Life-threatening food allergies on the rise, along with the need to take precautions

DBV Technologies' Dr. Pierre-Henri Benhamou tells WSJ's Simon Constable how his company is working to annihilate food allergies, especially peanut allergies. Photo: Getty

Laura Bantock’s daughter was 15 months old and toddling past her brother who had just eaten a peanut butter sandwich when she picked up a piece of crust. That was enough to almost kill her. Rebecca Laurin’s friend, who had eaten a piece of strawberry shortcake hours before, gave her a kiss on the cheek. That, too, was enough to almost kill her.

Severe, life-threatening food allergies, known as anaphylaxis, are on the rise.

Over the last seven years visits to the emergency department for anaphylaxis nearly doubled. In the same time frame, there was also a 64 per cent increase in the number of Canadians using a prescription epinephrine auto-injector (more commonly known under the trademarked name EpiPen).

The rise in both figures indicates a growing awareness of the potentially fatal consequences of anaphylaxis, a serious allergic reaction that is rapid in onset and may cause death.

“Some people when they hear the word allergy, they assume I’ll get sick or have a rash. I’m anaphylactic, it’s an emergency medical situation for me, a life-threatening one,” says Laurin of Vancouver Island.

Laurin, who goes into anaphylactic shock when she comes into contact with strawberries, is so severely allergic that she has been hospitalized after using a pen that had been touched by someone who had eaten strawberries with their fingers

In September, university student Andrea Mariano, who was in her second day of her first year of studies at Queen’s University, died after having a smoothie on campus. She was severely allergic to peanuts and dairy.

While the number of emergency room visits is rising, deaths remain rare. Youths remain most at risk and risk reduction strategies are essential, according to Bantock, the western region director for Food Allergy Canada.

Bantock learned her 15-month-old daughter had a severe allergy to peanuts after that incident with a crust of a peanut butter sandwich.

“The main point is everything has to start with a good diagnosis. It’s essential that people understand what they’re trying to avoid and the next step is to do everything they can to reduce the risk with the identified allergen, prevent cross contamination,” she said.

Crucial to be prepared

Bantock’s daughter is now in university and living away from home and has had drilled into her that hand washing, surface cleaning for possible contamination with peanuts and reading and understanding labelling on food labels are crucial for her to stay alive.

“My message to her is to take food up to the university. Plan ahead now what you’re going to eat before you’re hungry,” said Bantock. “Equally as important is being able to respond appropriately in an emergency. You must have an epinephrine pen; it’s the first line drug. There’s avoidance and risk reduction and getting 911 on its way early.”

Both Bantock and Laurin say not just one but two EpiPens are needed for people who can go into anaphylactic shock if they come into contact with the wrong food.

“I’ve heard people say it’s $100 and expensive, but you really don’t want to pay with your life,” said Laurin.

Dr. Harold Kim, an allergy and clinical immunologist at the University of Western Ontario and McMaster University, says the level of awareness is higher than ever as to the potentially fatal consequences of not having an EpiPen.

Asthma and allergies related to pollination are at their peak around this time of year until the frost arrives for people allergic to wheat and some trees. Food allergies are also at heightened risks because children have returned to school and university students have started their semester.

People can develop allergies at any time.

Bantock’s daughter was a toddler when the family learned about her severe allergy to peanuts. Laurin didn’t know until she was 19 that she was allergic to strawberries.

Laurin believes that her allergy became so severe because she was under a lot of stress at the time. What had once been just sensitivity to strawberries grew to a potentially fatal reaction to the fruit.

Kim, who is a consultant at Aterica, a digital health company that is focused on people living with food threatening allergies, said “confounders,” which can be anything from stress to exercise to alcohol or even a cold or a flu, can turn an allergy into an anaphylactic reaction.

Allergies to one thing can indicate reaction to another

There is growing awareness, said Kim, of the links and triggers between food and allergies. Tropical fruit allergies such as kiwis, banana, passion fruit and mangos are becoming more common because they’re more popular. There have also been discovered links to birch pollen allergies to allergies in apples, peaches and pears. Grass allergies have also been linked to kiwis and tomatoes. Allergens in latex are also very similar to protein found in some fruit.

“One of the biggest fears is to have an accidental contamination. Some people may be aware of their allergies and know what allergens they have but we can’t prevent accidents completely,” said Kim.

Awareness and keeping two EpiPens on hand at all times are essential, according to him.

It’s especially important during times in the fall and into Christmas. Halloween can create issues for kids with food allergies and holiday entertaining are rife with the potential for the wrong food to get too close to someone who can be anaphylactic.

One solution that has emerged was the launch last year in the United States of the Teal Pumpkin Movement, designed to raise attention to potential Halloween pitfalls.

Owners who place a pumpkin painted teal were giving a sign to kids with severe allergies that the household is handing out non-candy items.

Bantock said trick or treating was her kids’ favourite night when they were younger and her daughter had to learn to ask at every doorstep if any of the candy had peanuts in them then politely decline anything that she wasn’t sure was safe.

“Teal Pumpkins is a sign that the house isn’t going to offer something that has the potential to be dangerous for someone,” Bantock said. “Every opportunity I have now, I’ll give out non-food. Pencils, erasers. Those are safe.”