanut allergies. I still take an active part in education (in schools) and am available to anyone who would require support”.

She adds, “You can give my name and phone number (527-0997). Here are a few sites I use for up-to-date information: www.peanutallergy.com; www.cadvision.com/allergy; www.anaphylaxis.org. These are all excellent web sites for resources, alerts, food recalls, and discussion boards”.

Pudwell suggests the following rules:
-carry Epi-pen
-wear a medical alert bracelet
-carry a cell phone
-do not ever share foods – eat only foods you have prepared yourself or in a child’s case only food your parents have prepared for you.
-read and re-read labels
-be aware of your surrounding

Pudwell says, “To believe that the world can be free of peanuts is unrealistic, or to single out a child as somehow not quite equal to another because of allergies is unfair. We believe children must learn to live with the knowledge of their allergies, and be taught from a very young age the coping skills they will need for a safe and healthy survival”.

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