PA teen death in Australia
By Matthew Thompson and AAP
March 23 2002
Sydney Morning Herald
The death of 14-year old Hamidur Rahman from eating peanut butter has renewed calls for a statewide allergy strategy in schools.
The Hinchinbrook teenager, a student at Hurlstone Agricultural College, died during a Year-8 excursion to Yanco in the NSW Riverina on Wednesday night.
Dr Robert Loblay, allergy unit director at the Sydney's Royal Prince Alfred Hospital, said the tragedy highlighted the urgent need for a school plan to cope with potentially lethal allergic reactions.
He said a meeting of education department and health experts last year failed to make any progress on an allergy training program for teachers, because many teachers were alarmed by the responsibility.
Legal and medical fears
A pediatrician with the allergy unit, Dr Velencia Soutter, who was also at that meeting, said training teachers in allergy response first requires overcoming their fears - both legal and medical.
"We surveyed school teachers and they don't want to be responsible for giving injections - they're worried about liability and just plain needle-phobia," said Dr Velencia Soutter, a consultant pediatrician with the allergy unit who also attended the meeting.
"Teachers feel it is not their role. Some were saying 'Do you really need to fuss that much?'
Parents don't want children singled out
"Currently the kids are dealt with on an individual basis - with one or two people at the school who know the children and are prepared to give the Epipan [adrenaline] injection, but there are [children] in the school system who are not known or whose parents haven't informed the school - they don't want their child to be singled out.
"Ideally teachers should think of it as first aid and not some exotic medical intervention," said Dr Soutter.
Peanut allergy increasing
Another problem is that untrained teachers may be too slow to call an ambulance because they do not recognise the symptoms of severe allergic reactions, Dr Soutter said.
The prevalance of peanut allergies has increased, said Dr Soutter, and whereas "ten years ago a school having an allergic child was rare, now every school has one," she said
Doctors are unsure why, but increasing nut consumption may be a factor: "Mothers are eating a lot more nuts and peanuts," said Dr Soutton.
"Twenty or thirty years ago they were a Christmas treat - now with all the health consciousness, you know, eggs are bad for cholestoral, jam is too salty, meat is bad - peanut butter has been promoted as a healthy alternative for snacks - and it is allergenic stuff," she said.
The majority of allergic reactions to peanuts are mild and usually include hives, eczema and vomiting.
However, people with greater sensitivity can develop a potentially deadly condition known as anaphylaxis.
In these cases death can occur within minutes from acute asthma, throat swelling, a sudden drop in blood pressure caused by allergic shock or heart failure.
Allergic reactions can be treated by an injection of adrenalin. People who know they have an allergy are advised to carry around a spring-loaded needle, or Epipen, which is automatically activated when pressed against the upper leg or stomach.
Because of the wide use of peanuts in processed food they can be hard to avoid and even trace elements, on the serrations of a knife for example, can trigger a reaction.
Even a kiss can spark reaction
For some people, a kiss from someone who has been eating peanuts or even the smell of the nuts can cause problems.
According to the Australasian Society of Clinical Immunology and Allergy the average nut-allergic person will have an accidental exposure every couple of years.
Many people will grow out of childhood peanut allergies while for others the symptoms decrease with age.
Australian laws require that any product containing peanuts or peanut traces must be labelled.
Genetic technologists working in the agricultural field say they have the technology to help selectively breed out peanuts containing allergens in the future.