Seven-year old Ammaria Johnson from Chesterfield County, Virginia returned to school after the holidays excited to see her friends and teachers. Sadly, that first school day of the new year turned tragically fatal as Ammaria, who had a peanut allergy, somehow became exposed to peanut protein and succumbed to an anaphylactic reaction. Details thus far are scant. We don’t know how she was exposed to peanut. Her mother says that she had an action plan that allowed her to get Benadryl, but that it was not given. She also states that she tried to give an aid an EpiPen for her at the beginning of the school year but was told to keep it at home. Whatever happened, Ammaria was in cardiac arrest by the time emergency personnel arrived at school, and was pronounced dead shortly later at a Richmond hospital.
This sad story provides us several reminders about food allergies. First, they can be life-threatening – particularly peanut allergies. Fully 80% of all deaths due to anaphylaxis from foods are from peanuts. Second, they are preventable. Complete avoidance is the only assurance that an allergic reaction won’t occur. Third, anyone with a food allergy or caring for someone with a food allergy should be prepared with the proper medications to treat an allergic reaction. This means epinephrine – and in some cases two doses. Too many people rely on Benadryl to treat an anaphylactic reaction. Epinephrine is the recommended first-line of treatment. It can never be given too early, but it can be given too late.
This food allergy-related death should never have happened. If your child has a food allergy, take the following steps to avoid a tragic occurrence such as the one that happened to this young child:
· Learn to read labels. The Food and Drug Administration (FDA) requires labels to indicate whether a food product contains peanut protein, or is manufactured in a facility where peanut protein may be present.
· Educate your child about his or her food allergy and the importance of avoiding the particular food – particularly not to eat anything that hasn’t been prepared or approved by you, their parent.
· Be aware of potential bullying of children with food allergies. This has become a problem in recent years. Tell your child to let you know if they get teased or threatened about his or her food allergies. Discuss this potential problem with school personnel so they can be aware of it and prevent it.
· Educate teachers, aids, school nurses, cafeteria workers and even bus drivers about your child’s food allergies.
· Be prepared. Make sure your child has an epinephrine auto-injector, such as an EpiPen or Twinject, available nearby at all times. Have your allergist train you and your child how and when to use the device.
· Make sure all school personnel who care for your child understand how and when to use an epinephrine autoinjector. Training devices are readily available to practice with.
· Have a written Food Allergy Action Plan signed by your child’s physician available to all appropriate personnel at school. Ensure that you supply the necessary medications to keep at school.
· Remember: Life-threatening reactions can occur even in someone who’s previous reactions were not severe.
Stephen W. Shield, MD
Allergy Partners of Eastern Virginia