Peanut Allergy: Ban or Plan?

School nurses and parents can develop ways to help a child avoid allergic reactions yet participate fully in all school activities. The physician should prescribe the child's treatment protocol for school use, with epinephrine as the first drug used in the emergency care of a life-threatening reaction. All persons who supervise the child need training in basic resuscitation and use of the auto-injector devices to administer epinephrine.

Some schools have "banned" peanut products, but the Food Allergy Network is concerned that children would develop a false sense of security rather than developing the skills to deal with a potential problem. Measures to control the risk of exposure to peanuts include substituting ingredients for food-related lessons and "no-trading" food or eating utensils.

Why the recent attention to peanut allergy? An estimated six percent of people have diagnosed food allergies. This increase is related to the increased prevalence of atopic disease generally, exposure to peanuts in the diet at an earlier age, and more attention to diagnosing food-related conditions.

Peanut and tree nut allergies develop during the first three years of life presenting with skin, GI and respiratory system symptoms. Unlike milk and egg allergies that are usually outgrown, peanut sensitivity appears lifelong. The child who had a mild reaction should be handled as if the next reaction will be anaphylactic in nature.

(Burks W and Wheeler L. Peanut-free or peanut-smart? Allergy education vital in schools. AAP News 1999; Feb:20)

COMMENT: The Food Allergy Network materials are available from calling 800-929-4040 or online at www.foodallergy.org.