Food Allergy Fatalities This Fall
This fall has been a tragic one for those in the food allergy community. The news of the freshman Andrea Mariano's passing during her first week of her studies at the University of Queens in Kingston Ontario and 16-year-old Simon Kaz's death in Colorado were fresh in our minds when 17-year-old Morgan Crutchfield succumbed to anaphylaxis in North Carolina. I cannot imagine the loss the parents and those around them feel. As a food allergy parent these stories send chills down my back and fear in my heart.
Similarities between the situations are striking:
- the deaths are attributed to anaphylaxis;
- they are teenagers (ie. Between 11 to 18 years old);
- they had peanut allergies;
- both were not carrying epinephrine with them (in two cases, no word on third);
- they were eating outside the home; and
- those around them both (friends) didn't know what to do during an anaphylactic reaction.
The research study Anaphylaxis-related deaths in Ontario: a retrospective review of cases from 1986 to 2011 published in 2014 examined the 92 anaphylaxis deaths in Ontario during that time period. The most common cause of allergy-related death was food (40 cases), followed by insect venom (30 cases) and medication (16 cases). Six cases did not have an identified cause. Most (84%) of those who died from food allergy-related anaphylaxis reported to have known or suspected allergy to the culprit food.
The 2014 study determined common factors associated with fatal anaphylaxis were: delayed epinephrine, asthma, allergy to peanut, eating outside the home, and teenagers with food allergies. The study conclusions lineup with the commonalities between the two most recent fatalities.
How Do Teens Manage Their Food Allergies?
A study published in 2010 from the University of Southampton (UK): How do teenagers manage their food allergies? aimed to examine the practical challenges for teenagers to manage food allergies. Researchers interviewed 18 teens aged 11 to 18 with food allergies with the most common allergens being tree nuts and peanuts.
Some common behaviors among the teenagers were:
- Many eat foods labeled as “may contain” for their allergen when think the food is unlikely to contain the allergen.
- Many only carried their EpiPens when they thought there was a particular risk of a reaction.
- Some do not know how to treat a reaction.
- More than half believe that educating their classmates about the seriousness of food allergies would make it easier to live with their allergy.
- A significant number of teens demonstrate risk-taking behavior with respect to their allergy.
- Teenagers felt it would be helpful for their peers to be educated about food allergies.
Teens at Risk For Anaphylactic Reaction and Fatality
So now we all know conclusively that teenagers are at a high risk for an anaphylactic reaction and fatality. The 2010 study has given us some hints as to how to help teens practically manage their food allergies.
Tips for Teenagers to Manage Food Allergies
1. Carry epinephrine with you - ALWAYS
Carry it on your person and no more than a minute away. In your car or locker is too far away. This is my mantra and the whole reason I started CarryNine. Keep your Epipen, Auvi-Q or Allerject in your wallet!
2. USE your epinephrine - do not delay. Then call 911.
Administer your epinephrine when you START to feel the symptoms of anaphylaxis. Then call 911. Sure everyone will talk about what happened to you, but you'll be around to hear it!
3. Educate your friends, coworkers, teachers about what to do for you in an emergency.
Show them where you keep your epinephrine, when and how to use it, and when to call 911.
4. Never eat a food unless you are absolutely sure how and where it was prepared and stored.
If you can't read it, don't eat it. Homemade food from someone else's kitchen is especially tricky since others don't read the labels as closely as you will...ie. Aren't all chocolate chips peanut free?
Please share and remind teens (and others) in your life of these simple guidelines. Let's not add another to the list of statistics.