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Deadly Meals

Eating out can trigger dangerous food allergies, so ask the right questions

SUNDAY, May 6 (HealthScout) -- Most people associate allergies with little more than annoying sniffles, sneezes and wheezes. But for sufferers of some food allergies, reactions can be far more serious -- even fatal.

And, experts say, the most frustrating aspect of the 150 to 200 food-allergy deaths in the United States each year is that many of them could have been prevented.

To focus attention on the problem, the Food Allergy and Anaphylaxis Network (FAAN) is sponsoring Food Allergy Awareness Week, starting today.

While many common food allergies are caused by shellfish and other fish, as well as milk, soy, wheat and eggs, the most life-threatening allergies are triggered by nuts, says FAAN founder Anne Munoz-Furlong.

"In every study on food-allergy deaths we've looked at, peanuts and tree nuts accounted for over 90 percent of allergic-reaction fatalities," she says.

Munoz-Furlong says food-allergy sufferers face the greatest risks when they eat out and aren't told truthfully whether nuts were used in the preparation of their meal.

"In the research we looked at, time and again allergy sufferers would ask about the food they were about to eat and identified themselves as being very allergic, but they were not given the right information," she says.

Some food-allergy sufferers can have severe reactions to even trace amounts of peanuts, Munoz-Furlong says.

In one case in a food establishment, a boy who ordered an ice cream sundae sent it back because he was allergic to the peanuts on it. The kitchen simply picked off the peanuts, applied more whipped cream and sent the sundae back to him. He subsequently had a severe reaction, Munoz-Furlong says.

It's those kinds of shortcuts and a lack of awareness that can cost people their lives.

In another case, Munoz-Furlong says, a woman at a wedding reception in upstate New York asked the waiter whether there were peanuts in the cookies he was serving. The waiter said no. But because the cookies had been made with a spatula used to make another dish containing peanuts, the woman had a severe reaction and died.

"If the waiter or waitress had taken just a few more minutes, thought about the question and answered it properly, that person might be here today," Munoz-Furlong says.

Don't take the waiter's word

Allergy sufferers also must be sure to clearly communicate their needs to food establishments.

"We did see a trend with the majority of fatalities being among individuals ages 10 to 19, and we believe it's because this group of people is still learning how to eat out away from home," Munoz-Furlong says.

"They are spending a lot of time in the company of friends and grabbing food here and there and are more susceptible to listening to other people -- and that makes them more vulnerable."

Dr. Scott Sicherer, with the Jaffe Food Allergy Institute at Mount Sinai School of Medicine in New York City, says all food-allergy sufferers who dine out, regardless of age, shouldn't blindly place their trust in the waiter or waitress.

"It may not be the waiter they need to talk to. It may be the chef or some other staff member who has more to do with food preparation," he says.

Sicherer says food-allergy sufferers also may want to rethink going to Asian restaurants and ice cream parlors -- both of which use many nut products -- because of the high number of reactions that occur at such places.

"There may be some places that simply should be off-limits to people with allergies. But if they must go, the main thing we suggest is that they have strong communication with the correct people at the restaurant," Sicherer says.

Experts add that all emergency response teams should be adequately prepared to deal with someone suffering from a severe food reaction.

Some states require that paramedics have the emergency allergy treatment epinephrine with them at all times, but many other states don't, says Munoz-Furlong.

"In many states, if you call 911, you'll just get the first wave of emergency medical technicians and they probably don't carry epinephrine. In most cases, they'll have to call for backup and usually by the time a backup comes, it's too late."

"So it's very important that all states allow all levels of emergency medics to carry this life-saving medicine."

What To Do

Read more about food allergies in these HealthScout stories.

Or visit the American Academy of Allergy, Asthma and Immunology for more information.

SOURCES: Interviews with Scott Sicherer, M.D., Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York City; Anne Munoz-Furlong, founder, Food Allergy and Anaphalaxis Network, Fairfax, Va.; FAAN press release
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