Peanut allergies are common among children and often show up in the first years of life. Unlike other food allergies, such as milk or eggs, most kids don’t outgrow a peanut allergy. The reaction can range from and minor irritation to a life threatening situation. And, individuals who have only a mild reaction today may build to a life threatening situation (anaphylaxis) in the future.
If you ever believe that you have had a reaction to peanuts you must discuss this with your physician immediately in order to both confirm the diagnosis and discuss future treatments. Individuals who have a response to peanuts or peanut butter will often show symptoms in the first minutes after exposure. Some individuals are so allergic that the peanut butter, or peanuts, may only be in the room in which they are residing and they will exhibit signs and symptoms of a reaction.
Some of the more common reactions are skin hives, redness or swelling, itching or tingling around the mouth and throat, digestive problems such as stomach cramps, nausea or vomiting, tightening of the chest, shortness of breath and a runny or stuffy nose. Less frequently an initial reaction will be anaphylaxis. Peanut allergies are the most common cause of anaphylaxis reactions. This is a medical emergency which requires immediate epinephrine and a trip to the emergency room where physicians can provide respiratory and body system support until the protein allergen has left the body.
Signs and symptoms of anaphylaxis include constriction of the airway, which can also include a small throat, making it difficult to breathe, a severe drop in blood pressure, rise in pulse and dizziness, lightheadedness or loss of consciousness.
Reliable statistics on individuals who suffer from peanut allergies are difficult to ascertain. While there is a lot of research on food allergies in general, there have not been a significant number done on peanut allergies alone. Numbers that have been extrapolated, or taken from other studies, are not reliable when the studies used nonrepresentative sample sizes. Peanut allergies are a very real problem with a potentially fatal reaction.
But, a few things are known, such as peanut allergy is one of the big eight food allergies that accounts for 90% of food allergies suffered by 21 million Americans. More than 3 million people report being allergic to peanuts or tree nuts and from 2004 to 2006 there was an average of 9,500 hospital discharges each year with the diagnosis related to food allergies in children zero to 17 years old.
Those who suffer from peanut allergies find that the immune system has developed an allergic type response to the proteins found in peanuts. It identifies these proteins as something harmful and then signals the immune system to release histamines which leads to the signs and symptoms of the allergic response. Those who are allergic can respond to three different types of exposure: direct contact which is the most common, cross contact which is the result of exposure during processing or handling of a food product, and inhalation when you inhale dust or aerosols containing peanuts such as peanut flour or peanut oil cooking spray.
While it isn’t clear why some people develop allergies to peanuts and others don’t, researchers have identified a couple of different risk factors. Those who have a family member with an allergy to peanuts, or any other allergy, are at higher risk for developing a peanut allergy. Individuals who were allergic as children but appeared to outgrow it may develop this allergy again.
It appears as if children who live in the city are more likely to develop allergies than those children who live in rural areas. This has led to a “hygiene hypothesis” which proposes that when children are exposed to many different microbes or allergens at an early age their immune system is more tolerant and less likely to react.
And, while there is no real known treatments or cure, some children are finding significant relief with a new treatment protocol that allows them to increase their tolerance to peanuts. A medically supervised daily dose appears to have helped children avoid a potentially life threatening condition.
Researchers from Duke University Medical Center reported at the Academy of Allergy, Asthma and Immunology in early 2009 the results of their study. Because even a minor exposure can place an individual in a life threatening situation there is ample reason to discover a way of avoiding this situation. Nearly half of the 150 deaths attributed to food allergies are caused by peanuts. (1)
Today, it is important to teach children who are allergic to peanuts to question the ingredients in processed foods and let people know that they are allergic to peanuts. Despite best efforts, avoidance may not be 100% foolproof. Children who are allergic should carry an EpiPen, a pre-loaded shot with epinephrine designed to keep them alive until they reach the emergency room. Medications such as antihistamines can reduce mild symptoms and should be taken after exposure to peanuts to help relieve the itching or hives. However, antihistamines will never be sufficient to treat anaphylaxis.
If an injection of epinephrine is necessary to treat a severe reaction, the individual should always be seen in the emergency room as soon as possible. Even though it may appear that the epinephrine was enough to treat the situation it has only alleviated the immediate response. The peanut proteins remain in the body and will continue to cause an allergic response once the effects of the epinephrine have worn off. This can place the individual in a significantly dangerous life threatening situation.
Discuss your questions and concerns with your primary care physician who will best be able to help you identify what may and may not be a peanut allergy and the correct course of action for treatment. Remember, however, that 100% compliance with avoidance of the product is highly unlikely and an accidental dosing must be planned for.
References:
(1) Journal of Allergy and Clinical Immunology: Safety of a Peanut Oral Immunotherapy Protocol in Peanut Allergic Children
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731305/
Resources:
KidsHealth.org: Nut and Peanut Allergy
http://kidshealth.org/teen/food_fitness/nutrition/nut_allergy.html
International Archives of Allergy and Immunology: Tree Nut Allergens
http://bio.fsu.edu/publication_pdfs/roux/Tree%20nut%20allergens.pdf
American College of Allergy Asthma and Immunology: Tree Nut Allergy
http://www.acaai.org/allergist/allergies/Types/food-allergies/types/Pages/tree-nut-allergy.aspx
Food Allergy Initiative: Tree Nut Allergy
http://www.faiusa.org/page.aspx?pid=378
Canadian Food Inspection: Tree Nut Allergy
http://www.inspection.gc.ca/food/consumer-centre/food-safety-tips/labelling-food-packaging-and-storage/tree-nuts/eng/1332439902096/1332439967941
Journal of Allergy and Clinical Immunology: Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study
http://www.ncbi.nlm.nih.gov/pubmed/14657884
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