“An Emerging Epidemic: Food Allergies in America” and Nevada SB 453

If you follow food allergy topics online, it is likely you’re already aware of a television special funded by FARE and Mylan Specialty (makers of the “Epi-pen”) that aired this morning.  I watched the special, narrated by father of a food allergic child, actor Steve Carell, online (click here to stream the entire program, thank you to Selena of Amazing & Atopic for sharing the link).  It is called “An Emerging Epidemic – Food Allergies in America” which is very fitting.

I’ll admit to crying a few times.  When you identify so keenly with something it is hard to escape reliving scenes from your own life.  I wonder how the program will impact people that don’t live with food allergies.  I wasn’t sure what to expect when I pressed “play” – it certainly is not something you want to watch with little ones because it comes right out and talks about fatalities with images of hospitals and a child in peril.

I think the program put faces to the issue but the questions I get as a parent of a child with food allergies were glossed over a bit.  For example, I’d say people ask me why there is an increase in the incidence food allergy and what causes food allergy.

The special mentions the hygiene hypothesis, which is one our pediatrician brought up most recently at the children’s 3 and 5 year well visit.  I brought up a lot of the other theories that I’ve been reading about and she hadn’t heard of them.  So to not present any of the other theories might perpetuate the implication of parental fault (which may be my “mommy guilt” talking).

The coverage given to oral immunotherapy is promising and exciting but there are already reports that the gains in treatment may not be lasting.  I know I love disclaimers but ending on the note of one treatment may diminish the impact of the program’s message.  Then again, as a food allergy mom I want to feel hopeful, I want to feel like people are working to help further research and awareness.

I have been feeling unsure of whether it is the best thing to keep this blog going but there is a part of the program where Dr. Ruchi Gupta mentions her mission to achieve safety for her child and others and it captured why we share and reach out.

As I wrote previously, I gave a presentation at my daughter’s school about food allergies.  I was then asked to write something for our school newsletter recently on the subject of food allergies and I decided to cover the new epinephrine law passed this summer in Nevada (using some of my notes from last year).  I want to be sure I thank my husband, my mother in law, my sister in law, Jenny (Multiple Food Allergy Help & FABlogCon), Missy (Marketing Mama), Elizabeth (Onespot Allergy & EpiCenter Medical), Tiffany (Food Allergy Fun), Caroline (Grateful Foodie), and Dana (The Las Vegas FARE Walk).  Each of them reviewed drafts of the following at various stages and provided valuable feedback.  I love this community, I know I say it often but I really and truly appreciate the support!  

I don’t know if this will be included in the newsletter in its entirety but I wanted to share it here in case it is of use to any of you out there in trying to raise awareness and impact the safety of all in the face of “an emerging epidemic.”  If you need my citations/references to feel free to leave a comment and I’ll get them to you.

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New Epinephrine Law Could Save Lives at School

During this summer’s 2013 legislative session, Nevada unanimously passed Senate Bill 453. The bill mandates that public schools obtain and have authorization to use injectable epinephrine (private schools are authorized but not mandated to obtain epinephrine). This allows them to save lives in the face of the rising risk of food allergies among children and anaphylaxis deaths nationwide. The New England Journal of Medicine has said that four of six deaths from food allergy occur in schools and are associated with delay in treating reactions with epinephrine

Anaphylaxis is associated with symptoms that may include hives, swelling, rapidly closing airways, and more. While not completely understood, anaphylaxis is essentially an overreaction by the immune system to any number of external triggers, including food. Estimates currently are that one in thirteen children suffers from food allergies. The most common food allergens are peanuts, tree nuts, milk, eggs, soy, shellfish, fish, and wheat. While some children might outgrow food allergies, they need protection at home, school, and play while their immune systems are so affected.

What does this development mean for students as they begin another school year in Nevada? Much like any person would obtain a prescription from their pharmacy, Nevada schools are now able and required to obtain and fill prescriptions for injectable epinephrine. Currently there is a program for schools so that each school can keep epinephrine injectors on hand without cost (the “Epi-pen” brand in this program). Discovery Charter School is making arrangements to obtain these free injectors to protect students and staff alike from known or undiagnosed food allergies. The Center for Disease Control reports that 25% of anaphylactic reactions in schools occur without a prior food allergy diagnosis.

During the legislative process, some wondered if epinephrine could cause more harm than good if used when it wasn’t needed but this is not the case. The side effects of mistaken use are mild and are greatly outweighed by the benefit of immediate use when needed. The only time giving epinephrine could be a problem is if a student has a heart disease but even so, physicians still feel that in a life and death situation, the epinephrine is worth the risk. So adverse reactions are rare and epinephrine is easy to administer to the thigh and even through clothing.

How does SB 453 help? In the case of an allergic anaphylactic reaction, epinephrine is most effective when used quickly. That means that a child who does not have their own prescription for injectable epinephrine would not even have the medicine at hand. The stock epinephrine could save that student during the delay in time for emergency services to arrive. Minutes make all the difference.

In Virginia, where a similar bill was passed, children have already had their lives saved because of stock epinephrine. A fifteen year old boy in Virginia was stung by a bee and two injections (the injectors are always provided in two-packs) stabilized him so that emergency personnel could assist him further.

I appreciate [my daughter’s school’s] embrace of training associated with food allergies and recognizing the signs of anaphylaxis. If you have any questions please feel free to get in touch with the school nurse. You are also welcome to contact me at [email]. Learn more about supporting the cause of awareness and a cure at http://www.foodallergywalk.org/lasvegas (the food allergy walk on November 2, 2013 at Green Valley Ranch’s The District is great for families — there will be a face painter, game truck, and more!).  I also encourage you to seek the assistance of a physician if you suspect your child has food allergies.

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School has been going wonderfully so far and it is the support of a caring community of staff, families, and friends that make all the difference.  Thank you for reading and being a part of that community.