Last year, we reported on the death of 21-year-old Anna Bellisario, a fashion design student with severe allergies to milk and eggs who was dining at Flower Burger, a vegan restaurant in Milan, with her boyfriend.
For dessert, Ms Bellisario ordered a ready-made vegan tiramisu after she asked a restaurant staffer to show her the ingredient label. Although the label warned of the possible presence of nuts, it did not mention her allergens of concern.
After two spoonfuls, she began coughing, developed hives, and had difficulty breathing. She tried to force herself to vomit to no avail.
She took her asthma medication and antihistamines, but did not have epinephrine on hand.
She lost consciousness and was brought to a nearby hospital, where, after spending ten days in a coma, she died. The cause of death was anaphylaxis, a life-threatening allergic reaction to a food, drug, insect venom, or environmental substance.
The Italian Ministry of Health recalled the dessert from 63 restaurants when traces of milk protein were found in other glasses of the same dessert brand. Traces of egg were also found in the supposed vegan mayonnaise used in the sandwich that Ms Bellisario had as an entree.
Prosecutors investigating the death testified that the company that manufactured the dessert exercised “fraud in commerce” when they failed to prevent cross-contact between manufacturing lines that processed milk and those that were ostensibly vegan.
Judge Fiammetta Modica said the testimony and additional information gleaned from wiretaps drew “a worrying picture of unscrupulousness” and banned the mother and daughter owners of dessert company from further entrepreneurial activity.
“If the separation of the ingredients and environments, and the correct training of the staff had been respected,” instead of just the four-hour course the staff received, “there would have been no mixing of casein with products of vegetable origin, which led to the fatal outcome,” said the judge.
Our hearts go out to Ms Bellisario’s family and friends, who once again are mourning the loss of Anna.
As we did when we reported the story last year, we remind our readers that epinephrine is the only drug that can halt and reverse the progression of anaphylaxis, but it can’t save your life if you don’t have it on hand or administer it in a timely fashion. Remember: the sooner you administer epinephrine when you suspect anaphylaxis, the better the outcome. Take two epinephrine auto-injectors everywhere, every time.
We also remind you that in the US, as in Italy, allergen labeling regulations do not require manufacturers to include precautionary allergen label warnings like “May contain…” or “Made on equipment that also processes…” as their inclusion on the label is entirely voluntary. Some major manufacturers include them, many don’t, and others warn for some allergens and not for others.
Here is a graphic summarizing the limitations of allergen labeling in the US: