Avoiding the Side Effects of Peanut Allergies. Part 2

8Nov

Avoiding the Culprit
But it’s not just the obvious foods that contain peanuts or peanut products that scare allergy sufferers like Susan. AAAAI has found that great risk comes from the “hidden” peanut products — residues and cross-contaminations that find their way into foods allergy sufferers eat. These residues, while often not present in high concentrations, can trigger allergic reactions, especially in highly sensitive individuals.

Sufferers can go to great lengths to avoid foods containing peanuts or peanut products. Foods that may contain hidden peanut products include cakes, biscuits, pastries, ice cream, desserts, cereal bars, confectionery items, curries, salad dressings, breakfast cereals, and Chinese and Indonesian dishes. This list is not exhaustive, and as those who have peanut allergies can affirm, totally avoiding peanuts is not as easy as it sounds.

“You can’t always see or taste peanuts or peanut byproducts,” Susan said. “All it takes for an allergic reaction to occur is for someone to use the same spatula when making sugar cookies that was used when making peanut butter cookies. The peanut protein can transfer just like that.”

Indeed, Susan believes that is what happened when she suffered the allergic reaction while eating that cookie 10 years ago. Just ordering a cookie without nuts didn’t guarantee that she wouldn’t suffer a severe allergic reaction.

Looking Out for Peanuts When Away From Home
“Unless you prepare the food yourself, you just never really know [if peanut products were used],” Susan said.

Residues of allergenic foods can occur in packaged and processed foods as the result of poor preparation practices, including failure to adequately clean shared processing equipment, incorporating leftovers back into new batches of a product, using the wrong packaging material, and labeling terms and regulations, according to AAAAI.

The AAAAI adds that restaurants can also have problems with shared equipment, including cooking and serving utensils and cooking surfaces. The use of shared cooking oil for different fried foods is another common and potentially hazardous practice in restaurants.

“The ubiquitous nature of these foods, combined with the potential for cross-contamination in bakeries, restaurants and processed food lines, makes avoidance difficult and accidental ingestion common,” Munoz-Furlong said.

Metcalfe agrees. “In spite of their best efforts to protect themselves, whenever someone with a peanut allergy eats out, that person is taking a certain risk,” he said. “You can tell the waiter you’re allergic to peanuts, but sometimes even the people preparing the food don’t know what’s in all the ingredients.”

Food manufacturers and restaurants have increasingly become sensitive to the number of people suffering from peanut allergies, and a growing number try to warn patrons of any peanut products used in their foods, the American College of Allergy, Asthma & Immunology reports. For example, the industry has adopted a number of labeling approaches, such as “may contain” statements, intended to assist food-allergic consumers. Still, individuals with a food allergy should diligently read all food labels and ask questions about foods prepared away from the home, such as in school or a restaurant, says the American Peanut Council.

Minimizing the Effects
Although no prevention or cure exists, efforts to minimize the severity of allergic reactions to peanuts and reduce the risk of these reactions have emerged. In addition to heightened awareness by the food industry, schools and childcare facilities are more attuned to the potential for peanut allergies, according to AAAAI.

“In spite of everyone’s best efforts, reactions are likely to occur,” said Mu?oz-Furlong. “When they do, quick action can be life-saving. Parents should be sure to inform school staff, childcare providers and others about their child’s food allergy avoidance strategies.”

Because peanut allergy sufferers are at high risk for experiencing anaphylactic shock, AAAAI issued a position that the first line of defense should be epinephrine (adrenaline), which is available in either auto-injector form (EpiPen) or as a two-dose needle and syringe (Anakit). “If epinephrine is prescribed for severe reactions, it should be with the child at all times,” Mu?oz-Furlong said.

Metcalfe says epinephrine should be administered early in the allergic reaction. Still, he says, a prompt visit to a doctor or emergency room is necessary. “Even after taking epinephrine, that person needs to be taken to or seek medical attention, because after the epinephrine wears off, the shock or other symptoms can return. There are other things that can be done in an emergency room to save that person’s life,” he said.

Crosby agrees. “Avoidance is really the only thing someone with a food allergy, like peanut allergies, can do. But if they do come in contact with the food, they should use an epinephrine self-injecting pen,” he said. Still, he added, “that just buys them time. They still need to get to a hospital or see a doctor.” Crosby stresses that getting to a doctor right away is important because the amount of epinephrine injected might not be enough to control the allergic reaction. Also, “there might still be enough peanut protein in the system that will still react once the medication wears off,” he said.

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