Officials Focus on Threat Posed by Food Allergies

An estimated 11 million Americans suffer from the potentially fatal condition

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By Amanda Gardner
HealthDay Reporter

SUNDAY, March 5, 2006 (HealthDay News) -- Potentially life-threatening allergic reactions to foods remain a major public health issue and one that is gaining in prominence.

It is enough of a problem that the White House designated Sunday as National Anaphylaxis Day. Anaphylaxis is a severe allergic reaction that can cause death.

"With this declaration of National Anaphylaxis Day, this disease will be elevated to the prominence it deserves," said Dr. F. Estelle Simons, president of the American Academy of Allergy, Asthma and Immunology (AAAAI), at a news conference in Miami Beach Sunday. "With that, more health-care professionals, more doctors and members of the general public will become aware of it and will be able to recognize the signs and symptoms."

Simon spoke at the annual meeting of the AAAAI.

Some 11 million Americans suffer from food allergies and 150 to 200 people die each year from unknowingly ingesting the wrong food. Food allergies account for at least 30,000 emergency room visits each year.

Allergy to peanuts is one of the most dramatic, and deadly, examples of food allergy. The prevalence of the allergy has doubled in children in a five-year period.

"There is no cure for food allergy," said Anne Munoz-Furlong, founder and CEO of the Food Allergy and Anaphylaxis Network (FAAN). "Strict avoidance of the food is the only way to avoid a reaction. Once a reaction begins, there is no way to predict how severe the symptoms will become."

The emotional toll of food allergies is fierce, Munoz-Furlong added. Marriages can break up, and parents leave full-time jobs to take care of allergic children, who may develop eating disorders and compulsive behavior.

The AAAAI meeting featured a number of reports that helped to shed light on the different nuances of this problem.

One study found that the number of visits to U.S. emergency rooms as a result of anaphylaxis may be grossly underestimated, with the real number closer to 1.04 million visits each year. This represents about 1 percent of all visits to emergency departments, said Dr. Carlos Carmago, senior author of the study and associate professor of medicine and epidemiology at Harvard Medical School in Boston.

The study also found that epinephrine, which is the standard antidote for such allergic reactions, was under-utilized in emergency rooms. "If you don't use epinephrine earlier, the disease progresses and it might be too late for the medicine to work, Camargo said.

Under-treatment may extend to other contexts as well.

A survey of families attending FAAN conferences found that 34 percent of the most severely food-allergic individuals were not receiving adequate medical care.

"Physicians and families must be educated to ensure that all food-allergic individuals have epinephrine available to them at all times and are trained to use it," said Dr. Elinor Simons, lead author of the study, which was done while she was a fellow at Mount Sinai School of Medicine in New York City. "It's important that anyone with symptoms seen by a health-care provider be instructed to avoid the food, instructed to carry epinephrine, given a prescription if they don't already have it and get adequate follow-up."

Although epinephrine is not entirely without risks, a health-care professional can make the judgment as to whether a reaction is progressing. "We're of the mind that it's better to be safe than sorry," said Simons, the AAAAI president.

Finally, researchers in the United Kingdom found that levels of carboxypeptidase, an enzyme associated with mast cells, were higher in people who had an anaphylactic reaction, compared to those without a reaction.

"The prevalence of severe allergic reactions seems to be increasing throughout the world, but there is uncertainty about the prevalence because of the lack of good, effective means of diagnosis," said senior author Andrew Walls, of the University of Southampton.

"We have developed an assay for this mast cell enzyme and looked at some 200 cases of anaphylaxis and found an increased concentration of carboxypeptidase in the blood," Walls said. "Our feeling is that this is going to be a useful new laboratory test for establishing a diagnosis of anaphylaxis."

More information

FAAN has more on food allergies.

SOURCES: March 5, 2006, news conference with F. Estelle Simons, M.D., president, American Academy of Allergy, Asthma and Immunology, Milwaukee, Wisc.; Carlos Carmago, M.D., associate professor of medicine and epidemiology, Harvard Medical School, Boston; Anne Munoz-Furlong, founder and CEO, Food Allergy and Anaphylaxis Network, Fairfax, Va.; Elinor Simons, M.D., assistant professor, Albany Medical College, Albany, N.Y.; Andrew F. Walls, Ph.D., University of Southampton, England

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