Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Death From Food Allergy In Children

Category: Asthma and Allergy


Dr. Hugh Sampson of Johns Hopkins reported in the New England Journal of Medicine about several children dying from food allergy reactions. This is becoming a more and more noticed problem and should put all schools, parents and physicians on guard. Over a 14 month period there were six fatalities reported in children aged 2 to 16 years. All six cases were due to allergic reactions to peanuts, other nuts and milk. All the children were extremely allergic by their past history and they all had asthma, hayfever, and a few also had eczema. The characteristics of their cases were that they had hives within 5 minutes of eating the foods along with GI symptoms such as cramping and discomfort. Most of them were treated with things such as Benadryl and some were even given adrenalin shots by medical professionals. They all had a second wave of symptoms which occurred at a more delayed rate, up to one or two hours later and at that time the reaction was much more severe. They went into shock and ultimately died. This bi-phasic response, which can occur up to four hours later should alert us to be careful with all serious food allergy reactions in children. We should not simply give a dose of Benadryl and send the child back to school or back out to play. We should go to the emergency room or the physicians office immediately. There one should observe the child up to four hours for any child who has a history of possible severe food allergies.

All schools would be wise to have an emergency plan for a child who accidentally eats a food they are allergic to and has a serious reaction as described above. That child should have a written medical plan in place, and adrenalin and antihistamines should be available to give the child immediately. There should be a plan to transport the child to an emergency room as rapidly as possible should a serious reaction come about. The patient should be treated, however, with immediate treatment at the school such as the adrenalin and antihistamine rather than waiting for the emergency room to initiate the treatment which may be too late.

Children with this type of food allergy should be extremely vigilant in reading food labels. They should recognize other names of foods such as casein, whey, dry milk solids, etc., which are all proteins found in milk. The child should carry adrenalin or have it readily available at the school at all times. The understanding of these serious food allergy reactions is becoming clearer, just over the last few years. Any one interested in the latest research and recommendations should contact the Food Allergy Network at: 744 Holoy Ave., Fairfax, VA 22070, or call: (703) 691-3179. Patients with severe food reactions should carry a Medic-Alert bracelet.