Friday, July 3, 2009

What is a Peanut Allergy?

I thought I'd take a few minutes to give my readers that are only just a little familiar with peanut allergies some more food for thought (peanut free food that is).

So, what is a peanut allergy? According to Wikipedia, a peanut allergy is a type of food allergy distinct from nut allergies. It is a hypersensitivity to dietary substances from peanuts causing an overreaction of the immune system which in a small percentage of people may lead to severe physical symptoms. It is usually treated with an exclusion diet and vigilant avoidance of foods that may be contaminated with whole peanuts or peanut particles and/or oils.

According to Wesley Burks, M.D., Chief of the Division of Pediatric Allergy and Immunology at Duke, despite their best efforts, many people with peanut allergy will accidentally ingest peanut products. Signs of an allergic reaction to peanuts in young children include skin, respiratory and gastrointestinal symptoms: hives, an itchy rash, wheezing, throat tightening, vomiting or diarrhea. Peanuts are the leading cause of food-induced anaphylaxis, a life-threatening reaction that constricts the airway and lungs, severely lowers blood pressure and causes swelling of the tongue and throat. Nearly 150 adults and children die from allergic reaction to peanuts each year in the US and the allergy causes an estimated 15,000 emergency room visits yearly. The only treatment once symptoms appear is taking an antihistamine, and then epinephrine, to relieve shortness of breath.

Nearly 1.8 million Americans are allergic to peanuts, and 400,000 of those are school-age children, according to the Food Allergy and Anaphylaxis Network. Only 21 percent of children outgrow it. Between 1997 and 2002, peanut allergy in children has doubled. The estimated number of Americans with food allergy has increased, and the scientific community doesn't know why.

More important, though, is what's on the horizon.
Currently there is no treatment to prevent or cure allergic reactions to peanuts. Strict avoidance of peanuts is the only way to avoid an allergic reaction. Sounds easy enough doesn't it? Peanut butter, peanut butter crackers, peanut M & M's...those are all obvious. However, almost all peanut exposure is accidental. Peanuts can also be found in prepared soups, chili, Thai & Chinese foods, ice cream, candy, chocolate, cookies, crackers and baked goods, to name just a few. The Food Allergen Labeling and Consumer Protection Act (FALCPA) requires food manufacturers to disclose in plain language whether products contain any of the top eight food allergens. It does not require manufacturers to disclose whether they also use these food allergens to manufacture another product in their facilities thereby risking contamination. So, what are children and adults with a peanut allergy advised to do? Carry epinephrine injectors to treat anaphylaxis and antihistamines to treat milder reactions.
While several companies have developed promising drugs to counteract peanut allergies, trials have been mired in legal battles.

A medically supervised daily dose of peanuts may help children with peanut allergies greatly increase their tolerance to the food. As reported in the New York Times, the new treatment uses doses of peanuts that start as small as one-thousandth of a peanut and eventually increase to about 15 peanuts a day. In a pilot study at Duke University and Arkansas Children’s Hospital in Little Rock, 33 children with documented peanut allergy have received the daily therapy, which is given as a powder sprinkled on food. Most of the children are tolerating the therapy without developing allergic reactions, and five stopped the treatment after two and a half years because they could now tolerate peanuts in their regular diet.

While the Duke Study has only proven successful for a handful of children to date, we feel considerably blessed that we are part of this ongoing research. Our study is different in that Abigail is not given powder, but a dosage under her tongue. However, we feel confident that she too can benefit from this therapy. On a recent visit to Duke, we found out that an adult doing the sublingual therapy (the same one as Abigail) recently passed his food challenge and was able to successfully consume a large quantity of peanuts. That gives us real hope.