"One Wrong Bite Can Kill Your Child"!

From near the top of a story about allergic schoolchildren in today's Cincinnati Enquirer comes this passage:

"It's hard to not worry when you know one wrong bite can kill your child," said Joe's mother, Nancy Greenlee of Sycamore Township. "The table protects him."

Joe and his classmates are among an estimated 8 million Americans - 2.7 percent - who suffer from food allergies. Of those, 3 million are allergic to peanuts, the leading cause of severe allergic reactions in the United States. Each year, up to 100 deaths are blamed on peanuts.

Such allergies are on the rise. Dr. Amal Assa'ad, a pediatric allergist at Cincinnati Children's Hospital Medical Center, recently built a database from patients that showed peanut allergies occur more frequently than cow's milk or egg allergies, which traditionally were more widespread.

No one knows for certain why this is happening…

As someone who got allergy shots for years despite never having had any allergic reaction to anything (even during tests), I can't shake the feeling that the peanut allergy craze that started a few years back is less medically than socially based. That is, it's got more to do with projected parental anxiety about their kids than specific chemical reactions (something similar may be at work with learning disabilities, asthma, and other youth-related conditions that allow for wide ranges in diagnosis).

Which isn't to say that some people really can't eat peanuts--but projected anxiety may explain the increase in allergies as much as anything else.

Comments

[Stretch]

Nick should file this post under "moral hazard" and use it to describe why health care costs are skyrocketing in this country - overconsumption of medical services as a result of poorly designed (and legislated) medical insurance plans. Giving somebody with no history of allergy problems a years-long regimen of immunotherapy is a spectacular waste of resources. Luckily he realizes this (way to throw mom under the bus there, Nick!).

[Tommy_Grand]

If your body produces antibodies in reaction to consumption of a food, you are allergic. The degree of your allergy is certainly variable, but whether or not an allergy exists is not really debatable."

The allergy may exist but present no serious symptoms. The issue: what level of reaction qualifies as a serious health issue requiring accommodations in lifestyle, treatment, etc? Are allergies "over diagnosed" in this sense? Yes. Doctors don't want to be sued.

[quaker120]

First, I think you were a bit smug when you distorted a fact (that some kids can die from eating one peanut) and made it a joke headline that insinuated that these mothers are a bunch of panicky yentas.

And as far as the "continuum," there is none in this case--these kids can die from eating very small quantities of peanut oil. That seems to be a pretty "exact point" of reaction to me.

Anyway, I agree that we do waste money on unnecessary medical procedures, and that people will never stop over-reacting to pseudo-science, but I don't think this story is evidence of neither phenomena. You seem to put this article on the same level as those "Is your [refrigerator/bathroom disinfectant/Oreo cookie] killing you?" I disagree.

Just out of curiosity, why were you given allergy shots if you never had any reaction at all, not even to a prick test? Was it at the explicit request of your parents?

[joe]

Well, yeah, but you have to bite the child in exactly the right place.

[jim]

Peanuts cure ADHD.

[Xmas]

Really, I thought the whole food allergy thing was caused by the cleanliness of modern life. Allergies and Asthma are on the rise in the US because of the way babies' immune systems learn to fight off infections. Since moms now longer needs to carry as many antigens for dangerous virus and bacteria, the babies immune system keys off of the innocous antigens to food protiens and dust mite droppings. Its the same reason we had a Polio outbreak in the 1940s.

[PLC]

Food allergies involve a measurable immune system response - not a "wide range in diagnosis". It may be that food allergies had previously been underdiagnosed, or the incidence of allergies may be actually increasing, but "projected anxiety" would not make kids product an immune response to certain foods.

[quaker120]

That's pretty smug, Nick.

As someone with a brother who also got allergy shots for years but, unlike you, has nearly died on many occasions from unknowingly eating miniscule amounts of nut and fish oils, I can understand these parents' concern. It's easy to laugh at these folks and paint them as Chicken Littles when you've never seen a kid suddenly stop breathing while eating something as benign as McDonald's french fries (the fries and McFish fillets are usually fried in the same oil).

[Charles Oliver]

I was diagnosed at about age eight with an allergy to potatoes. I'm the only person I know with such an allergy.

But anyone who knows me knows that potatoes, especially in the form of french fries, are the major staple of my diet. The only "allergic" reaction I've ever had is the spare tire I've developed over the last couple of years.

[thoreau]

I think Nick's point is that there are probably some kids out there who DON'T have allergies, but their parents have a sort of "Munchausens's-by-proxy" syndrome (hope I got the spelling right). He's not saying that all allergy diagnoses are bogus, just that some of the boost in new diagnoses may be bogus.

It's plausible: Over-protective parents with either way too many worries or way too few worries sometimes look for something simpler and more convenient to worry about.

[Nick Gillespie]

Some quick points in response to PLC and quaker120: First, I'm not being smug--or denying that some people have real, life-threatening allergies. Still, a lot of people with "allergies" don't have such severe reactions (or even any noticeable reactions at all--I know because I was one of those supposedly allergic kids).

Second, there is no strict rule of when something rises to the level of a measurable immune system response. As with all sorts of other observable conditions (cholesterol, say) tthere's a continuum and the exact point when a level is deemed a problem is always being redrawn and negotiated.

[PLC]

Nick - I don't really disagree with your skepticism; I just tend to think the issue is more of a journalism problem rather than medical. I did a little googling, and found that when researchers look into this, they tend to find that incidence of food allergies has increased but not by a statistically significant amount.

Perhaps there is better diagnostics today, but most likely, the press is creating a story where none lies. About 150 people die each year of food allergies - it is just that the press has decided to focus on it at this point in time (sort of like "the summer of the shark").

However, I do have to correct your misapprehension about allergy diagnosis - it is not really a continuum. If your body produces antibodies in reaction to consumption of a food, you are allergic. The degree of your allergy is certainly variable, but whether or not an allergy exists is not really debatable.

[Ric]

My ex had a severe peanut allergy and it was genetic. She was an crib-dwelling infant when she was given a taste of peanut butter by parents who didn't have any allegies and luckily they were wise enough to rush her to the hospital when she started to choke.
I don't know the genesis of other food allergies but in the case of peanuts, I know a "too clean" environment is not a sole cause.

[CC]

These allergy scares are great for government bureaucracy. In NYC public schools, if a child has a peanut allergy, the parent can request that the child be accompanied by a paraprofessional AT ALL TIMES, lest a classmate offer the child a piece of his Snickers bar. I wouldn't want to be the kid who has to be watched constantly to make sure he doesn't pop a peanut in his mouth. But it does keep the paras employed.

[jachor]

I got very angry reading you letter!!!! I am going through -ell with my 5 year old who can die from peanuts. In her school there are 10 children with an anaphylaxic allergy to nut and peanuts. I know my daughter is allergic because at 2 she licked an peanut butter sandwich and within 10 minutes she had hives all over. This is not in my head nor in the other 10 families at the school. People dont just assume their child has an allergy. It is proven to them first by the reaction and then by the dr. who performs the allergy test. Do your research!!!!!

[Creeply]

This kind of thing makes me nervous. I mean, im not that old but when I went to school I don't know of one person that had this peanut allergy. If even one person ever had it I would have known. This person says 10 kids at her daughters school have it. WOW with numbers that high its strange that no one at my school ever died by accident from eating a snickers or somthing. If it was so under diagnosed then I should have seen a number of deaths im sure. Either this is non sense or something major has happened in the peanut industy and no one want to own up to it.