As we approach the start of another school year, parents, teachers and school health professionals are developing plans to help accommodate millions of children with food allergies. This year places extra emphasis on planning, as many school districts will be incorporating the use of stock epinephrine into their emergency procedures as provided for by legislation passed by state governments over the preceding years.
The feedback we have been receiving from our readers indicates that school districts across the country run the gamut from well prepared to haven’t got a clue how to deal with food allergies, and the shortage of school nurses to help develop and implement procedures isn’t helping matters.
We received many questions regarding those “May contain…” type messages you find on labels after our Time article yesterday. With that in mind, here’s a 10 second quiz to see how well you know what those warnings really mean:
The following are allergen warnings you might find on a product that does not contain the allergen as an ingredient. Simply put them in order of safest to most risk that the product contains traces of the allergen:
A – May contain allergen
B – Manufactured in a facility that also processes allergen
C – Manufactured on equipment that also processes allergen
D – May contain traces of allergen
E – [No statement]
You have 10 seconds while we bring you this graphic. Go!
An article by Markham Heid posted on Time’s website yesterday seeks to answer whether you can rely on those voluntary “May contain…” and “Manufactured on equipment that also processes…” warnings that appear on food products. We say voluntary because the FDA only requires that manufacturers disclose when a Top-8 allergen is an ingredient of a product, not when there is a danger of cross-contact with an allergen that is processed on the same equipment or in the same facility as the product.
While the article is well written, it may mislead the reader by giving the impression that you can rely on labels to determine whether a food product is safe because “no one is trying to hoodwink consumers—or expose someone with an allergy to a potentially harmful ingredient.”
As reported in the Daily Mail, a new UK study published in the medical journal Allergy finds that for every child diagnosed with a milk allergy via blood and skin prick tests, another goes undiagnosed that will suffer a reaction.
Dr Kate Grimshaw, a specialist pediatric dietitian at Southampton Children’s Hospital, reported that not all allergies can be detected by measuring levels of immunoglobulin E (IgE) antibody, which is linked to allergic reactions.
Dr Grimshaw, who participated in the EuroPrevall study funded by the European Union, said:
We know that sometimes if a child is seen for a possible food allergic reaction – to any food, not just milk – but tests show there is no measurable IgE, then a possible food reaction may be ruled out, when in fact the child may be reacting to the food, just not via IgE. This research will hopefully highlight to GPs and non-allergy specialists that just because an IgE test is negative, the child may in fact be reacting to a food and further investigations should be carried out.
The study, which followed over 9,000 babies from nine European countries until age two, found that 1.3% of children from the UK reacted to milk within two hours, but only 45% had IgE levels associated with symptoms.
ABC News Australia reports that a study of hospital admissions in the country from 2005 to 2013 found a 50% jump in children admitted for anaphylaxis.
Professor Mimi Tang of the Murdoch Children’s Research Institute (MCRI) said the highest rates of hospital admission were for younger children, but that rates for older children aged 5-14 more than doubled.
“What we think is happening is that more children are getting food allergies but of concern, these allergies tend to be peanut, tree nut and shellfish that you don’t grow out of,” she said.
Yesterday, WRIC – the ABC affiliate in Richmond, VA – aired a report leading with a stock photo of an EpiPen®, claiming that epinephrine was in short supply. Since then we have received a number of inquiries from panicked readers concerned that auto-injectors will not be available when needed.
Though it’s true that the Food and Drug Administration (FDA) has indicated numerous epinephrine shortages on their website for months now, these are specifically for vials and syringes of the drug generally administered by healthcare professionals in a hospital or clinical setting. Despite the reported shortages from specific manufacturers, our understanding is that epinephrine is generally available when needed.
The FDA’s site makes no mention of a shortage of auto-injectors, the devices that sufferers of severe allergies carry with them for emergency use in case of a severe reaction. A series of calls to pharmacies in five states confirmed that they are readily available and that there are no warnings of pending shortages from their suppliers.
Please note that we have removed a product from the Safe Snack Guide due to a change in labeling, manufacture, or disclosure:
- ShopRite Red White Blue Pops 12 Pack
We have confirmed with a representative of the Wakefern Food Corporation, the manufacturer of many ShopRite brand products, that this item is currently manufactured in a line that also processes tree nuts.
Also note that we incorrectly identified Vermont Nut Free Fudge with the advisory [EGG processed in Facility] when in fact it should have been identified with the advisory [Contains EGG]. This has now been corrected and we apologize for the error.
No longer do you need to run around with scissors to save money on your favorite allergy-friendly products. Simply click here to visit the Coupons Page to find deals on old favorites and explore new options.
You’ll find printable coupons for the market and others that provide codes for discounts on products and shipping from online shops.
To start, we currently offer coupons for products from the following manufacturers:
The American College of Allergy, Asthma & Immunology (ACAAI) issued a press release earlier today, highlighting a study of biphasic anaphylaxis published June 22. The term biphasic anaphylaxis describes a secondary reaction that occurs hours after the first.
The study looked at records of 484 visits for anaphylaxis at two large Canadian pediatric emergency departments. Of those, 71 patients (14.7%) developed a biphasic reaction.
The study found five independent predictors for a biphasic reaction:
- Patient is 6-9 years old;
- Delay in presentation at emergency department or administration of epinephrine of 90 minutes or longer;
- Wide pulse pressure at triage;
- Treatment of initial reaction requires multiple doses of epinephrine;
- Respiratory distress requiring administration of inhaled β-agonists (bronchodilators).
“We found that 75 percent of the secondary reactions occurred within six hours of the first,” said Waleed Alqurashi, MD, lead author of the study. “A more severe first reaction was associated with a stronger possibility of a second reaction. Children aged six to nine, children who needed more than one dose of epinephrine and children who do not get immediate epinephrine treatment were among the most likely to develop secondary reactions.”
It’s been seven years since Brian Hom lost his son BJ to an anaphylactic reaction in 2008 while on vacation in Mexico to celebrate BJ’s high school graduation. Since then, Brian has been a tireless advocate for the food allergy community.
In memory of BJ Hom, please take a few moments to see this video entitled “Food Allergies Don’t Take Vacations”. Even if you’ve seen it before, this cautionary tale will remind you of the stakes involved when anaphylaxis strikes:
Our thoughts are with the Hom family. May Brian’s work and BJ’s legacy save the lives of many others suffering with severe food allergies.
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