How many times can peanut antigen be transferred?

My son (age 12) does not wash until I tell him. Then he fusses about it! When younger had an "oral fixation" and was always putting little things in his mouth (rubber pieces from playground, stones, etc). At age 8 he put a 1/2 peanut in his mouth, sucked on it and then spit it out. This caused an ana reaction.

He has attended school (until last year they were small private schools) and played on the equipment and had no restrictions other than not entering the cafeteria on days they actually cooked a peanut product.

The only contact reaction was at about age 6 (?) he climbed on the kitchen counter and smelled a knife DH had used in PB. We believe he touched it and then may have rubbed his eye and/or put his hand in his mouth. This also caused a trip to the ER. It is possible this was an airborne only reaction. (We then banned ALL peanut products from the house... we are slow learners but eventually figured it out).

We have never washed any playground equipment or washed him after touching anything. Were we just lucky for not ever having an unknown contact reaction? Maybe. Is it just a very remote possibility of having an unknown contact reaction? Maybe.

I'm hoping he will soon enjoy washing and bathing. Until then, will I make him wash after possibly touching somebody that possibly has residue? No, just me. Can we truly assess the risk of touch to touch to touch having enough residue to cause a reaction? Probably not.

Good luck with figuring out your situation.

Have a blessed day,
Bridget

I think that since the allergen remains in the saliva, that it could be transferred mouth to fingers and onto your daughter. But, my understanding is that unless your daughter then transfers it into either eyes, nose, or mouth, it would only be a skin contact reaction (and that would probably be very minor due to the very small amount of allergen).

My son has had many skin contact reactions because he is allergic to multiple foods, but they have only resulted in hives and itching. He has known that he should not touch his face (eyes, nose, mouth), if he doesn't know if his hands are clean. But, besides that he hand-slaps (sports), and touches all sorts of places that would / could contain various allergens. He does wash his hands afterwards, and he always washes before he eats.

I hope that your daughter soon overcomes her fears.

Take care,
Naturemom

Okay, but say she then touches her leg. If she later touches her leg and then her mouth, can she have a reaction? I guess I am confused because there are people on this board who say their kids have had life threatening contact reactions. Are they referring to just from skin contact? Or are they saying there was contact, and then their child touched his eyes, nose, or mouth? Because I would then think that is an ingestion reaction if they touch their mouth, or an inhalation reaction if they then touch their nose. I am getting confused about what the real risk is. No need for dd to worry if the risk truly isn`t there.

I have to add that dd had an anaphylactic reaction to egg on her "first exposure" at age 2 1/2. Three days before the anaphylactic reaction, she had a skin test to egg which was negative. So her allergist told me that the skin test was actually her first exposure. So by the same reasoning, if someone eats pb, puts their fingers in their mouth, touches dd, and she touches her leg, is that the same thing as the skin test exposure? Maybe not, because it has been transferred so many times by then. I am so confused.

Sometimes people call a reaction contact if they came into contact with the residue, even if it really became injestion by entering a mucous membrane, because they did not intentionally eat something. I only know of contact resulting in anaphylactic reactions with a cup of milk spilling onto a child. Other contact reactions that were serious were due to the allergen entering the body. I think that it would take a large quantity of the allergen to cause a severe reaction, which would not be the case if they were finished eating. Even if some saliva got on her with a bit of allergen, she would have to touch the same spot, and then before it came off her hand, touch her mouth. Even so, how much allergen could there be? Also, I don't think that a contact skin reaction would count as an exposure, unless it penetrated the skin as in the test.

Has she had any recent contact reactions?

Quote:Originally posted by Carefulmom:
[b]This is related to my thread about dd being anxious. If someone eats pb and washes hands, but later puts their fingers in their mouth (which it seems like a lot of kids do) and they later touch your child, and then your child touches his arm, leg, etc, can peanut antigen be transferred to your child`s arm or leg? Do you think your child then needs to wash his arm or leg? I know we have people on this board who have kids who have had contact reactions. Have any had contact reactions in this way? (where the child transferred the peanut antigen from his hands to another part of his body).

Also, if you are an adult with pa, do you shake hands and do you wash your hands after? For example, you meet someone new, so they go to shake your hand. They don`t know you are pa. Do you wash hands right after, or just not worry about it? In this hypothetical situation, you have no idea if they have recently eaten peanut products.[/b]

This is not directly related, but I think it's pertinent. I have a pretty severe cat allergy. I am always and forever having to wash my hands after shaking hands with someone because I often (and this is weekly) get little weals on my face a few minutes after I've shaken hands with someone (and then apparently touched my face).

When we had a dog, if my DH would pet the dog and would then go open the door and then later that day or week I would touch the door knob and then rub my eye, it would swell up.

So--I would assume peanut would work the same way. I do have DS wash hands after touching railings in public places. I try not to be too paranoid about it, but knowing my own less severe reactions, I do worry.

Can you refresh my memory---how old is your ds? My thinking was the same as yours, but now that dd is so anxious I wonder if I have gone overboard.

He's 7--going into second grade.

Well, we've never had a reaction from holding on to rails, so if your DD is really anxious right now, maybe this is not the time to dwell on this. I do think our kids obsessing over their allergy can be harmful.

For the last two weeks of school last year, DS was extremely anxious after he came to the realization all by himself that kids were eating PBJ at lunch and then were touching the playground equipment, etc. It's the kind of thing that I just tried not to worry about until I saw a need to do so. At the beginning of the year they did use hand sanitizer on all the kids going out to the playground, but I knew it didn't do that much. I knew they weren't going to have all the kids wash their hands. At some point they stopped with the sanitizer. And then it just hit DS that he would be unsafe. So he quit playing on the equipment. He wouldn't particpate in Field Day because he was scared some of the kids had eaten PB for breakfast. Fortunately, school ended, and the fear subsided, and we hope it doesn't arise this year.

My only real concern though, the one that pops up in the back of my mind or the front from time to time is the little girl in Dallas we knew who had an anaphylactic reaction at a children's gym class after touching equipment that had apparently been touched by a kid who had eaten PB. The EpiPen worked. So I think of that. But I try not to worry about it so much because there's just only so much I can do.

As a rule, I am a frequent handwasher. It predates food allergies in out lives. I just believe in frequent handwashing to reduce catching colds and spreading icky germs that cause stomach bugs and all that! Worked in healthcare, and always washed after each patient, and before the next if I did anything in between(at least that much, sometimes more).

So, I am quite a stickler for handwashing with the children before any eating, when we enter the house, especially after being at stores or places where we touch lots of things.

That said, I do not worry that much about peanut and food residues on hands and equipment, etc... but feel our handwashing practices aid in that. I do not dwell on dd washing peanut or food residues off her hands, but remark on germs being there. That is our focus.

I guess I feel we are doing the most we can do and the rest is up to fate if dd is to lead a normal life. Since we already wash our hands for other reasons, I do not drill into her to do it for peanut residue, since it is getting done anyways. I want her to wash her hands alot, for very many reasons. That is my focus in teaching her good hygeine.

If she does put her fingers in her mouth or nose, etc... I remind her of germs and occasionally do mention there could have been peanut on something she touched. Interestingly, she will make a startled face and jump about the peanut comment, not the germs comments, LOL. It is a funny little thing, though, not a real fear. But she does take her hand away when I say that.

Of course, I would fear that talking to your dd about all the other disgusting things out there at this time my feed her anxiety and add more to her list of fears! It might not be the right time to make that switch in emphasis. Just sharing what is currently working for us, and dd is still only 5(for another month).

becca

[This message has been edited by becca (edited August 13, 2005).]

My son is soon to be 21 and has never had a contact reaction even though his elementary school had PB everywhere he turned. He did not have airborne reactions then either. And his first ingestion reaction was age 14 and BIG. I suspect an episode as a toddler may have been a reaction.

I do remember when I was nursing him in his first three months he would get ONE hive on his wrist. I had no idea what it was or why but I did eat lots of PB back then. So that may have been his first exposure from my skin or the furniture. But it was just one hive and no other problems.

He's careful now, very careful as a young man out in the world but I really doubt he washes his hands any more than he feels necessary so he probably comes in contact with residue but does not seem to react. Maybe he IS NOT contacting residue? Who knows.

Peg