\"How serious?\" question about PA

Yes, this is my all-time biggest pet peeve about PA.
I've answered the question a million times. In fact, I answer it when it's not a question. I always look at it as an opportunity to educate.
Say what you've said to us, that there is no such thing as a "mild" allergy because this allergy has the potential to be unexpectedly fatal and there's no way to predict that. So therefore, all PA must be treated as potentially lethal.
Clarify that there is a difference between the type of reaction a person has experience and what they CAN and will experience if exposed.
This FA is different from other types of allergies. People just associate what they know. Use the opportunity to educate them.
[This message has been edited by teacher (edited November 09, 2006).]

While I agree with that logic, I think what many of us wonder from time to time is [i]"What on earth could motivate such a question in someone who 'theoretically' knows how to deal with a PA??"[/i]
I think that the answer is how widely variable people's comfort zones are with PA. We all know them-- the families who claim that they have an allergic child, but allow that child to eat bakery food, may contains, and even Asian restaurant cuisine. All with no reactions. Maybe they don't even carry epinephrine.
Those people might "mention" this child's PA in passing to a school administrator, but they certainly aren't going to thank school officials for calling them into special meetings to develop an action plan and demanding authentication from a physician as well as two or more epipens to be kept at the school... KWIM?
SO I think at least half the time, [i]that[/i] is what that question is really about.
It isn't "How serious is the allergy?" so much as "How seriously do you take the allergy?" (Meaning that for the most part, they intend to follow suit.)

I always look at it as an opportunity to do some friendly education, too. Most of the time when I get this kind of question, I find that I'm talking to someone who knows a younger child 1-4 years old who has PA but the parents think "it's not that serious" because there has never been a serious anaphylaxis incident, "just hives."
I don't get mad about it, because I was there myself a few years ago--being one of the parents who said "luckily Nate's allergy isn't that bad..." It's garden-variety ignorance, nothing malicious.
I always assume that the person I'm talking to has talked to another parent of a PA child. I ask if they've talked to other PA families before, what the ages of the children were, etc.
Then I tell them that many parents of PA children are unaware of the severity and progression of the allergy, that many children have mild reactions in the beginning that proceed to anaphylaxis when they're older, etc. I tell them that I used to say things like that, but now I know better...and that I wish more physicians knew how to adequately educate parents about PA...that 80% don't outgrow it, that small exposures (sensitization) can increase the liklihood of a big reaction, that the next reaction could be anaphylaxis, etc.
April

40% of the general population will say they have an "allergy" if asked, so this confusion is understandable. When I'm asked this question, I always say that my son has been hospitalized for reactions and has a prescribed Epi-Pen. This is really what school administrators want to know. It helps them to differentiate our children from the kids who are "sensitive" to things. I would find this a reassuring question, not a frightening one.
I think it's fair for people who have to deal with this daily to ask how a child has reacted in the past so they know what to expect. Yes, it's true that any reaction can turn serious, but most don't. Given that, what the typical course of progression is for any given child is a good question for a school administrator to ask (and one my allergist asked too).

April (and anyone else who cares to comment), one follow-up question. I keep hearing people say on this board that exposures "sensitize" allergic children and make future reactions worse. That is not what I've read in the literature, and not what I've been told by my son's pediatric allergist.
If a child is allergic, he's allergic. If the amount of allergen he's exposed to is over his particular threshold, he will react. What's the basis for trace "exposures" making allergies or reactions worse even if they don't cause a reaction? Is there anything scientific to back this up?
[This message has been edited by BriandBrinasmom (edited November 09, 2006).]

I don't have a background in science or anything, but I have done some reading . . . I haven't found anything definitive suggesting that trace exposures definitely make an allergy worse. I think most peoples' experience is that the "natural history" of peanut allergy is that it tends to get worse . . . whether that is related to the number of exposures or what I'm not sure that we can say for sure.
It seems to me (from reading allergy message boards) that there is a general belief (among allergists) that a kid has a greater likelihood of outgrowing the allergy if the said kid completely avoids the food. Whether that has been scientifically proven or not, I have no idea. This is a separate (but perhaps related) issue, however.
I have, however, read that there is evidence that oral avoidance of an allergen together with contact reactions = tendency for the allergic reaction to become more severe.
[This message has been edited by LisaM (edited November 09, 2006).]

Could they be asking perhaps about how *sensitive* your child is, and maybe just wording it incorrectly?
A friend works at our Church Preschool. They currently have several kids w/ Epis. Some of the kids are contact-reactive, some are inhalant-reactive. Do you think this may be what they are trying to ask? I sometimes ask "how reactive" when answering questions on this board, as it may depend upon the situation.
Not doubting what you're asking, just trying to think from a laymen's perspective. (Of course, you can tell what they mean from their tone.)
Good luck,
Daisy

To Daisy's point, I have always used that terminology to explain to people that my son is NOT touch or inhilation sensitive. THen I go on to say that past reactions are not indicative of future reactions b/c the peanut allergy is so unpredictable. First reaction can be mild, second, deadly.
At least these people are asking questions and trying to understand, KWIM!