Allergy alert: Peanuts coming 2/1/09
Jan 18, 2009, 6:42 am
#16
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Peanut allergies overstated?
Peanut allergy epidemic may be overstated
It does appear to be a case of over reaction. We too were concerend about my children inheriting almond allergies from me. My wife was also concerned about the almond allergy evolving into allergy from other nuts such as peanuts too. She avoided peanuts, almonds and all nuts in general in their diet. But we never sheltered them from nut eating people around them. My wife and I continued to eat nuts. Fortunately my children never developed allergies to nuts. Studies have confirmed that children in southern Europe, where environment in which children grow up is less sterile, have better immune systems than chilfren from northern Europe. It would seem that over protection, rather than controlled gradual exposure is doing children a disfavour.
By Dr. Darshak Sanghavi | January 30, 2006
Anxieties about peanut allergy are understandable -- the condition can be deadly -- and some concerned parents today support banning peanut-containing foods from public places.
But the medical research suggests that severe peanut allergies are not as common as people think and are surprisingly difficult to diagnose accurately. And although, as a parent, it may seem that peanut allergies have reached epidemic proportions, the evidence is surprisingly thin.
According to Anne Munoz-Furlong, a researcher and the founder of the Food Allergy and Anaphylaxis Network, an advocacy group, today about 25 percent of parents believe that their children have food allergies, although only about 4 percent really do. A parent may suspect one after a few spit-ups or a screaming fit following a new food. Yet these are rarely true allergies. And even among children with true allergies caused by harmful IgE, only a tiny fraction will have life-threatening reactions, called anaphylaxis.
Anxieties about peanut allergy are understandable -- the condition can be deadly -- and some concerned parents today support banning peanut-containing foods from public places.
But the medical research suggests that severe peanut allergies are not as common as people think and are surprisingly difficult to diagnose accurately. And although, as a parent, it may seem that peanut allergies have reached epidemic proportions, the evidence is surprisingly thin.
According to Anne Munoz-Furlong, a researcher and the founder of the Food Allergy and Anaphylaxis Network, an advocacy group, today about 25 percent of parents believe that their children have food allergies, although only about 4 percent really do. A parent may suspect one after a few spit-ups or a screaming fit following a new food. Yet these are rarely true allergies. And even among children with true allergies caused by harmful IgE, only a tiny fraction will have life-threatening reactions, called anaphylaxis.
Last edited by Yaatri; Jan 18, 2009 at 6:50 am
Jan 18, 2009, 6:57 am
#17
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What was nice with the previous policy was that I did not have to worry when I was on a NW flight. Back to the old tested habit of refusing anything that looks like it may have nuts. Oh well...
Jan 18, 2009, 7:01 am
#18
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Once out of MCO, we had a child with nut allergies. This was when we still served hot meals in coach and served peanuts with the beverage.
The mother of the child informed us of the allergies and told us we were not to serve peanuts and not allow other passengers to eat any nuts that they may have brought on board. In addition, the dessert on the meal tray was a cake with crushed peanuts on top. She told us that we would have to remove the desserts from the passengers trays.
After some discussion, we found out that the woman had not informed NW about the childs allergies when booking the flight and she didn't have an epi-pen with her.
After relating this information to the Captain and to a ground supervisor, the ground supervisor asked the woman to come with him so that they could make other arrangements for their travel. She was furious. But the Captain didn't want to take a chance with the child on board under the circumstances.
I guess with the new rules, those with nut allergies are going to have to think twice about the new policy.
The mother of the child informed us of the allergies and told us we were not to serve peanuts and not allow other passengers to eat any nuts that they may have brought on board. In addition, the dessert on the meal tray was a cake with crushed peanuts on top. She told us that we would have to remove the desserts from the passengers trays.
After some discussion, we found out that the woman had not informed NW about the childs allergies when booking the flight and she didn't have an epi-pen with her.
After relating this information to the Captain and to a ground supervisor, the ground supervisor asked the woman to come with him so that they could make other arrangements for their travel. She was furious. But the Captain didn't want to take a chance with the child on board under the circumstances.
I guess with the new rules, those with nut allergies are going to have to think twice about the new policy.
Jan 18, 2009, 7:18 am
#19
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Jan 18, 2009, 7:20 am
#20
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I do not have or know anyone with nut allergies, so I need some educating. Could someone please explain briefly why a person with nut allergies cannot sit on the same plane with someone eating nuts -- whether it's their seatmate or someone 20 rows away. Thanks much for the info.
Jan 18, 2009, 7:29 am
#21
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To dispel some rumors: my son was breastfed 100% from birth to 8 months. And until you’ve witnessed your own toddler swollen head to toe, one eye swollen shut and having difficulty breathing just from eating a scrambled egg, then you can promote the “over reaction” to food allergies. Thankfully we have prevented any exposure to peanuts or peanut dust; just going off blood results confirming the peanut allergy and instructions from our doctor.
I just always appreciated the “above and beyond” attitude of the NW crews in our situation (and witnessed it for others a couple of times traveling solo) and am sorry to see peanuts re-introduced.
Jan 18, 2009, 7:54 am
#22
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I agree with that action too. I’m not suggesting it is any airline’s responsibility to keep my son (or any passenger) safe from food exposure and we take every precaution possible (outside of just driving).
To dispel some rumors: my son was breastfed 100% from birth to 8 months. And until you’ve witnessed your own toddler swollen head to toe, one eye swollen shut and having difficulty breathing just from eating a scrambled egg, then you can promote the “over reaction” to food allergies. Thankfully we have prevented any exposure to peanuts or peanut dust; just going off blood results confirming the peanut allergy and instructions from our doctor.
I just always appreciated the “above and beyond” attitude of the NW crews in our situation (and witnessed it for others a couple of times traveling solo) and am sorry to see peanuts re-introduced.
To dispel some rumors: my son was breastfed 100% from birth to 8 months. And until you’ve witnessed your own toddler swollen head to toe, one eye swollen shut and having difficulty breathing just from eating a scrambled egg, then you can promote the “over reaction” to food allergies. Thankfully we have prevented any exposure to peanuts or peanut dust; just going off blood results confirming the peanut allergy and instructions from our doctor.
I just always appreciated the “above and beyond” attitude of the NW crews in our situation (and witnessed it for others a couple of times traveling solo) and am sorry to see peanuts re-introduced.
And yes, I have taken my SO to the emergency room because she mistakenly inhaled or ingested something with peanuts, but even with near death experiences, she won't go out of her way to inconveinece others because of her allergies.
Jan 18, 2009, 8:02 am
#23
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I do not have or know anyone with nut allergies, so I need some educating. Could someone please explain briefly why a person with nut allergies cannot sit on the same plane with someone eating nuts -- whether it's their seatmate or someone 20 rows away. Thanks much for the info.
I am usually ok with someone eating nuts next to me but I will "sense" them before I see them. Touching a rag that has been in contact with nuts will affect me. But for me to get a significant (life threatening) event involves ingestion.
Jan 18, 2009, 8:13 am
#24
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I think Delta/NWA is the first airline that is absolutely truthful about the peanut allergy problem. Even if this truth hurts and doesn't come in puffy, cuddly blanky.
They know there are people with this condition but they can't guarantee that their planes are safe or free of allergens. Every airline that offers something like nut-free flights just plane lies into the face of customers.
There is nothing like a peanut free flight. Maybe if you clean the plane with chlorine gas. Everyone who has a allergy has to take the necessary precautions and is in my opinion very naive if he or she believes anyone telling that something is peanut free.
About the "I die if I inhale one peanut particle on the plane.". I wonder how taking a bus, going shopping, going to a sports game or other activities are working for this people. I accept that people can die from eating peanuts, shellfish or whatever they allergic but about other ways I'm very sceptic.
They know there are people with this condition but they can't guarantee that their planes are safe or free of allergens. Every airline that offers something like nut-free flights just plane lies into the face of customers.
There is nothing like a peanut free flight. Maybe if you clean the plane with chlorine gas. Everyone who has a allergy has to take the necessary precautions and is in my opinion very naive if he or she believes anyone telling that something is peanut free.
About the "I die if I inhale one peanut particle on the plane.". I wonder how taking a bus, going shopping, going to a sports game or other activities are working for this people. I accept that people can die from eating peanuts, shellfish or whatever they allergic but about other ways I'm very sceptic.
Jan 18, 2009, 8:21 am
#25
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There was one child at my daughters Kindercare that had a peanut allergy. Parents insisted that the entire facility be completely free including the kids in other classes and teachers. After tons of arguing the fact at a family night we asked the parent what the doctor said. She said the doctor didn't say anything. We all thought that was odd until we found out the child had never been tested for a peanut allergy and the whole thing was over the fact that the child had flu like symtoms once after eating peanuts. 99% likely the kid had the flu and isn't allergic to nuts at all but now the mother doesn't want the child tested.
I have also read info like Yaatri posted above that the vast majority of kids whose parents believe have a peanut allergy don't. I think that at least in school situations where many children are affected by not being allowed to bring nuts or peanut butter sandwiches to school, that the parents should have to supply information from the doctor that the child has a peanut allergy and has been tested. I think too many parents are just over protective and I also think some like the attention they get from raising the peanut issue. When I was young I was allergic to milk but the school, or an airplane would never have removed all milk because of it. I think to some parents, having a peanut allergy child is a fad and they may enjoy the power and attention of being able to remove nuts from schools and planes. I have nothing against the people who really do have the allergy and I will skip nuts on a plane for them, I just think some test results and doctors note should be provided before the measures are taken.
I have also read info like Yaatri posted above that the vast majority of kids whose parents believe have a peanut allergy don't. I think that at least in school situations where many children are affected by not being allowed to bring nuts or peanut butter sandwiches to school, that the parents should have to supply information from the doctor that the child has a peanut allergy and has been tested. I think too many parents are just over protective and I also think some like the attention they get from raising the peanut issue. When I was young I was allergic to milk but the school, or an airplane would never have removed all milk because of it. I think to some parents, having a peanut allergy child is a fad and they may enjoy the power and attention of being able to remove nuts from schools and planes. I have nothing against the people who really do have the allergy and I will skip nuts on a plane for them, I just think some test results and doctors note should be provided before the measures are taken.
Jan 18, 2009, 9:17 am
#26
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About the "I die if I inhale one peanut particle on the plane.". I wonder how taking a bus, going shopping, going to a sports game or other activities are working for this people. I accept that people can die from eating peanuts, shellfish or whatever they allergic but about other ways I'm very sceptic.
Self-reported allergic reactions to peanut on commercial airliners. Sicherer SH, Furlong TJ, DeSimone J, Sampson HA. J Allergy Clin Immunol. 1999 Jul;104(1):186-9.
BACKGROUND: Allergic reactions to food occurring on commercial airlines have not been systematically characterized. OBJECTIVE: We sought to describe the clinical characteristics of allergic reactions to peanuts on airplanes. METHODS: Participants in the National Registry of Peanut and Tree Nut Allergy who indicated an allergic reaction while on a commercial airliner were interviewed by telephone. RESULTS: Sixty-two of 3704 National Registry of Peanut and Tree Nut Allergy participants indicated a reaction on an airplane; 42 of 48 patients or parental surrogates contacted confirmed the reaction began on the airplane (median age of affected subject, 2 years; range, 6 months to 50 years). Of these, 35 reacted to peanuts (4 were uncertain of exposure) and 7 to tree nuts, although 3 of these 7 reacted to substances that may have also contained peanut. Exposures occurred by ingestion (20 subjects), skin contact (8 subjects), and inhalation (14 subjects). Reactions generally occurred within 10 minutes of exposure (32 of 42 subjects), and reaction severity correlated with exposure route (ingestion > inhalation > skin). The causal food was generally served by the airline (37 of 42 subjects). Medications were given in flight to 19 patients (epinephrine to 5) and to an additional 14 at landing/gate return (including epinephrine to 1 and intravenous medication to 2), totaling 79% treated. Flight crews were notified in 33% of reactions. During inhalation reactions as a result of peanut allergy, greater than 25 passengers were estimated to be eating peanuts at the time of the reaction. Initial symptoms generally involved the upper airway, with progression to the skin or further lower respiratory reactions (no gastrointestinal symptoms). CONCLUSIONS: Allergic reactions to peanuts and tree nuts caused by accidental ingestion, skin contact, or inhalation occur during commercial flights, but airline personnel are usually not notified. Reactions can be severe, requiring medications, including epinephrine.
BACKGROUND: Allergic reactions to food occurring on commercial airlines have not been systematically characterized. OBJECTIVE: We sought to describe the clinical characteristics of allergic reactions to peanuts on airplanes. METHODS: Participants in the National Registry of Peanut and Tree Nut Allergy who indicated an allergic reaction while on a commercial airliner were interviewed by telephone. RESULTS: Sixty-two of 3704 National Registry of Peanut and Tree Nut Allergy participants indicated a reaction on an airplane; 42 of 48 patients or parental surrogates contacted confirmed the reaction began on the airplane (median age of affected subject, 2 years; range, 6 months to 50 years). Of these, 35 reacted to peanuts (4 were uncertain of exposure) and 7 to tree nuts, although 3 of these 7 reacted to substances that may have also contained peanut. Exposures occurred by ingestion (20 subjects), skin contact (8 subjects), and inhalation (14 subjects). Reactions generally occurred within 10 minutes of exposure (32 of 42 subjects), and reaction severity correlated with exposure route (ingestion > inhalation > skin). The causal food was generally served by the airline (37 of 42 subjects). Medications were given in flight to 19 patients (epinephrine to 5) and to an additional 14 at landing/gate return (including epinephrine to 1 and intravenous medication to 2), totaling 79% treated. Flight crews were notified in 33% of reactions. During inhalation reactions as a result of peanut allergy, greater than 25 passengers were estimated to be eating peanuts at the time of the reaction. Initial symptoms generally involved the upper airway, with progression to the skin or further lower respiratory reactions (no gastrointestinal symptoms). CONCLUSIONS: Allergic reactions to peanuts and tree nuts caused by accidental ingestion, skin contact, or inhalation occur during commercial flights, but airline personnel are usually not notified. Reactions can be severe, requiring medications, including epinephrine.
Severe food allergies by skin contact. Tan BM, Sher MR, Good RA, Bahna SL. Ann Allergy Asthma Immunol. 2001 May;86(5):583-6.
BACKGROUND: Ingestion is the principal route for food allergens, yet some highly sensitive patients may develop severe symptoms upon skin contact. CASE REPORT: We describe five cases of severe food allergic reactions through skin contact, including inhalation in one. METHODS: The cases were referred to a university allergy clinic, and evaluation comprised detailed medical history, physical examination, skin testing, serum total and specific IgE, and selected challenges. RESULTS: These cases were found to have a strong family history of allergy, early age of onset, very high total serum IgE level, and strong reactivity to foods by skin prick testing or RAST. Interestingly, reactions occurred while all five children were being breast-fed (exclusively in four and mixed in one). CONCLUSIONS: Severe food allergic reactions can occur from exposure to minute quantities of allergen by skin contact or inhalation. Food allergy by a noningestant route should be considered in patients with the above characteristics.
BACKGROUND: Ingestion is the principal route for food allergens, yet some highly sensitive patients may develop severe symptoms upon skin contact. CASE REPORT: We describe five cases of severe food allergic reactions through skin contact, including inhalation in one. METHODS: The cases were referred to a university allergy clinic, and evaluation comprised detailed medical history, physical examination, skin testing, serum total and specific IgE, and selected challenges. RESULTS: These cases were found to have a strong family history of allergy, early age of onset, very high total serum IgE level, and strong reactivity to foods by skin prick testing or RAST. Interestingly, reactions occurred while all five children were being breast-fed (exclusively in four and mixed in one). CONCLUSIONS: Severe food allergic reactions can occur from exposure to minute quantities of allergen by skin contact or inhalation. Food allergy by a noningestant route should be considered in patients with the above characteristics.
Jan 18, 2009, 9:34 am
#27
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While I am sympathetic to the concept of food allergies....
a) Although a bit suspicious of at least one claim here of a person allergic to both tree nuts and peanuts, about as far removed from each other as egg whites and filet mignon.
b) With a brother in law who makes a quite good living as an Allergist, a veteran of a good residency in Pediatric Allergy at one of the centers for research, and far more medically qualified than most shamans or TV authorities.
c) Myself apparently allergic to a laundry list of stuff, most of which started giving me discomfort in my childhood, long before we identified such agents, and now as then doing nothing to counter them, I even react to a number of California Red Wines - something in the yeast there, I guess (or at least in parts of there).
...But folks, the world around us has been altered by those who conclude that the tribulations of one offset the trials of many.
No longer is it: "Stop the world, I want to get off!"
Now it's: "Stop the world and the rest of you get off!"
a) Although a bit suspicious of at least one claim here of a person allergic to both tree nuts and peanuts, about as far removed from each other as egg whites and filet mignon.
b) With a brother in law who makes a quite good living as an Allergist, a veteran of a good residency in Pediatric Allergy at one of the centers for research, and far more medically qualified than most shamans or TV authorities.
c) Myself apparently allergic to a laundry list of stuff, most of which started giving me discomfort in my childhood, long before we identified such agents, and now as then doing nothing to counter them, I even react to a number of California Red Wines - something in the yeast there, I guess (or at least in parts of there).
...But folks, the world around us has been altered by those who conclude that the tribulations of one offset the trials of many.
No longer is it: "Stop the world, I want to get off!"
Now it's: "Stop the world and the rest of you get off!"
Jan 18, 2009, 10:22 am
#28
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After relating this information to the Captain and to a ground supervisor, the ground supervisor asked the woman to come with him so that they could make other arrangements for their travel. She was furious. But the Captain didn't want to take a chance with the child on board under the circumstances.
Jan 18, 2009, 11:59 am
#29
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I wonder how many people fly Southwest with their low fares and peanuts, yet who also claim or actually have alergies to peanuts or other nuts?
Ok, like many people, I have some alergies that have appeared over the years, however I also have learned to manage them, what to avoid, how to be prepared, and so forth.
Why should just peanuts or any nuts be removed from the plane?
Why not pet cats or pet dogs that people sometimes travel with?
How about people who smoke and have smoke smelling clothes with them?
How about wheat based products including some beer?
How about milk or dairy based products?
Should people with cough, colds and the flu be allowed on the plane and impact others?
Why not the carry on items that have been in contact with cats, dogs, peanuts or other items people are alergic to?
Wait, Im alergic to bad service, can we remove, well, thats getting a bit to far and that's how some of these scenarios end up.
NOT to all the above and many others...
Make it clear to passengers that if you have alergies, you should have your medicine, a mask if needed, or, ask to be re-seated on the plane, on a different plane, or a different carrier (might be a bit extreme). If your alergies are so severe, you should have a Dr note as well as take pro-active measures including a mask, medicines and other precautions.
People need to keep in perspective that comercial flights are shared flights and not private charters, that they are traveling in shared space and that others just might have alergies to people who dont think of the others around them, in other words, it goes both ways.
-H
Jan 18, 2009, 1:19 pm
#30
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The Stein article was heavily read and commented upon at the LATimes.com website last week. Personal responsibility is the key. I am (or was) allergic to animal dander, specifically cats. Nothing life-threatening, but not pleasant. Did I freakout the first time I saw a "hand-bag doggie" in the cabin with me? No.
Could I have? Yes, but I knew that in doing so, I'd make more of an ... of myself than usual, plus I believe that if I want to travel on any form of public transport, there are things I need to do myself (i.e. bathe) and put up with, to an extent.
Later in life I forced myself to adopt a stray cat and now I am not as allergic, thanks to the constant exposure.
Presently I am only allergic to one thing on an airplane:
Economy Class!!