By Mariah Pieretti, MD
There has been a real increase in food allergy in recent years. In fact, a recent study found that the prevalence of peanut allergy has tripled from 1997-2008. 6-8 percent of children now have food allergies.
How common is peanut allergy?
The prevalence of peanut allergy is 0.6-1.3%. Fortunately about 20 percent of young children with a peanut allergy outgrow it.
Why are allergies more prevalent than they used to be?
There are currently a couple of hypotheses about the rise in allergies in general. One theory speculates that because our society has become so hygienic, our natural immune systems simply don’t develop the way they used to, which puts us at greater risk for allergies. Another hypothesis is that waiting to introduce highly allergic foods such as peanuts into a child’s diet may increase the child’s risk of developing allergies to those foods.
Are people with peanut allergies also allergic to tree nuts or beans?
If you are allergic to peanuts there is a 25-50 percent chance that you will also have a tree nut allergy. Peanuts are actually beans, which means that a few people with peanut allergies are also allergic to other beans such as green beans or peas. Because peanuts and tree nuts are often processed together, cross contamination is an additional problem. For this reason it is often safer for people with peanut allergies to restrict their consumption of both peanuts and tree nuts.
Can a peanut allergy be successfully treated?
The only treatment available right now is to avoid peanuts and to be prepared in the event of an accidental exposure. There are treatments on the horizon but they are not available yet. In a clinical trial at Duke (Durham, NC), researchers are working on peanut oral immunotherapy to desensitize people with peanut allergies. In another clinical trial at Mount Sinai (New York, NY), researchers are developing a vaccine for peanut allergy. Diagnostic progress is also being made, which will enable physicians to predict which specific peanut allergies people have. This is significant because some peanut allergies are more severe than others.
What are the typical symptoms of food allergies?
Generally within minutes to hours of eating the food in question, an allergic person will develop one or some of the following symptoms: hives, nausea, vomiting, shortness of breath, sneezing or throat symptoms. In infants, the allergic reaction may show up as eczema. Consistency is key: if every single time your child consumes a particular food he or she has a problem, then the child is probably allergic.
Is there a difference between allergy and intolerance?
Yes, there is a big difference between allergy and intolerance. An allergy is an abnormal immune response and can be life threatening if someone suffers anaphylaxis. By comparison a food intolerance, such as lactose intolerance, may make you uncomfortable but it is never life threatening. This is an important distinction to make.
What happens during anaphylaxis?
This is a life threatening reaction that occurs rapidly and can happen anytime there is accidental exposure to the allergen. Symptoms include shortness of breath, tightness in the chest or throat, coughing, fainting, and/or a drop in blood pressure. It is important to treat anaphylaxis immediately with epinephrine (EpiPen) and to call 911 for further treatment. You should get to the nearest emergency department as quickly as possible because an allergic reaction may progress even after a dose of epinephrine.
Should I take my child to an allergy specialist?
There is great value in seeing an allergist if your child is experiencing symptoms. You will have lots of questions that can be answered during your appointment. Educating both you and your child about safety and appropriate emergency response is an important first step.
If your child has a serious allergy to peanuts or other foods there are steps you can take to reduce risks. Keep an EpiPen handy at all times for an emergency dose of epinephrine. Practice strict avoidance of the allergen. Talk to school nurses and babysitters. Emphasize to your child the importance of not sharing food with friends and encourage them to seek help rather than go off on their own if they begin to have allergic symptoms.
Dr. Pieretti is board certified in Allergy and Immunology, as well as Pediatrics. She is on the medical staff of Cayuga Medical Center and is in practice with Asthma and Allergy Associates where she can be reached at (607) 257-6563.