Guardian Unlimited Newspaper Article

Posted on: Sun, 04/22/2001 - 11:05am
vic's picture
vic
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pOne in 200 children in Britain is allergic to nuts. For some of them, it isbr /
an irritant, little more. For others, it is a potentially fatal time-bomb,br /
just waiting to go off. But 40 years ago, such allergies were almost unheardbr /
of. What has changed?br /
Saturday June 24, 2000br /
The Guardianbr /
This boy is perfect. He is healthy and strong. He has a wide smile, abr /
chipped tooth and floppy, dark blond hair. His limbs are strong and fleshy -br /
his belly sticks out above his trouser-belt. His shins are scuffed andbr /
bruised, his fingernails are dirty. He is beautiful. He's perfect.br /
This boy is noisy and bold. He shouts at the top of his voice - at allbr /
times. He jumps up and down with excitement when he's happy. He's got abr /
tender little scar on the right-hand side of his forehead. He picks his nosebr /
and slips a slimy finger into his mouth when he thinks you're not looking.br /
This boy is happy. He's healthy. He's lovely.br /
But this boy is booby-trapped. Somewhere inside his sturdy five-year-oldbr /
body, there's a tripwire that is every bit as deadly as a terrorist bomb -br /
it's primed and ready to blow. Trigger it, and within minutes his life is inbr /
danger. This boy has an allergy - not the sort that gives you itchy eyes, orbr /
a runny nose, or a bloated feeling in your stomach for an hour or two. It'sbr /
the sort that can kill.br /
He is one of a growing number of children who are allergic to nuts - itbr /
might be walnuts or brazil nuts, hazelnuts, cashews or almonds. But it isbr /
the peanut - not really a nut at all, strictly speaking, but a member of thebr /
legume family - that is most hazardous.br /
Strange, isn't it? Nuts. Natural, ancient foods that sustained ourbr /
hunter-gatherer ancestors. The sort of food we all thought was good for us -br /
a healthy alternative to today's sugar-drenched, polystyrene-packed,br /
processed-to-the-point-of-annihilation foods. For most of us, nuts - rich inbr /
energy and nutrients - are still the healthy alternative, but to this childbr /
they are as lethal as cyanide. Even if he eats the most minuscule amount,br /
even if he simply inhales the papery dust that puffs out of tens ofbr /
thousands of packets of peanuts in pubs up and down the country every day,br /
he may become dangerously ill. First, his lips swell like party balloons,br /
then a rash of knobbly hives flush up over his body; his skin goes blotchy,br /
then he might start wheezing and coughing. His tongue might start swelling,br /
his tubes may become constricted - he may start to suffocate and his bloodbr /
pressure might plummet. He may collapse, lose consciousness and die. It'sbr /
called anaphylactic shock, and it's a million miles from the popular idea ofbr /
allergy as minor irritation or hypochondriacal delusion - a deadly ripostebr /
to voguish, smart-arse headlines such as "Allergy - is it all in the mind?"br /
All parents worry about their children. We live our lives in a near-constantbr /
state of anxiety. We read about an outbreak of meningitis in Devon andbr /
instantly we're frightened that our child will get it, even though we livebr /
in Dundee; a little girl is abducted and killed, and we're suddenlybr /
terrified to let ours go to the corner shop; we worry about them being mownbr /
down on the roads; about drugs and dropping out, bullying, suicide andbr /
teenage pregnancy. Some of our fears are more real and rational than others,br /
but the chances are most of them will never happen to you or your child.br /
Chances are, he or she will grow up to be a strong, healthy adult with hisbr /
or her own children to worry about. Even when you're worrying yourself sickbr /
about them, that's part of the equation: part of you subconsciouslybr /
rationalises that most children will make it safely through to adulthood,br /
despite all the risks along the way; yes, terrible things do happen, butbr /
they're more likely not to.br /
So it's peculiar, having spent one's life worrying about dread and direbr /
events that are extremely unlikely to happen, to be told that your child hasbr /
a potentially fatal allergy to nuts. It's not an illness, it's not somethingbr /
you can see - yet your child can be perfectly healthy one minute and inbr /
intensive care the next. If he doesn't eat nuts, he will be fine; should hebr /
eat nuts, he may die. Suddenly, you have something very real to be afraidbr /
of.br /
Life-threatening nut allergies have been recognised only fairly recently. Inbr /
the cuttings file, little more than a sad roll-call of those who have died,br /
the earliest article dates back to May 1990. It is a single paragraph:br /
"Peanuts can prove fatal to people who are allergic to them, chestbr /
specialists at University College Hospital, London, warn today after thebr /
deaths of two men who ate peanuts contained in a satay sauce and in a mealbr /
thought to be free of nuts."br /
From that point on, the articles make for sobering reading - many of thosebr /
who have died are teenagers, their deaths sudden, bizarre and shattering forbr /
all who knew them. Youngsters such as Michaela Mortimer, 16, who diedbr /
minutes after eating her school lunch - a wafer she had for dessertbr /
contained peanuts; Josephine Turner, 17, who ate a peanut-filled pretzel atbr /
a cocktail party; Sarah Reading, 17, who ate a slice of lemon meringue piebr /
that contained crushed peanuts; Craig Todd, 19, who ate a trifle at abr /
friend's house that included ground almonds; and Lucie Crawford, 13, whobr /
didn't realise that her portion of chips and curry sauce contained peanutbr /
butter. "She was effectively poisoned," her heartbroken father told thebr /
papers. "She might as well have been bitten by a rattlesnake."br /
The list goes on: each victim killed by food that, to most of us, would bebr /
utterly innocuous. Whoever thought that lemon-meringue pie or trifle couldbr /
kill you? Many of them were aware that they were allergic, but had littlebr /
idea that their lives were in such grave danger as they'd suffered only mildbr /
reactions before. Then, last year, there was vivid illustration of thebr /
potential severity of nut allergies when international hurdler, Rossbr /
Baillie, 21, one of Britain's most promising athletes, died after eating abr /
coronation chicken sandwich. Here was a young man, strong, healthy and atbr /
the peak of his fitness, yet still he died.br /
It is impossible to know exactly how many people die of anaphylactic shockbr /
every year - estimates put it somewhere around six, eight, possibly 10. It'sbr /
a tiny number when you consider that as many as one in 200 children may bebr /
allergic to peanuts, and that at least half of them are at risk of a severebr /
reaction. But there is concern that some anaphylactic fatalities may bebr /
mistakenly blamed on asthma. Symptoms look very similar, and manybr /
nut-allergy sufferers are also asthmatic - indeed, that's what makes theirbr /
allergy particularly deadly.br /
Laura Thrasher's parents were told that their 18-year-old daughter, who wasbr /
in her first week at Cambridge University, had died after a severe asthmabr /
attack at a freshers' dinner. They had no reason to suspect otherwise -br /
Laura had a long history of asthma. But Laura also had a suspected allergybr /
to nuts that had never been properly diagnosed: when she was about seven,br /
she had been sick after eating a nut at a friend's house; on anotherbr /
occasion, she tasted one and her lips became slightly swollen. Her mother,br /
Heather, mentioned it to the family doctor, and asked whether Laura shouldbr /
have tests, but was told that this was unnecessary and that the testsbr /
themselves could be dangerous. So Laura took it upon herself to avoidbr /
anything containing nuts, and they never really thought about it again.br /
Until, that is, she ended up in intensive care on life support.br /
It was a little less than two years ago, and it had been the happiest summerbr /
of their lives, says her mother, Heather, a PE teacher from Liverpool.br /
"Laura had applied to Cambridge. She got her offer: two As and a B. She gotbr /
the grades she needed. Our son Ian had got good GCSEs. We got everythingbr /
ready and took her down to Cambridge on the Saturday. She was studyingbr /
economics. We settled her into her room. We went out for a meal on thebr /
Saturday night and on Sunday we went shopping, picking up odds and ends shebr /
needed."br /
They said their goodbyes at about 2pm; Mr and Mrs Thrasher set off forbr /
Liverpool, and Laura began to find her feet at St Catharine's. The next day,br /
she called her mother to say it was all going brilliantly; she had settledbr /
in, she was making friends, they had been shopping for clothes and she wasbr /
looking forward - with some trepidation - to the formal freshers' dinnerbr /
that night. It was the last time the Thrashers heard from their daughter.br /
Later that evening, they were called by one of the dons who said that Laurabr /
had gone to hospital with what appeared to be an asthma attack. They rangbr /
the hospital and, after being passed from pillar to post, were told thatbr /
their daughter had suffered a cardiac arrest and that there was little hopebr /
of a recovery. A friend drove them down to Cambridge. When they arrived,br /
they were told that doctors had managed to revive her, but that she wasbr /
gravely ill on life support.br /
It transpired that Laura had been taken ill after eating a dessert thatbr /
included a shortcake base containing nuts - whether peanuts or almonds isbr /
unclear. "She must have taken one mouthful and realised there was somethingbr /
wrong," says her mother. "If she'd been with us, she would have spat it outbr /
and that would have been that, but in the situation she was in - at a formalbr /
dinner, with people she didn't really know - it was difficult. Whether shebr /
swallowed it we don't know. She then had to sit through coffee. At the end,br /
she went to her room and was sick." Laura struggled down to the telephonebr /
and called her boyfriend back in Liverpool. She told him she didn't feelbr /
well; she thought it was something she had eaten. He told her to get help,br /
but it was too late.br /
Laura remained on life support for three days, but tests showed that she wasbr /
brain dead. Her organs were donated; the cause of death was given as asthma.br /
And that would have been that had a friend not called the hospital to ask ifbr /
Laura had eaten nuts. Blood tests confirmed her nut allergy; inquiries tobr /
the caterers provided the cause. "At the time, we wondered how many deathsbr /
are put down to asthma," says Heather. "If we had never questioned it, itbr /
would never have come up. She had such a brilliant future ahead of her. Shebr /
never failed at anything. She threw herself into her work, and she enjoyedbr /
herself. She used to go out clubbing - coming back at three or four in thebr /
morning. She lived a full life in those 18 years. There were not anybr /
regrets. But just think what was ahead - and what she could have done. Ibr /
know everyone says that their daughter is special. But she did havebr /
something. She would have landed an incredible job. She would have, I knowbr /
she would have."br /
The Thrashers' biggest regret is that they didn't push for their daughter tobr /
be tested when they first suspected she had an allergy, because, had shebr /
been tested, the chances are she would have been prescribed an emergencybr /
adrenaline injection called an EpiPen, which might have saved her life.br /
Severe allergy sufferers are advised to carry an EpiPen at all times - evenbr /
if they're just walking down to the postbox at the end of the road - sobr /
that, if they feel an attack coming on, they can inject themselves at once.br /
The adrenaline works directly on the heart and lungs to reverse the fatalbr /
effects of anaphylaxis; it relieves symptoms and can give sufferers preciousbr /
time to get to hospital for emergency treatment.br /
Most people don't die of their nut allergy. Most people live with it. Theybr /
learn to cope with the risk it carries and to navigate the dangers. Andbr /
because of the sheer numbers of people developing the allergy, the world isbr /
slowly adapting to make life a little bit safer for them. Food labellingbr /
includes warnings about nuts; schools are becoming nut-free zones; airlinesbr /
are banning peanut snacks during flights (with good reason - if peanuts arebr /
being eaten by a passenger at one end of the plane, someone with an allergybr /
at the other end may have a reaction after inhaling the dust circulated inbr /
the cabin). For a parent, however, the fear remains - a moment ofbr /
forgetfulness at a children's party, an oversight in a restaurant, a slip-upbr /
on a food-production line, and their child's life hangs by a thread.br /
The first few months after a child is diagnosed with a nut allergy arebr /
nothing short of terrifying. Food ceases to be a source of pleasure. It isbr /
no longer spontaneous, it is no longer a source of relaxation. It is abr /
matter of life and death. Suddenly, it's not about experimenting, gettingbr /
your child to try new tastes and experiences. It's about getting them tobr /
stick to what they know. Food shopping - armed with Sainsbury's nut-freebr /
list, a bible for nut-allergy sufferers, but an awkward, unwieldy bookletbr /
that falls apart after a few outings - takes twice as long as it used to:br /
reading labels tests even the best eyesight, as manufacturers pitch you intobr /
a game as dangerous as Russian roulette. For nuts, once regarded a Christmasbr /
luxury, are now as common as refined sugar, and can crop up in the mostbr /
unexpected places with an inconsistency designed for disaster.br /
Take Ragu tomato sauce: some jars carry warnings of nut traces, othersbr /
don't. Why on earth should there be nuts in a tomato pasta sauce? Well,br /
there shouldn't. It's just that some jars are made on the same productionbr /
line as satay sauce and might be contaminated by nuts; others are made on abr /
nut-free line. Then there are Smarties: in a tube, they are nut-free, butbr /
Mini Smarties "may contain a nut trace". Tesco's custard "may contain"br /
traces of nuts, as might its chicken-and-smoked-ham sandwich, its vegetablebr /
lasagne and its golden savoury rice. Bob The Builder party cake, which oncebr /
carried the label "suitable for nut allergy sufferers", became unsuitablebr /
because it moved to a production line used to make a marzipan product. Evenbr /
Pears' soap - pure, fragrant Pears, ever associated with bonny, curly-hairedbr /
children - contains an ingredient derived from peanuts.br /
But while food labelling has in one way been an enormous help, the defensivebr /
labelling strategy adopted by most manufacturers and supermarkets can bebr /
hugely restrictive. Literally thousands of products carry "may containbr /
traces of nut" warnings, though most will be safe for nut-allergy sufferersbr /
to eat. Rather than ensuring that production lines are entirely safe forbr /
consumers with a nut allergy, manufacturers cover themselves in case ofbr /
cross-contamination. Research has shown that almost all teenagers ignorebr /
"may contain" warnings, believing the risk to be minimal. "They think it'sbr /
just fat cats covering their backs," says David Reading, director of thebr /
Anaphylaxis Campaign. "But one day I'm sure something dreadful will happen."br /
A small number of firms have gone to extraordinary lengths to prevent nutbr /
products in their factories contaminating their nut-free goods. Kinnerton,br /
for example, which makes novelty chocolates, invested/p

Posted on: Sun, 04/22/2001 - 1:24pm
rilira's picture
Offline
Joined: 11/11/1999 - 09:00

Vic,
Thanks for posting that! It is a long read but very much worth it. I love the way the writer completely personalizes the kids. It was a very well written story, thanks again for sharing.
Linda

Posted on: Mon, 04/23/2001 - 3:26am
EILEEN's picture
Offline
Joined: 04/06/1999 - 09:00

Here is the link to this great article, thanks for spotting it Vic
[url="http://www.guardian.co.uk/Archive/Article/0,4273,4032812,00.html"]http://www.guardian.co.uk/Archive/Article/0,4273,4032812,00.html[/url]

Posted on: Mon, 04/23/2001 - 12:35pm
Gardner's picture
Offline
Joined: 04/05/2001 - 09:00

Great article. I'm from Canada and really enjoyed it and will pass it on to family members. Thanks for posting it.

Posted on: Mon, 04/23/2001 - 2:00pm
Anonymous's picture
Anonymous (not verified)

Vic, thank-you SO much for sharing that wonderful article with us. It was an excellent read, although it had to be done in "quiet" time to be completely absorbed (which to me, means it's "good"). Also, I liked the fact that it was from the U.K. and not another American or Canadian article for some reason. I guess because it does show the allergy is just not specific to North America, the difficulties of living with PA are not specific to North America.
I really liked it and I really appreciate the time you took to post it here.
Many thanks and best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
------------------

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