Researchers from Addenbrooke Hospital in Cambridge, England reported in this month’s edition of the journal, Allergy, that by studying a small group of peanut-allergic children, they have found a possible way of reducing the risks associated with accidental peanut ingestion.

The study authors pointed out that an allergy to peanuts may affect the entire family, particularly when a child has a food allergy.  Families affected by food allergies have a great deal of pressure put upon them, as well as anxieties associated with this condition.

How to cope with food allergies:

Eating out of the home requires planning and education to avoid an allergic reaction.  I often tell my patients to be a “label detective” and understand food labels ― or when dining out, present a “food ingredient card” to the server or kitchen staff to alert them, in order to reduce unwanted exposure to peanuts and other food allergens.  Don’t forget to always ask questions about ingredients and food preparation if you have a history of food allergies.

Bottom line: the only 100 percent successful treatment for food allergies in 2010, is education, prevention and avoidance, as well as preparedness for possible allergic reactions. There is a great need for more research as it is too soon to know whether this approach will ultimately work for the many millions with allergies to peanuts and nuts! 

Check out some additional strategies as well as one of the upcoming food allergy conferences taking place this year hosted by the Food Allergy and Anaphylaxis Network at:  http://www.foodallergy.org/conferences.html. 

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

It’s a good thing I never became a judge, because if I had, Stewart Parnell, president of Peanut Corp. of America would have been in jail by now.

The public evidence is overwhelming: He showed blatant disregard for the safety of millions of Americans, including children. He allowed contaminated peanut products to end up in our food supply.

People have died here! Where is the outrage??!! Stop the hearings, and send this guy and people like him to jail! Just this afternoon, medical examiners confirmed another salmonella-related death in Ohio, which brings the death toll up to nine people that have fallen victim to this profit-mongering filth.

Earlier today, e-mails were released as evidence where Parnell was quoted as saying he wanted to “turn the raw peanuts on our floor into money.” And this man had the audacity to respectfully decline to answer questions at his hearing on the advice of his counsel.

I believe in due process, but I also believe that there are certain circumstances that call for more immediate action.

I have three beautiful children, all school-aged, and one of them had to come home from school today because he was nauseous. Yes, this is probably your run-of-the-mill flu virus, but for a fleeting moment, I actually thought to myself, “I hope he didn’t contract salmonella.”

When anyone or anything threatens the welfare of our children, due process must change and you should be guilty until proven innocent.

CLICK HERE FOR THE LIST OF RECALLED PEANUT PRODUCTS. (You can also find the list on our Health home page next to the most up-to-date salmonella story in headlines)

Health Officials Report Salmonella-Linked Death | RECALL

Salmonella is an animal bacteria that lives in the intestines of cows and chickens.  It has become prevalent in these animals and can easily spread to humans through live chicken handlers and food handlers. We raise our poultry in close quarters and squalor, injecting them with steroids and antibiotics that weaken their immunities and create resistant bugs. Salmonella can also easily spread to crops from manure and irrigation, so people can then become infected from eating contaminated produce. Peanuts have not been part of previous outbreaks, but the bacteria is spreading to vegetables never before affected.

At this point there are 2 to 4 million cases of salmonella food poisoning every year in the U.S., with close to 1000 deaths.
  
The current outbreak involves a resistant salmonella that is becoming a growing problem. Peanut Corp of America has not done an effective job — in fact, salmonella was found on the floor of one of its Georgia factories. The bacteria probably got into the peanut butter in the manufacturing process.
 
More than 125 products have been recalled, including 7 million cases of Kellogg Keebler crackers and Amos cookies, General Mills products, Perry ice cream, NutriSystem granola bars and Pet Smart dog biscuits.

Despite these recalls, the overall risk to the consumer remains statistically quite low. For those who don’t want to take even the slightest risk (I can’t blame them for this) a listing of the 125 products that have been recalled is available at the FDA website.

How to solve the growing Salmonella problem?
*  FDA regulations and manpower need to be increased because the problem is very difficult to oversee. The current outbreak is an example: Peanuts grown in Georgia are made into peanut butter in Minnesota and then sold throughout the country
*  Other techniques that should be considered to protect our peanut crop and other vegetables include radiating vegetables, altering crops genetically to make them resistant to bacteria, and using chlorine dioxide compounds which kill salmonella in the growing and food-handling process.

What should you do if you think you are sick with salmonella poisoning?
*  Symptoms of salmonella poisoning include nausea, fever, and diarrhea
*  Dehydration is a primary concern, so keep well-hydrated
*  Consult with your physician
*  Antibiotics may be considered if the infection is not resolving

To check out my oped in Newsday this past week on the Salmonella/peanut butter outbreak, click here.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: The Truth about the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.”  Read more at www.doctorsiegel.com

A new study published in the December issue of the Journal of Allergy and Clinical Immunology (JACI) found a higher likelihood of anaphylaxis, or severe and/or life-threatening allergic reactions than previously reported.

In the study, Wyatt W. Decker, MD, Chief of Emergency Medicine at the Mayo Clinic in Rochester, Minnesota, reported that the incidence rate of food-allergic reactions increased significantly from 1990 to 2000. Researchers reported about a 10 percent increase in cases of life-threatening allergic reactions over the 10-year period of the study. 

Children ages 0 to 19 are at the highest risk for these severe reactions. Based on the new study, it’s estimated that food allergies cause 50,000 emergency room visits per year, with overall cases approaching 150,000 annually.

“This study shows anaphylaxis affects significantly more people, many of whom are children, than previously reported,” said Anne Muñoz-Furlong, Founder and CEO of the Food Allergy & Anaphylaxis Network (FAAN). 

Increased prevalence of peanut and tree nut allergy

Almost every day I am asked by patients, colleagues and the media why there are so many new cases of food allergies — particularly, nuts and peanuts. The prevalence of peanut allergy in the U.S. has been estimated to affect as many as 6 million people. The incidence of peanut allergy is said to have doubled in American children in the five years between 1998 and 2003.

Since there is no treatment or cure for food allergies, avoidance and education are the most important methods of reducing risk. Another important strategy is to become a “label detective.” To better understand food labels, carry a “food allergy identification card” (especially when eating outside of the home), and be prepared to treat severe allergic reactions when they occur. 

For more information on food allergy, contact FAAN at (800) 929-4040 or visit www.foodallergy.org.  In addition, see a board certified allergist for testing, and if you or a family member has food allergies, ask for a food allergy action plan!  

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

It’s time for the old end-of-year office party or family holiday dinner.  During the holiday season the likelihood that you will ingest high-risk foods that may cause allergic reactions is at an all-time high.  So if you are one of the estimated 11 million people affected by food allergies, focus on being a label detective in order to avoid these potentially hazardous ordeals. 

Sharing meals during the holidays is one of the highlights of the season for many families. The most common food allergens in the U.S. are cow’s milk, eggs, soy, wheat, fish, shellfish, peanuts and tree nuts.  Unfortunately, food allergies make up over tens of thousands of emergency room visits annually. Peanut allergy is associated with potentially fatal allergic reactions and often, allergic individuals will not outgrow it.

When invited as a guest to the home of a friend or family member during the holidays, it’s important to explain what your food issues and concerns may be. By doing this, you can hopefully avoid unnecessary trips to the emergency room.

Watch our for these holiday culprits:

• Eggnog (the word albumin on a label indicates the presence of eggs)

• Fruitcakes (may contain nuts)

• Glazed rolls and bread or other bakery items (containing egg)

• Mixed nuts

• Chocolate, candies and other confectionery items (many contain nuts, milk)

• Dips, fondues and salsas (may contain diary cream and egg)

• Quiches (often contain egg)

• Fried foods – if you are seafood-allergic (as the same oil used in the fried fish may also be used in the preparation of other fried foods such as French fries)

• At least some alcoholic beverages (if you are grain or wheat sensitive)

• Soybean oil salad dressings – (if soy sensitive)

• Caesar or Greek salad (may contain anchovies)

• Marzipan (a paste made of ground almonds, egg and/or milk)

• Worcestershire sauce (may contain fish)

• Yams, sweet potato pie (may contain egg, pecans, walnuts or dairy)

• Pumpkin pie (may contain peanut/nuts, nutmeg)

• Gingerbread cookies (may contain egg, milk, soy, corn and wheat)

• Potato pancakes served for a Chanukah celebration (may contain egg)

Here are some strategies for the holidays:

• Use caution if you eat Chinese, Vietnamese, Thai and Mexican cuisine as many foods may contain nuts. 

• Keep a “restaurant food allergen ingredient card” with you to make the kitchen staff aware of your food allergy when dining out.  Ask for a list of ingredients before ordering.    

• Be a label detective! Learn to read food labels as many ingredients can be misleading or confusing.  Check out the recommendations on “How to Read a Label” at www.foodallergy.org.

• When visiting with friends and family, let your host know if you need to avoid certain foods so they can prepare alternate choices. 

• Bring safe, homemade, allergy-free dishes when invited to someone’s house.

• Keep a spot in the food preparation area of the kitchen free of food allergens.

• Be sure and know the earliest signs of an allergic reaction and how to give the emergency medication(s) prescribed by your allergist/physician.

• Develop an emergency plan that includes ample medication, including epinephrine auto-injectors (be prepared for prolonged reactions).

• Plan ahead if you need to travel during the holidays and have safe snacks and foods with you, especially if you have a food-allergic child.

• Stay with “simple dishes” that avoid hidden ingredients.

• Avoid salad bars where containers can have traces of allergens and cross contamination is common.

• Use caution when ordering deli meats where the same equipment may be used to slice meat and milk-based cheeses.

Having an allergy to a food does not mean you cannot enjoy the many and varied holiday foods this time of the year.  Many alternate foods can be substituted and still ensure a safe and enjoyable holiday season!  For more tips on avoiding food allergens during the holidays, vitit www.aaaai.org or www.acaai.org.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Just yesterday I was traveling back from Seattle from the annual meeting of the American College of Allergy, Asthma and Immunology.  Quite a coincidence I, the “allergist,” was seated next to a young woman who was recently hospitalized and admitted to the ICU for severe anaphylaxis to peanuts.

It was very relevant and timely, as the snack service provided by the airline included the serving of peanuts and peanut crackers to passengers.  My physician assistant and I immediately got involved and requested a “peanut-free zone” be extended around the food allergic passenger’s seat.  The flight attendants worked smoothly and professionally to make this happen and to avert a potentially serious health issue for the passenger who has a life threatening food allergy to peanut and nuts. 

Take home message: Don’t be afraid to speak up when traveling on a plane! Many airlines will likely try and accommodate you if they are aware of this type of condition.  It’s not a bad idea to alert the airline when you are making your reservation so the “on plane” staff is also aware of your allergies and can easily help assist you if peanut products are served aboard the aircraft. Some airlines have already moved to peanut free snack foods. Check with your airline to learn if they are peanut/nut free! For travelers with the severest allergies, it is best to bring food from home just to ensure freedom from allergy-causing ingredients.

Let’s review food allergy avoidance and management while away from home.

• First, if your provider has given you an epinephrine auto-injector (i.e. Twinject, Epi-Pen) make sure you have this medication with you at all times when traveling in case of anaphylaxis (food allergy and anaphylaxis plan should be in place). 
• Also remember to have a note from your provider indicating the need for you to carry the “auto-injector” on the plane. 

The Food Allergy and Anaphylaxis Network is a great resource for food allergy safety tips while traveling if you or a family member has a food allergy.  One strategy mentioned is to choose the first flight available in the morning. Airplanes are sometimes cleaned at the end of each day and flying early in the morning may decrease the chance that the seats will contain food crumbs or residue.

Go to http://www.foodallergy.org/Advocacy/airlines.html for more information. It’s important to remember that more than 3 million Americans have food allergies to peanuts and nuts.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Dr. Bassett

In the July issue of American Journal of Respiratory and Critical Care Medicine researchers found “consistent positive associations” between the amount of nuts eaten during pregnancy, including peanuts, and respiratory symptoms (i.e. shortness of breath, wheezing) in their children through the first 8 years of age. 

The study which took place at Utrecht University in the Netherlands interviewed over 4,000 pregnant women with and without a history of allergy and asthma.  Daily ingestion of nuts in these women increased the likelihood that their child would have “wheezing” and shortness of breath, compared to those mothers who rarely consumed nuts.  The researchers felt it was too soon to recommend a nut restricted diet during pregnancy, and agreed these results should be confirmed by future research. 

I have generally adopted the practice of recommending that women with a strong history of asthma and allergic conditions (i.e. hives, food allergy, seasonal allergies, eczema) should consider a nut restriction during pregnancy. 

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended to diagnose or treat any condition.