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Increase in food allergies among youths prompts more caution


Atlanta Journal-Constitution (GA)

06-14-13

June 13--Murphy Williams did what most parents encourage their children to do -- share with each other.

But a single cashew the generous 6-year-old gave his younger brother, Charlie, promptly resulted in paramedics coming to their DeKalb County home last August.

Soon after he popped the nut in his mouth, Charlie's lips turned bright red and his face started swelling.

"He looked like a platypus," said his dad, photographer Patrick Williams, who quickly fished out the culprit and called 911. Fortunately, the reaction was relatively mild.

Unfortunately, metro doctors are seeing more patients like Charlie.

A recent report by the Centers for Disease Control and Prevention found food allergies among youths under age 18 increased significantly from 1997 to 2011 -- from 3.4 percent to 5.1 percent. Skin allergies also increased.

Why?

"That's the answer that everyone wants to know," said LaJeana Howie, one of the report's authors. The report, however, only looks at trends and doesn't explore the causes, she said.

For the Williams family, there was no previous indication that young Charlie had food allergies, but a visit to an allergist later determined he was allergic to tree nuts, specifically cashews and pistachios. Now Williams and his wife, Angel, are never far from their EpiPen Jrs. and Benadryl to treat allergic reactions.

"It used to be all day long we'd see asthma and nasal allergies," said Dr. Kathleen Sheerin, a food allergy expert at the Atlanta Allergy & Asthma Clinic. "Now we are seeing a lot more food allergies and eczema than we used to."

She knows firsthand the problems allergies can cause. She developed a shrimp allergy when she was 25 and has a son who is allergic to pine nuts.

Reactions can range from mild to, in the worst-case scenario, life-threatening. Symptoms might include chest discomfort, difficulty breathing and swallowing, hives, skin redness or swelling of the face and eyes.

More than 200 deaths occur each year due to food allergies, according to the Maryland-based Asthma and Allergy Foundation of America. Ninety percent of all food allergy reactions are caused by eight foods: milk, soy, eggs, wheat, peanuts, tree nuts, fish and shellfish, based on information on the foundation's website.

Experts suspect a few possible causes including the "hygiene hypothesis," a notion that excessive cleanliness throws off the normal development of the immune system. "No one picks an Oreo off the carpet, dusts it off and eats it anymore," Sheerin said. "We're always sterilizing pacifiers. And we're not throwing kids in day care from day one. A little dirt or germs are good for you. We're just too clean."

Other possible reasons include heightened awareness and reporting among parents who waste little time in taking their children to a doctor if they suspect an allergic reaction; vitamin D deficiencies; delayed introduction of certain foods like milk, eggs or peanuts; and an increase in consumption of certain fast foods, which may contain allergens.

Despite all those theories, though, "the bottom line is we really don't know," she said.

Schools are taking note of the increases.

About 25 percent of first-time allergic reactions among students and staff happen in the schools, according to Karen Harris, president of Food Allergy Kids of Atlanta, which was formed three years ago and pushes for more school systems to have epinephrine in stock and for more training. Each year, the organization, which has 700 members that include parents, educators and food-allergic adults, hosts a food-free Halloween event.

Harris said her organization is receiving more calls from school systems and nurses for its education program, which she hopes to take into more schools in the fall.

"That particular teacher is the one who cares for those students during the day," she said. "Most of the time, they are going to be the first to recognize an allergic reaction."

Food Allergy Kids of Atlanta has worked for years with the 39,000-student Forsyth County school system, said Connie Trent, the health services facilitator.

The school system's nurses have been trained by the organization and stock epinephrine in all schools.

Last year, four students were aided by stocked epinephrine -- three for food allergies and one for an insect allergy. And a parent who sampled a dish during a special event at the school was helped when a nurse recognized that she was having an allergic reaction and gave her Benadryl.

"We need to be prepared if there is an unknown reaction," Trent said. "If we have epinephrine in stock, we can already start implementing something for that child while we're waiting for EMS to get to the school. The sooner you get the epinephrine, the better chances you have of surviving."

Sheerin said testing is done only if there are symptoms to dictate taking a deeper look. "Occasionally, we will test a baby whose sibling is food-allergic before they start introducing solid food. There is no age that determines if testing is OK or not. ... (There) seems to be a myth out there that suggests a child must be 2 ... not true."

Patrick Williams thinks the sooner the better.

"Boy," he said. "You don't want to find out the other way."

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(c)2013 The Atlanta Journal-Constitution (Atlanta, Ga.)

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Copyright Atlanta Journal-Constitution (GA) 2013

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