Peanut Allergies

Factual Questions
1

With school starting the topic of peanut allergies, peanut free zones and peanut free schools has again reared its ugly head.

On one side are the parents who wail “but my baby could DIE if they SMELL or TOUCH a peanut!” On the other side the parents who say “my kid lives off peanut butter, this is what I pack for lunch.”

I understand ingesting peanuts can be life threatening and this is a serious illness. And I’m all for accomodation if I’m accomodating a true risk. But has anyone ever died from touching or breathing peanuts in the quantities a child would be exposed to in school - not ingesting - just touching or breathing (which I suppose is ingesting in a form)? I haven’t been able to google up much - the girl in Canada who didn’t die because her boyfriend had just eaten a peanut butter sandwich isn’t making the case here.

2

Cecil has already adressed this question.

3

There have been numerous threads on the subject. I’m too lazy to look them up, but I know they exist.

From what I’ve read, some people are allergic to peanuts. And yes, some people have even died. This notwithstanding, it is my opinion that there exists a lot of neurotic parents who believe their child is allergic to peanuts, when in fact they’re not. (I believe the same situation exists for ADD.)

I suspect the wife of a friend of mine is one such parent. She believes her 10-year-old daughter will die if she inhales one peanut molecule.

I remember the first time they came over to our house. Before she came over, she called the local emergency response team to alert them that they will be in the area, and to be ready in case their daughter was exposed to peanuts. (I am not making this up.) When they arrived she spent half the time looking through our refrigerator and cabinets looking for any food products that might contain peanuts. She finally found something with a label that said, “This product may contain peanut residue” or something like that. She then made a big show of putting this item in the back of a top cupboard. At the time I thought, “Wow, her daughter must be very sensitive to peanuts.” But then as we got to know her, we concluded she is, in general, a bit… strange. She seems to thrive on attention. I often wonder if the peanut thing is nothing more than a way for her to gain attention.

4

[QUOTE=constanze]
Cecil has already adressed this question.
[/QUOTE]

Reaction does not equal lethal reaction. From what I’ve been able to dig up, they usually mean a rash - same study by the way Cecil found - but all that is dated and the study is British children.

I’m not fond of the idea of keeping peanuts out of school because “OH MY GOD, My Kid Could Get A Rash!” I’m all for “Yes, there is a non-insignificant risk that a child could die from contact.”

5

[QUOTE=Crafter_Man]
There have been numerous threads on the subject. I’m too lazy to look them up, but I know they exist.

[/QUOTE]

I did search, and found a lot of threads about peanut allergies, but none I found answered the question “can casual contact really be lethal”

(And I’m pretty sure that if you took someone with a high sensativity level and slathered them in peanut butter - or put them in a peanut processing plant - you’d get a lethal dose - I’m talking more casual contact that you hear parents in school talk about - peanut free lunchrooms because touching a table where someone ate a peanut butter sandwich an hour ago could cause death.)

6

[QUOTE=Crafter_Man]
I suspect the wife of a friend of mine is one such parent. She believes her 10-year-old daughter will die if she inhales one peanut molecule. [snipped amazing story]
[/QUOTE]

Um. blink
blink
blink

Holy crap. That does seem the weeist bit extreme…

7

I know this has been done … but has the following ever been answered:

Why did peanut allergies get no attention 20-30 years ago?

8

[QUOTE=OpalCat]
Um. blink
blink
blink

Holy crap. That does seem the weeist bit extreme…
[/QUOTE]
Yea, it was interesting.

A week before they came over, she asked me for the location of the nearest emergency response team. I gathered this information and gave it to her. A couple days later she said she called them to inquire if they had the proper equipment for handing a peanut allergy emergency. She also said she gave them our address, and (according to her) the response team would be “prepared and ready” when they came over to our house.

Based on what we’ve learned about her since then, I have a nagging suspicion her daughter is not allergic to peanuts at all. Poor kid. :frowning:

9

I found the information you are looking for here. It’s linked from an excellent looking (haven’t read the other articles yet) page on peanut allergies here.

Summary? Very, very few children have died from peanut allergies.

About 125 people die each year in the US due to food allergy anaphylaxsis, but some of those are adults, and most of those are not peanut. It does not break down the statistics by type of food.

From 1992-2002 in Britain: zero children died of peanut allergies, zero children suffered “near fatal” reactions, and 10 suffered “severe” reactions. In TEN YEARS!

In Ontario, Canada, 10 children have died between the years of 1986 and 2000. 14 years, 10 deaths, and children eat much more peanut butter in Canada than in Britain.

In Australia, 3 child deaths from food allergies in the last 30 years - these were not specifically peanut allergies. Again, I believe peanut butter is not commonly consumed in Australia. Certainly not at the levels in the US.

In France, one fatality due to peanut allergy (anaphylaxsis) in 2002.

Now, this isn’t to say that those allergic shouldn’t carry an Epi-pen. They should. Undoubtedly, one of the reasons those numbers are so low is because kids who start to get wheezy are given their Epi-pen and survive what might otherwise be a fatal attack.

But, IMHO, there’s no reason for this mass hysteria and “peanut-free zones”. I’m far more worried about my kid *choking *on a peanut and dying than dying from a peanut allergy.

10

[QUOTE=WhyNot]
Summary? Very, very few children have died from peanut allergies.

But, IMHO, there’s no reason for this mass hysteria and “peanut-free zones”. I’m far more worried about my kid *choking *on a peanut and dying than dying from a peanut allergy.
[/QUOTE]

Right, and thanks for the cites.

When I went to school, they served P-nut Butter sandwiches. And, they were also a common lunch item. We never heard of allergies to the extent that we do today- no school even considered “peanut free zones”.

Here is a fascinating scientific study of the peanut allergy problem in kids:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=28527
Resolution of peanut allergy: case-control study

Here’s another from the NEJoM:
http://content.nejm.org/cgi/content/abstract/348/11/977?journalcode=nejm&minscore=5000&qbe=nejm%3BNEJMoa022613&searchid=1083134926690_136&FIRSTINDEX=0&minscore=5000&journalcode=nejm
*Conclusions Sensitization to peanut protein may occur in children through the application of peanut oil to inflamed skin. The association with soy protein could arise from cross-sensitization through common epitopes. Confirmation of these risk factors in future studies could lead to new strategies to prevent sensitization in infants who are at risk for subsequent peanut allergy. *

In other words, it seems like feeding soy milk to kids is causing them to develope peanut allergies.

P-nut allergies can be outgrown:
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WH4-45SRK8K-W&_coverDate=02%2F28%2F2001&_alid=441472179&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=6840&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=65f8150d284c92f8bd1089e5edbfd0ad

Conclusion: This study demonstrates that peanut allergy is outgrown in about 21.5% of patients. Patients with low PN-IgE levels should be offered a peanut challenge in a medical setting to demonstrate whether they can now tolerate peanuts

http://www.jacionline.org/article/PIIS009167490114683X/abstract
Volume 107, Issue 1, Pages 191-193 (January 2001)

S. Allan Bock a, Anne Muñoz-Furlong a and Hugh A. Sampson a

*Abstract
Fatal anaphylactic reactions to foods are continuing to occur, and better characterization might lead to better prevention. The objective of this report is to document the ongoing deaths and characterize these fatalities. We analyzed 32 fatal cases reported to a national registry, which was established by the American Academy of Allergy, Asthma, and Immunology, with the assistance of the Food Allergy and Anaphylaxis Network, and for which adequate data could be collected. Data were collected from multiple sources including a structured questionnaire, which was used to determine the cause of death and associated factors. The 32 individuals could be divided into 2 groups. Group 1 had sufficient data to identify peanut as the responsible food in 14 (67%) and tree nuts in 7 (33%) of cases. In group 2 subjects, 6 (55%) of the fatalities were probably due to peanut, 3 (27%) to tree nuts, and the other 2 cases were probably due to milk and fish (1 [9%] each). The sexes were equally affected; most victims were adolescents or young adults, and all but 1 subject were known to have food allergy before the fatal event. In those subjects for whom data were available, all but 1 was known to have asthma, and most of these individuals did not have epinephrine available at the time of their fatal reaction. Fatalities due to ingestion of allergenic foods in susceptible individuals remain a major health problem. In this series, peanuts and tree nuts accounted for more than 90% of the fatalities. Improved education of the profession, allergic individuals, and the public will be necessary to stop these tragedies. *
It appears that peanut allergies are really on the increase:
http://www.jacionline.org/article/PIIS009167490201429X/abstract
Abstract
Background: Allergy to peanut is common. However, it is not known whether the prevalence of sensitization and clinical allergy to peanut is increasing. Objective: We sought to determine any change in the prevalence of peanut sensitization and reactivity in early childhood in 2 sequential cohorts in the same geographic area 6 years apart. Methods: Of 2878 children born between September 1, 1994, and August 31, 1996, living on the Isle of Wight, 1273 completed questionnaires, and 1246 had skin prick tests at the age of 3 to 4 years. Those with positive skin prick test responses to peanut were subjected to oral peanut challenges, unless there was a history of immediate systemic reaction. These data were compared with information on sensitization and clinical allergy to peanut available from a previous cohort born in 1989 in the same geographic area. Results: There was a 2-fold increase in reported peanut allergy (0.5 % [6/1218] to 1.0 % [13/1273]), but the difference was nonsignificant (P = .2). Peanut sensitization increased 3-fold, with 41 (3.3 %) of 1246 children sensitized in 1994 to 1996 compared with 11 (1.1 %) of 981 sensitized 6 years ago (P = .001). Of 41 sensitized children in the current study, 10 reported a convincing clinical reaction to peanut, and 8 had positive oral challenge results, giving an overall estimate of peanut allergy of 1.5% (18/1246). Conclusions: Sensitization to peanut had increased between 1989 and 1994 to 1996. There was a strong but statistically nonsignificant trend for increase in reported peanut allergy
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=11113829&Dopt=Citation
CONCLUSIONS: The majority of children with clinical peanut hypersensitivity followed up for 5 years will have adverse reactions from accidental peanut exposure. Symptoms experienced during subsequent adverse peanut reactions may not be consistent with symptoms reported during initial reactions. Therefore proper education regarding peanut avoidance and treatment of adverse reactions is necessary in all cases of clinical peanut hypersensitivity. Young children who are allergic to peanuts can lose clinical hypersensitivity.

So, indeed, peanut allergies are getting more common, and they can be serious.

11

Father of a peanut-allergic kid checking in here. Prepare to be amazed…

It’s hysteria. I’m willing and prepared to demand that my sons classroom not do any peanut-related projects (like making peanut butter sandwiches, which my oldest son did in school a couple of years ago, or making bird feeders with peanuts) but that’s about it.

Now, you’d better sit down for this next part.

We have peanut butter in the house! Yes. The oldest lives on the stuff, they don’t sit together when he’s eating it, but the evil peanut protein doesn’t rise up and SMITE my other son for our hubris.

On the other hand - we don’t take him to major sporting events after a fairly serious reaction at Mile High stadium a few years ago. Peanut dust is far more dangerous than peanut butter, IMHO.

The school still serves pb&j… Know what? Little Bobo doesn’t eat it! Yes, that works.

People are insane.
Obligatory food allergy website link

12

[QUOTE=Crafter_Man]
…Based on what we’ve learned about her since then, I have a nagging suspicion her daughter is not allergic to peanuts at all. Poor kid. :frowning:
[/QUOTE]

Munchausen by Proxy?

13

Thanks, all, so far you are finding the same things I am - while ingesting peanuts can be really bad (and breathing them in the sort of quantity that you get at a ballgame does sound problematic as well - that makes sense - I’ve been around peanuts at a ball game), the chance my kid’s peanut butter smeared hands are going to kill some poor child out on the playground are pretty darn slim.

14

[QUOTE=Bobotheoptimist]

On the other hand - we don’t take him to major sporting events after a fairly serious reaction at Mile High stadium a few years ago. Peanut dust is far more dangerous than peanut butter, IMHO.
[/QUOTE]

:eek:

Have any such cases been documented in medical literature before, say, 1990? Not coming from a position of doubt … rather, I’d like to think we, collectively, could stop doing to these kids whatever it is modern society is doing to these kids to cause these allergies :mad:

The soy milk connection made above is an intriguing one. For one, soy products were barely available in groceries (around here) before around 1990 or so. For another, there seems to be a “culture of worry” at work here with little ones.

One anecdote: my wife is a worrier, while I am Alfred E. Neuman. Anyhow, when my wife first gave our daughter whole milk, she claimed to have seen a rash develop on our daughter’s bum. I couldn’t see this same rash at all … well, maybe there was something, but if that was “the rash”, it was super-mild and really coldn’t be told apart from garden-variety diaper redness (IMHO). My wife chalked it up to me being too cavalier, and proceeded to profess to the pediatrician that our daughter was conclusively allergic to cow’s milk.

The pediatrician ran no tests, but instead just suggested a switch to soy formula. Easy enough … and I guess he figured “no harm”. BUT … if enough worrying parents do the same things, they may be creating cases of peanut allergies where none previously existed.

BTW … my daughter is not allergic to dairy products, and I suspect she never was. She can eat cheese, ice cream, pudding made with milk, etc. all day long with no ill effects. I and others have given my daughter whole milk many times as well (though she’s used to soy), also with no ill effects. My wife is the lone holdout – she still holds fast to the milk allergy thing … despite the fact that she herself feeds and has fed plenty of other dairy products to our daughter with no effect.

15

[QUOTE=bordelond]
Have any such cases been documented in medical literature before, say, 1990? Not coming from a position of doubt … rather, I’d like to think we, collectively, could stop doing to these kids whatever it is modern society is doing to these kids to cause these allergies :mad:
[/QUOTE]
One school of thought is that our kids are too clean and healthy. A lack of filth and pure healthy foods are causing children’s bodies to react to the wrong things (cite)
I’m fairly sure that peanut allergies didn’t suddenly appear in 1990, but I don’t have anything handy (knew a guy in '95 that was in his mid-30’s and allergic, best I can come up with right now).
Seems to me that the 80’s were full of shellfish allergies.

Anyone see that CSI type show where the killer ordered a peanut butter sandwich as his last meal so he could kill himself?

If you have doubts, please get your kid to an allergist. Ian had mis-diagnosed eczema for months and it wasn’t until his first peanut reaction that we discovered that his allergies were the problem. Changing his diet slightly fixed so many problems… But this was after a poke-test and an MD recommending the changes, not some herbalist pushing a vitamin.

16

My boyfriend is allergic to all nuts and I practically live on peanut butter. No problems from kissing, or eating food that has been prepared on areas where peanuts have once touched. If he eats them he says he gets a slight rash and flu-like symptoms that last for about a day. I don’t doubt that there are people with more severe reactions but I also doubt that very casual contact can provoke a lethal reaction in even those cases.

Another disease fad, I think. I am sure that there were peanut allergies before 1990 but since the majority of reactions are so minor most parents probably didn’t worry about it, or just cut off the kid’s supply of peanuts if they could identify the reaction. More parents wanting to protect their kid from even the slightest illness and also using the “you’re special!” thing, I think.

Reminds me of that Home Movies episode where Melissa is all excited because she’s been diagnosed with a kiwi allergy and gets to carry around an epipen.

17

[QUOTE=davenportavenger]
Another disease fad, I think.
[/QUOTE]
Agree. As with any fad, it’s just about impossible to separate the real component from the imaginary one.

Slightly off topic, but I have always been fascinated by fad diseases, Munchausen Syndrome, and hypochondria. A few that come to mind:

Wool allergies. A lot of people swear they’re allergic to wool. But in reality no one is. (Though there is some evidence the chemicals used during processing may linger in the wool, and may cause a reaction in some people.)

Bee stings. I am a small-time beekeeper. When I tell this to people I receive this reply 50% of the time: “I could never be a beekeeper. I’m allergic to bee stings!” But in reality, very very few people (less than 1% from what I’ve read) are allergic to stings from honeybees.

MSG: Remember the hysteria over MSG? To this day my cousins swears she sweats and gets heart palpitations if she consumes MSG. Yet she eats a lot of processed foods. I once told her that a lot of the processed foods she eats contains MSG (often labeled as “other natural ingredients”). It didn’t faze her. She still thinks she’s allergic to MSG, and always makes a big deal about it at Chinese restaurants.

Sick Building Syndrome. A recent British study implied it’s a bunch of hooey.

ADHD: Does it exist? I’m skeptical. Even if it does exist, most would agree it is over-diagnosed to a great extent.

18

My own favorite is Fetal Alcohol Exposure. Not Syndrome. FAS is a very real birth defect and anyone who drinks frequently and heavily during preganacy should NOT. FAE is “why does my child have a hard time in school” “Well, maybe it was that glass of wine you had before you knew you were pregnant.” FAE is a common diagnosis in adoption circles - where its nearly impossible to know what the birthmother did or did not do during her pregnancy. Hey, lets blame birthmom!

19

[QUOTE=Crafter_Man]

Bee stings. I am a small-time beekeeper. When I tell this to people I receive this reply 50% of the time: “I could never be a beekeeper. I’m allergic to bee stings!” But in reality, very very few people (less than 1% from what I’ve read) are allergic to stings from honeybees.
[/QUOTE]

[hijack]

Can’t recall if I’ve ever been stung by a honeybee (doubt it) … but wasps have caused some ugly localized swelling and burning pain when they’ve stung me. However, I’ve found that over-the-counter Benadryl liquid helps a lot.

Is there a noted difference between bee stings and wasp stings?

[/hijack]

20

[QUOTE=DrDeth]
Patients with low PN-IgE levels should be offered a peanut challenge
[/QUOTE]

[Swaggers up dressed in full gladiatorial array]

“I will accept the peanut challenge!”