Food allergies are adverse immune reactions to proteins in certain foods. About 1.5 million people in the United States are severely allergic to peanuts, and half of these are also allergic to tree nuts such as almonds, pecans, cashews, walnuts, and pistachios.
Two of my classmates in medical school, for example, had peanut allergies, and both had suffered severe reactions after ingesting even tiny amounts of those nuts (actually legumes). Before every meal, they were understandably keenly focused on identifying any foods that might contain peanuts, and I remember they were especially wary of salads, even when told that no peanuts or other nuts had been added.
Interestingly, the apparent doubling of peanut allergies among children between 1997 and 2002 has not been explained.
Another estimated 10 million Americans are allergic to a variety of other foods. Each year about 30,000 visits to emergency departments and 150 to 200 deaths are triggered by severe allergic reactions involving anaphylaxis, a medical emergency that can result in abnormal heart rhythms, vascular collapse, low blood pressure, and even death.
Typically, reactions to a food allergen start within minutes with hives — raised, red, and itchy spots on the skin — and, for some people, that is all their allergic response amounts to. However, people with more severe reactions can experience difficulty breathing, nausea, vomiting, abdominal pain, and anaphylaxis. Peanuts, tree nuts, fish, and shellfish cause the most food-related anaphylactic reactions.
Though I had been aware of food allergies among adults for many years, the egg allergy of our 4-year-old grandson really brought home to me the serious problems faced by children with food allergies and their parents.
Fortunately, our grandson's allergic manifestations are usually mild, with only an outbreak of red, itchy patches on his skin. Other times, however, he develops an alarming cough and wheezing.
His parents must therefore question every restaurant where they dine, as well as investigate every food product that they buy, for the presence of eggs. It turns out that eggs are a component of many foods, and often one must even question the baker or other food preparer to find out if a product contains them. Food labels are, of course, helpful, but our grandson's reactions have at times followed his ingestion of a food whose label makes no mention of eggs.
Since 2006, U.S. law has required that food labels clearly disclose when they contain highly dangerous allergenic ingredients, like peanuts or dairy products; however, less dangerous allergenic ingredients are not required to be listed on the label. To add to the danger, consumers are often confused by the many different wordings of the warnings regarding possible allergenic components of foods.
People with food allergies and parents of food-allergic children are already well aware of the only general advice I can give: constant and sometimes nerve-racking alertness, questioning, investigating, and caution.
Severely allergic adults and children must at all times also have immediate access to, and instructions on how and when to use, a device for self-injection of adrenaline (epinephrine), such as an EpiPen®. Epinephrine slows the bodily reactions that can lead to anaphylaxis. People who have had dangerous reactions to insect stings or bites should also carry such a self-injection device for adrenaline whenever they are going to be in any danger of getting stung.
