Irish Times Article

Posted on: Mon, 06/28/1999 - 10:13am
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Jim
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Copied and posted from the Irish Times, June 28, 1999 [url="http://www.ireland.com:80/newspaper/features/1999/0628/fea1.htm"]http://www.ireland.com:80/newspaper/features/1999/0628/fea1.htm[/url]

Monday, June 28, 1999
The nut buster

No one should die from a violent food allergy, say Irish campaigners for better awareness and prevention of the condition.
Anne Dempsey reports Could Scottish athlete Ross Baillie's life have been saved if he had carried an adrenaline pen with him? The promising 21-year-old hurdler suffered a seizure, known as anaphylactic shock, triggered by a nut allergy while eating a
coronation chicken sandwich. He died two days later, on June 18th, in intensive
care at a local hospital. Baillie knew nuts were dangerous for him and tried to
spit out the sandwich as soon as he tasted it. But by then it was too late.

Chand Kohli, whose daughter Dominique also suffers from a lethal food allergy
to nuts, is one of the founders of the Irish Anaphylaxis Campaign: "This is such
a tragedy because we don't believe that anyone should die from an anaphylactic
reaction these days," he says. "Adrenaline can save lives in 99.9 percent of
cases. The Epi-Pen can be self-administered; you merely stab yourself in the leg
and immediately the adrenaline gets working. Deaths like these are one of the
reasons why it's so important to raise awareness about fatal allergies, which we
feel are on the increase."

Peanut allergy first hit the headlines in 1993 when 17-year-old Sarah Reading
from Surrey died at home some hours after eating lemon meringue pie in a local
department store restaurant. The pie base contained crushed peanuts. Three
other deaths took place around the same time. As they were publicised, scores
of parents began talking about near-misses when children became extremely ill
after eating products containing nuts.

Dominique Kohli is one of an unknown number of Irish people suffering from a
life threatening allergy. The reaction occurs because the body's immune system
overreacts in response to the presence of a foreign body which it wrongly
perceives as a threat. This causes it to release a chemical substance which acts
negatively on blood pressure, blood vessels and lungs. An immediate injection
of adrenaline counteracts these symptoms. The adrenaline pen contains a ready
loaded dose of adrenaline.

There have been three known Irish deaths in recent years and a further unknown
number which may have been misdiagnosed as asthma deaths. While peanuts
have hit the headlines as the fatal foods, there are other allergens: "There are
125-145 deaths per year in Europe from anaphylactic shock," says Dr Joe
Fitzgibbon, allergist. "They died not only from peanut, but from fish, sesame
seed, egg, fruit. We need an accurate diagnosis, not a woolly ban on all foods.

"The latest data - as yet unpublished - indicates that people with pre-existing
asthma need to be extra vigilant. Many anaphylactic deaths have been of people
with pre-existing asthma - which doesn't mean that those without asthma can be
complacent," he says.

Child allergies have been described as a 20th-century disease and as a price we
pay for affluence. A study into the lives of east German families following
reunification found a sharp rise in allergies among the children. Western
prosperity was blamed, with its wall-to-wall carpets which hold dust mites,
central heating, more processed foods, more household pets, more access to an
international cuisine.

"It's true I didn't see peanut butter until I was 10 years old," says Joe
Fitzgibbon. "When children taste foods earlier, it makes for earlier
desensitisation."

Last November, the Allergy Foundation of Ireland was set up by a group of
doctors specialising in allergies and respiratory problems. The aim is to educate
the medical profession and to disseminate up-to-date and accurate information
on allergies.

"Allergies have always been the poor relation of medicine," says Dr Conor O'Toole, the foundation's secretary. "The public don't necessarily know the
difference between proper allergy testing and going to some quack. Many
people with allergies don't take them sufficiently seriously. Someone who has
had a fright through a severe reaction needs appropriate information and advice.
An attack which caused a swelling of the tongue, problems with throat, fainting,
wheezing must always be taken seriously. Our basic message to doctors and to
the public is that the only thing that works in a severe attack is adrenaline."

Increased awareness of serious food allergies, coupled with a greater variety of
global foods and a greater tendency to eat out, makes allergies a consumer and
catering issue as well as a medical one. It is proving impossible to have
manufacturers list every single ingredient in food. Instead, the EU has issued
draft directives on food labelling which state that if certain listed products are
present in a particular food, they must always be named as such. This list
includes gluten foods, shellfish and shellfish products, eggs and their products,
fish, peanuts, soya and other legumes, milk and milk products, tree nuts, and
seeds such as sunflower, sesame and millet, peach plum and apricot. This
directive is not yet law.

Chand Kohli deplores a growing practice in which Irish manufacturers and
supermarkets are issuing general disclaimers such as all the yoghurts or all their
bakery products "may contain nut traces". "This is an appalling practice as the
technology exists to detect allergens in foods, and it allows the manufacturer to
evade responsibility while unnecessarily restricting the food choices," he says.
"Parents contacting us were annoyed about the yoghurt, which is a very good
food for children; it puts all the responsibility on the parent and lets the
manufacturer off the hook."

There is no allergy-related legislation regarding unprocessed foods, so when it
comes to eating out, Dr Fitzgibbon is unequivocal: "I have to tell my patients
who have had a life-threatening incident: `never put your life into the hands of a
caterer'. Some people with a severe allergy have experienced their eyes swelling
up by just entering a seafood restaurant. The simple advice is never eat out," he
says.

"It's a very hard station but we mustn't be afraid to bite the bullet. If there has
been a severe attack, take appropriate care for the future, and always carry your
adrenaline with you. We also need to educate the caterers." He refers to the
"Quality" or "Q" mark for hygienic food preparation and storage now being
awarded to restaurants and caterers, and says he would like to see allergen
awareness given the same priority: "It would be nice to piggyback on this
scheme so that, say, if a melon were being sliced on a clean board we would
know it contained no traces of the previous food," he says. "When you're
talking about food allergies, all the risk factors are outside the home," agrees Dr
O'Toole. "A child gets something at a party, an adult eats in a restaurant.
Restaurants don't understand that very little is lethal. If you fry some peanut
based food in a pan and wipe it clean for the next food, that's not enough. The
changing pattern in people's lives means that, when it comes to serious
allergies, the more we eat out, the more we are at risk."

The Anaphylaxis Campaign is forging links with catering interests here: "When
you visit a food-processing plant, you do understand the difficulties they have,"
says Kohli, "and we are in the process of producing an information chart for the
catering industry which we think will be helpful. "Finally, I would say if you
work in a restaurant and someone tells you they are allergic to something and
asks you if that food is present, do take them seriously and tell the truth, it could
literally be a matter of life or death."

Irish Anaphylaxis Campaign, PO Box 4373, Dublin 18 (01-2952791)

Allergy Foundation of Ireland, PO Box 6668, Blackrock, Co Dublin

[This message has been edited by Jim (edited June 28, 1999).]

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