It’s back-to-school time for kids across the nation, and as our children head off into days filled with classes, recess, snack time and lunch, it’s important to remember not all immune systems are created equal.
Some children (and adults, of course) are faced with not being able to fully enjoy a quick snack or time in the lunchroom without worrying about getting sick as the result of allergic reactions to foods brought in by or prepared by others.
“This is definitely a hot topic right now,” said Dr. Jaison Jose, a staff physician with Geisinger’s allergy and immunology department.
What is a food allergy?
A food allergy is an immune system reaction that occurs soon after eating a certain food — this is not to be confused with a food intolerance, which is a person’s difficulty in digesting certain foods.
“Unlike food intolerances, food allergies are caused by your immune system incorrectly identifying some of the proteins in a particular food as harmful,” he explained.
According to Jose, most food allergies are caused by what he refers to as “the big eight.” Those eight foods include cow’s milk, eggs, tree nuts, peanuts, shellfish, fish, soy and wheat.
“Allergies vary from person to person,” said Jose. “Everyone is different, but typically in adults we tend to see more fish allergies and in kids it’s all the others — milk, eggs, peanuts, etc.”
If you’re not sure whether or not you’re really allergic to a particular food, you can make an appointment to see an allergist. He or she will conduct tests to help determine if you have a true food allergy or an intolerance to a particular food or food group.
“When it comes to food allergies, as far as testing goes, we usually do skin testing,” said Jose. “The allergen comes in liquid form and we have an applicator that we use to scratch the skin, typically on the forearm or the back. Then we wait for a period of time. If there is a reaction you’ll get a tiny hive at the site.”
Sometimes blood testing can be done as well.
Importance of testing
It is important to get tested to see if you have an actual food allergy because it could mean the difference between life and death.
“What I tell people who question testing is that it’s important to determine if you have an allergy or intolerance,” said Dr. Nathaniel Hare, an allergist at UPMC Susquehanna.
That’s because how you handle an allergic reaction versus an intolerance varies greatly.
Though it seems as though people suffering from food allergies are all around us, the fact is, according to the Center for Disease Control and Prevention (CDC), only five percent of children and between two and three percent of adults in the United States actually suffer from true allergies.
That equals about one in every 13 children.
The CDC also reports that although food allergy is more prevalent in children than adults, many affected children can “outgrow” food allergies with age. In adults, however, food allergies tend to be life-long. Children with peanut, tree nut, seed, fish, or shellfish allergies generally maintain these allergies for life, and they comprise a large proportion of food-allergic adults.
“With 90 percent of people, allergies will happen with the six main food groups — if you have a reaction to food in that group it will happen within two hours,” said Hare.
Reactions can vary and include, but are not limited to, hives, respiratory issues, belly pain, vomiting, swelling, itchy mouth/skin, light-headedness and more.
Hare stressed that if upon eating you experience any of those symptoms — or anything atypical — you should seek immediate care at an emergency room.
“If you know you have a food allergy, having an epinephrine injector is very important,” said Hare. “Because unfortunately, there is no way to treat a food allergy in a preventive way on a daily basis, so if you have a reaction, you should do an injection and then head to the emergency room.”
In fact, Hare said, anyone who has a known food allergy should keep two epinephrine injectors with them in the case a second dose is necessary prior to an ER visit.
What if I’m allergic?
“If someone has a true food allergy, that can be very severe and life threatening,” explained Jose. “Therefore, the first thing to do is avoid those foods (which you are allergic to). The second step would be to make sure you start reading the ingredients before eating — that includes asking at restaurants or elsewhere — to make sure the food you are allergic to is not mixed into your meal.”
Can I prevent a reaction?
The only real way to prevent an allergic reaction to particular foods, right now, is simply avoidance and knowledge.
Avoidance can prove difficult, though, because, as Jose noted, “You’re never completely sure unless you’re making the food yourself.”
Jose advised anyone concerned about food allergies take the extra step of asking whoever is preparing their food about the ingredients, to hopefully avoid an episode.
Potential allergy sufferers should also do his or her research to learn what’s in different foods, recipes and prepackaged food items.
“There are lots of websites that talk about food allergies — I usually recommend our own national allergy website — www.aaaai.com, where you can find tons of information about food allergies, videos and suggestions.”
Are there meds?
The short answer to this question is no — at least, not yet.
According to Hare, there is research being done on skin patches (similar to a nicotine patch) that may help desensitize a person to a particular food allergy over time.
“There are ways to develop a tolerance — a desensitization — but these things are not yet FDA approved, and may not be FDA approved,” he said. “There is a company called Aimmune trying to get a peanut designs kit through FDA, and there is also a peanut skin patch that works to desensitize through the skin.”
There is also oral immunotherapy (OIT) that would have a patient put the treatment in the mouth and eating it; and sublingual desensitization, which consists of putting a liquid form under the tongue.
For right now, though, Hare said data on epicutaneous reports that roughly 60 percent of patients have success.
Unfortunately, the larger studies report that these desensitizations don’t necessarily get rid of the risk for anaphylactic reaction.
He did note that researchers are looking at medicines that may alter the immune system down the road.