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Children's allergies require schools, parents to remain alert

| Tuesday, Sept. 6, 2011

Amy Taylor does a lot of reading in the grocery store.

Since her young daughter, Maura, suffered a scary reaction to peanuts a few years ago, every box of cereal, pastries and snack food has to be looked over before it's purchased.

"We don't take chances," says Taylor, 37, of Cranberry.

An estimated 11 million Americans are allergic to some kind of food. An increasing number of them are school-age children.

About 4 percent of the nation's 62 million schoolchildren, to age 18, have some kind of food allergy, according to the National Center for Health Statistics. The number of reported food allergies among those younger than 18 increased 18 percent from 1997 to 2007, the agency reports.

As the condition has become more prevalent over the years, many parents have become more vocal with their school districts about setting up food-allergy emergency action plans to safeguard their children.

"There's been a real increase out there," says Dr. David Skoner, director of Asthma, Allergies and Immunology at Allegheny General Hospital, North Side. He says about one-third of his patients need help with allergies to food, compared with 5 percent when he began practicing medicine in Pittsburgh in the 1980s.

"With the rise in cases we're seeing out there ... schools simply can't afford to not pay attention," Skoner says. "They can't afford to not look at it."

Food allergies cause 30,000 cases of anaphylaxis -- a whole-body allergic reaction -- and are responsible for roughly 150 deaths each year. Eight foods account for 90 percent of all food-allergy reactions -- cow's milk, eggs, peanuts, fish, shellfish, soybeans, wheat and tree nuts (such as walnuts, pecans, almonds and cashews).

While most schools and school districts say they stay updated on food-allergy trends, there's no one clear way to deal with them:

• Pittsburgh Public Schools' Anaphylactic Allergy Action Plan requires students to disclose their allergy, whether they will provide their own lunches and whether they will be permitted to carry epinepherine to open airways.

• Bus drivers in Penn Hills are trained to recognize symptoms of an allergic attack and administer an injection if they have to.

• Officials at the Western Pennsylvania School for the Deaf, in Edgewood, are crafting a written policy concerning food allergies. Enrollment there has climbed since 2009, when state officials transferred ownership of the Scranton State School for the Deaf there.

"We're not seeing so much an increase in (the volume of) allergies. What we're seeing is a change in the severity," says Gregg Bowers, the School for the Deaf's chief operating officer. "We know we're dealing with more severe cases because of what's in their medical histories."

Taylor and her husband, Ronald, meet each year with nurses and other officials at Maura's school to make sure emergency-contact information is updated.

Maura, 9, was 15 months old when Taylor fed her a cracker with a small spread of peanut butter. Maura had earlier outgrown an allergy to coconut and sesame, and had eaten peanut butter before with no problem.

But this time was different. She broke out in hives and started to gasp as her airway began closing.

"It was horrible. I was terrified," Taylor says. "I didn't know what I was doing wrong. It's the worst feeling in the world for any mother to have."

Maura was rushed to the hospital and recovered after several doses of epinephrine. Since then, the family has tossed out everything peanut-based from the cupboards, and Taylor packs Maura's lunch every morning.

Buying new packaged foods sometimes can mean calling manufacturers to make sure there's nothing in them that can make Maura sick.

"We don't have a treatment for it at this point, so avoidance is the best you can do," says Dr. Todd Green, assistant professor of Pediatrics in the division of Allergy and Immunology at Children's Hospital. "It's a matter of being prepared and having (patients) steer clear of things and situations that will lead to a reaction."

The National Association of School Nurses, in Silver Spring, Md., is days from releasing its Online Food Allergy Tool Kit that was funded jointly by the Centers for Disease Control and Prevention, the Food Allergy and Anaphylaxis Network and the National School Boards Association. The grant-funded report aims to be an aid for parents, schools and districts on the importance of being proactive with food allergies.

Its release also comes at a time when penny-pinching districts are strapped for cash and are weighing cutting faculty and staff that includes school nurses.

"Kids are coming into schools much more medically complex," says Sally Schoessler, the association's interim executive director. "There's no question school nurses are vital to a district's public safety and well-being."

Watch for the National Association of School Nurses' Online Food Allergy Tool Kit later this month. Details will be released on the association's website at .

If your child has food allergies

• Notify the school of what food(s) you child is/are allergic to.

• Provide written medical documentation, instructions and medications as directed by a physician.

• Provide properly labeled medications, and replace medications after use or upon expiration.

• Teach your child how to read food labels and when they're supposed to tell an adult they might be having allergic problem.

The school's responsibility

• Review any and all health records submitted by parents and physicians.

• Include food-allergic students in school activities. Students should not be excluded from school activities solely based on their food allergy.

• Set up a team made up of a school nurse, teacher, principal, school food service and nutrition manager, and counselor to work with parents and the student to establish a prevention plan.

• Ensure that all staff who regularly interact with students can recognize symptoms of an allergic reaction and know what to do in an emergency.

• Designate personnel who are trained properly to administer medications in accordance with the state Nursing and Good Samaritan Laws.

Source: Pennsylvania Department of Health

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