need your input

Posted on: Thu, 04/05/2007 - 5:07am
paulette816's picture
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Does anyone have statistics or know a web site where I can find out about anaphylaxis as a result of touching or inhaling peanut/nut products....I work in a school and this topic makes teachers so very nervous. I need to give them accurate info.

We have a highly allergic (p-nut) student who, by Mom's account is becoming obsessed about being careful ie. handwashing til her hands are raw... not kissing her parents for fear they may transmit residue...even though they are extremely careful and follow precautions. Anyone with similar issues and how can we help this child?

3rd time this has happened here...the 06-07 school year we had a Mom that asked us to follow all guidelines for her daughter re: nut allergies. Her daughter never had a reaction and was not tested but the Dad was allergic to p-nuts so she feared her daughter was. We followed all recommendations for that school year all the while encouraging the Mother to have the child see an allergist. The mother would not comply...meantime we continued to take precautions....letters to other parents etc. In Oct. of this year she finally took her daughter for testing and her daughter was totally negative. How would you handle a situation like this and do you think this is fair?
In advance....thank you for your input.

Posted on: Thu, 04/05/2007 - 6:10am
Momcat's picture
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There is very little in the way of statistics because the CDC does not collect data on anaphylaxis. However, there are documented cases of anaphylaxis from contact and inhalation of aerosolized proteins. Most peanut allergic people are not that sensitive, but it sounds as if one of your students is highly allergic and may be one of those people.
You have to understand that children with life-threatening food allergies must deal at a young age with the knowledge that one bite of the wrong food could be deadly. Many suffer from anxiety. If you want to help this girl, make sure that the adults around her are informed about her allergies and take them seriously. Make the school environment as safe as possible. Her anxiety will lessen if she feels that she is in a safe environment and can trust the adults around her.
About the mother who insisted on precautions for the child who had not been tested... I would like to give her the benefit of the doubt. With a father who is allergic to peanuts, the child is at high risk for developing the allergy especially if she is exposed to peanuts at a young age. She has probably not been exposed at home due to the father's allergy, and her parents are probably following medical advice to delay her exposure.
If someone has not been exposed to an allergen, their body is not sensitized to it. This means that allergy tests will be negative. But if that person is later exposed to the allergen, they can become sensitized and develop the allergy. This is particularly true of children, whose immune systems are immature.
The important thing is for the school to make sure the medical needs of its students are met. If the parents are following medical advice to avoid exposing the child to peanuts, then the school needs to take steps to protect the child from exposure.
Cathy
------------------
Mom to 7 yr old PA/TNA daughter and 4 yr old son who is allergic to eggs.

Posted on: Thu, 04/05/2007 - 6:24am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Have the parent(s) provided the school with an epi-pen?
Does you school district require physician orders for the administration of medication, including the epi-pen?

Posted on: Thu, 04/05/2007 - 6:42am
paulette816's picture
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Re: the issue of the girl who is becoming obsessive...all of those precautions are/have been taking place and the mom feels that it is due to that vigilance this other problem has been created. The school has done everything the parent has requested and has followed all doctor recommendations. So your suggestions while appreciated are not helpful in this situation...but thanks for your reply.
I'm not sure I'm following your thoughts on the girl who ended up not being allergic. We got a letter from the allergist and no precautions are in place now per his information. The mom is not following any guidelines at home either.
I still would like to have some documented evidence about severe reactions from contact or inhalation as these matters are not taken lightly in a school setting. If anyone can help from a reputable allergy immunology source I would greatly appreciate it.
The children in this building have had reactions due to ingestion and not contact or inhalaltion but we take all precautions anyway. Also, we have standing orders from our school physician for epipen use so even if a child with no known food or insect allergy presents with symptoms we are able to provide treatment stat.

Posted on: Thu, 04/05/2007 - 6:56am
Greenlady's picture
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Joined: 06/30/2004 - 09:00

Hi paulette. Statistics on anaphylaxis are pretty sketchy. I haven't personally heard of a documented case of fatal* anaphylaxis as a result of inhalation or contact, but many members here have kids who have had severe reactions to both of these types of exposure. If a child is constantly experiencing swollen eyes, itchy hives, wheezing, etc, etc, it would be hard to claim that they have a safe learning environment even if they don't experience anaphylaxis.
As far as helping the "obsessed" child, I think showing empathy and taking her concerns seriously would be the best path. Trying to use data to convince her that she's over-reacting would be counter-productive - she knows what her body is experiencing better than anyone else.
As far as taking percautions for someone who turns out to be non-PA, that is what I hope I'm doing right now with my daughter. Because her brother is PA, we've asked the daycare to treat her as PA, in the hopes that it will help avoid the allergy. We plan to have her tested this summer, though, well before elementary school. I'd agree that if a family is asking for accomodations at the elementary school level, it would only be fair (for both the child and the school) that they confirm the allergy by testing, unless otherwise advised by their doctor.
Hope this helps!
*Edited to clarify: I meant to say that I haven't personally heard of any deaths from anaphylaxis from inhalation or contact, but as Momcat said, there have been documented cases of anaphylaxis.
[This message has been edited by Greenlady (edited April 05, 2007).]

Posted on: Thu, 04/05/2007 - 7:17am
Greenlady's picture
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I was also wondering what exactly are the percautions you are refering to? Things like a peanut-free classroom and peanut-free tables protect against accidental ingestion as well as inhalation and contact. Given that deaths have been documented from ingestion of an unbelievably small amount of allegen (e.g. Robyn Allen, who died from eating a sandwich that had been cut in half with a knife that had been used to make a pbj sandwich and then wiped clean), your school's percautions may be reasonable even if the risk from contact reactions is small.

Posted on: Thu, 04/05/2007 - 7:39am
paulette816's picture
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Thanks for your response. We are taking this child seriously and she has been reassured that we are all watching...ie. letters to other parents re: snacks, nut free table in cafeteria, epi-pen in place, all parties being trained, identification of student to all her teachers, table wiping, handwashing, food workers aware. This is her 3rd year with all of the above and for some reason, she doesn't seem to trust us and is becoming almost hyperaware. The Mom has asked if she should seek psychological because help she is getting so bad with this. I have discouraged this for now as I'm hoping that with continued talking she comes to balance things in her mind and understand that we are all taking the necessary precautions for her safety. Thanks for your input...I'd like to also hear from others as well.

Posted on: Thu, 04/05/2007 - 8:50am
Momcat's picture
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It sounds as if this is a developmental stage where she is becoming more aware of the dangers of her allergy. I don't think this necessarily means that the school should change its approach to prevention. It sounds like you are doing a lot of good things to protect her.
Maybe working with her to teach her to read labels, ask questions about food, feel comfortable explaining her allergy to others, practice using the epipen and so forth will help her feel more in control of her allergy. Of course, she will still need all the support and accommodations you have made at school while she takes these baby steps.
Also, I don't think counseling is such a bad idea. It might help her to talk about her feelings.
I think it's important not to minimize the risks she faces or dismiss her anxiety. There are real risks, and anxiety can be protective. What she needs to find is the right balance. This is what we call our "comfort zone." When our kids are young, we parents must find our comfort zone. As they mature, kids must find their own comfort zone. It sounds like she is in the process of doing that.
Cathy

Posted on: Thu, 04/05/2007 - 8:51am
Spoedig's picture
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Joined: 09/17/2004 - 09:00

Posts beginning March 19, 2007 "Feeling sad" under Living With Peanut Allergy is about 11 and 12 year olds and might be helpful for you to read.
My son is 10 and PA/TNA. I personally would at least want to address the "obsessive" situation with a counselor or psychologist -- As much as we know you are doing everything (and her parents), she is not feeling that way. Feelings that are not acknowledged, may make it worse for her.
Also, is it possible she has Obsessive Compulsive Disorder.

Posted on: Thu, 04/05/2007 - 11:07am
chanda4's picture
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Joined: 12/14/2006 - 09:00

My son is just 6, but he is showing some signs of anxiety already in school. The school serves pb&j's on Monday's and he asks me to come every week...and I have. He says he's afraid someone might touch him with their sandwich, understandable....I am also in the process of our 504 designation for him as well and I will be asking the school for some couseling or psychiatric help if they want to continue serving the pb....he needs to know he is okay, which I tell him all the time. But you know, I understand his fear...heck the very thing that could possibly kill him is just feet away, how in the world would I react...anxious!!! But it is about comfort zones, right now the comforts zone is what I've established and like previous posted stated, he'll be developing his own in time. I do think the handwashing girl does need to professional help, before it's too late(since the parents have tried everything) and developes into a disorder. anyways, good luck, this is hard, at least it is for me!
------------------
Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig and EE)
Savannah-1 (milk and egg)

Posted on: Thu, 04/05/2007 - 11:31am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Quote:Originally posted by paulette816:
3rd time this has happened here...the 06-07 school year we had a Mom that asked us to follow all guidelines for her daughter re: nut allergies. Her daughter never had a reaction and was not tested but the Dad was allergic to p-nuts so she feared her daughter was. We followed all recommendations for that school year all the while encouraging the Mother to have the child see an allergist. The mother would not comply...meantime we continued to take precautions....letters to other parents etc. In Oct. of this year she finally took her daughter for testing and her daughter was totally negative. How would you handle a situation like this and do you think this is fair?
I think this is really interesting.
How old is the child? I'm just curious. . .
Allergists suggest that parents avoid introducing foods too early and delay introducing certain foods as a preventive measure to avoid developing food allergies. And many posters here practice exteremley strict avoidance in the hope that our children have a greater chance to outgrow their allergy. Since that child had a clear genetic predisposition to atopy (father has allergies), I can understand why the mother would want to avoid exposure. So, like Momcat posted, I can totally see that she may have been trying to keep her duaghter away from the exposure with the hope that this would prevent her from developing PA.
But don't feel that your efforts were 'wasted' because she tested negative. It could be true that the very lack of her exposure (through some of the safeguards you provided her) contributed to the fact that she tested negative. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] Who knows. It can't be proven one way or the other.
So to answer your question~ Yes, I think it's 'fair' for a child, especially a young child, who has a predisposition to allergy with no testing (or even a negative test) to receive accommodations to avoid developing a food allergy.

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