Major front page story today on 4/2/07 To read comments go to desmoinesregister.com. Click on news stories....scroll down to story
Peanut risks put schools on alert Educators join families in taking precautions, and districts alter policy as allergy dangers grow
By GRANT SCHULTE REGISTER STAFF WRITER
April 2, 2007 25 Comments
Andrew Fung was gasping his way through respiratory failure by the time his mother reached the emergency room, 45 minutes into a near-fatal allergic reaction to one bite of a peanut-butter cookie.
The 3-year-old - leaning forward, head back, fighting to breathe - was in such danger that emergency room doctors abandoned another high-risk patient to tend to her son, Jeanne Fung said.
"He was very, very, very near death - from one bite," said Fung, of Urbandale. "We didn't realize how bad it was until a couple weeks later."
Andrew, now 6 and a first-grader at Walnut Hills Elementary School, is one of 56 students in the Waukee school district with a life-threatening allergy - and part of what medical experts call a small but growing number of peanut-allergy cases across the nation.
The increase prompted Waukee officials to consider a ban on peanut products for students in kindergarten through seventh grade, stirring a community outcry. The proposal - since changed to "strongly discourage" peanuts, but still among the toughest statewide - is likely to come before the Waukee school board at its next meeting April 10.
Cases increase in state, nation
The district's plight harks to a broader food-allergy concern affecting as many as 12 million Americans, including 2.2 million schoolchildren. Nationally, the number of children known to have peanut allergies, which are likely to persist throughout life, more than doubled between 1997 and 2002, according to the Food Allergy and Anaphylaxis Network.
School health workers in districts statewide said they have seen notable increases in peanut-allergy cases within the past decade. Few Iowa districts track the precise number of cases, and neither do the state departments of education or public health.
School nurses and medical experts said cases are rare and vary in intensity, but their increasing presence has resonated throughout the state. For example:
- Administrators at Johnston Middle School pulled a pretzel-and-cereal trail mix from their cafeteria this year after a girl suffered a severe allergic attack. The mix did not contain peanuts, administrators learned, but was exposed to peanut oils in a factory that used them in other products.
- In Urbandale, a high school student reacted after eating a cookie with traces of nuts, which were not clearly labeled. The boy injected himself with epinephrine, a hormone used to fight allergies, but the incident prompted the school to more clearly label the cookies. Another family pondering a move to Urbandale next year told the school district's health associate that its handling of peanut allergies would play heavily into its decision.
- The Iowa City school district added allergy information to the data stored digitally on electronic student lunch cards as an added safeguard.
- Schools in Ankeny, Cedar Rapids, Des Moines, Iowa City, Johnston, Urbandale and West Des Moines have established "peanut-free" tables in cafeterias for students with allergies. Affected schools in Waterloo created a "peanuts-only" table restricting those products to one area.
"We've got to be very careful," said Suzy Ketelsen, the food and nutrition director for Cedar Rapids schools. "It is very scary, and no one - no one - wants a child to be in an unsafe situation."
Even a hint of peanut - in a sandwich, on a countertop, in a whiff of breath - can trigger an episode. Sometimes, the symptoms subside with an over-the-counter antihistamine. In extreme cases, the reaction is a throat-tightening, rash-forming, cramp-filled terror treated by an injection of epinephrine.
Family takes safety approach
Life for the Fungs has since become a litany of label reading. The family seldom eats out, and wipes down tables before allowing Andrew to sit. Andrew's sister, 9-year-old Maddie, loves peanut butter but limits herself to macaroni and cheese or crackers around her brother.
The Waukee proposal, which school officials expected to pass with ease, instead opened a districtwide debate pitting the needs of at-risk youngsters against the desires of other students to enjoy a peanut-butter sandwich.
An early version of the proposal, banning peanut products for students in kindergarten through seventh grade, encountered fierce resistance until a school board committee softened the language to "strongly discourage" peanuts.
The proposal is critical for younger children, at least until they mature and learn to live safely in a world with peanuts, Jeanne Fung said.
"I'm hoping the opponents will be a little more sensitive," she said. "I don't know that people realize this is death."
Sensitivity carried into adulthood
Trace amounts of peanut frequently exist in baked goods, many Asian foods, cereals, ice cream, soups, natural flavoring, candy and energy bars, according to the Asthma and Allergy Foundation of America, a national advocacy group.
Extreme food allergies kill between 150 and 200 people per year, according to the Food Allergy and Anaphylaxis Network.
"It's the hidden ones that really get us, the ones you don't even think of," said Beth Hanna, director of nutrition services for the West Des Moines and Norwalk school districts. "It's impossible to tell anybody that a facility is entirely peanut-free."
No one knows for certain why more peanut-allergy cases are appearing. Some allergists believe the answer may lie in the way peanuts are roasted in this country. Such allergies are virtually nonexistent in Asia, where peanuts are boiled, even though the per-capita consumption roughly matches the United States.
One theory holds that roasting peanuts at high temperatures exposes allergy-inducing proteins. Young children who ingest the peanuts, or who received them from their pregnant mothers, might develop a sensitivity not discovered until years later.
"It doesn't appear to require large amounts or repeated exposures," said Dr. Mary Beth Fasano, a University of Iowa clinical associate professor of internal medicine specializing in allergies. About 80 percent of youngsters with peanut allergies, she said, will carry their sensitivity into adulthood.
Few Iowa school districts have imposed all-encompassing guidelines, opting instead to let school nurses, principals, teachers and parents handle peanut allergies case by case. Families with a peanut-allergic child most often meet with school officials before enrolling to outline dietary and emergency plans, school nurses said.
"We try not to make it a big issue," said Susie Poulton, health services director for the Iowa City school district. "We just approach it in a nonchalant way; this child is just like everybody else. It can be isolating, though, there's no doubt about it."
Dietary allergies grow in range
An increase in peanut allergies has accompanied a gradual 20-year rise in special dietary allergies relating to milk, eggs, tree nuts, soy and wheat, said Hanna, director of nutrition services for the West Des Moines and Norwalk districts who is a registered nurse. Such allergies tend to be less life-threatening.
In Des Moines, more students report milk allergies than peanuts or any other potential substance, said Teresa Nece, the district's food and nutrition manager. The district, with 31,218 students, does not use peanut products, except on rare occasions, and has not seen a noticeable rise in peanut-related reactions.
Peanut concerns have also changed the lunchroom experience, requiring more menu-planning time for school nutritionists. Students at North Central Junior High School in North Liberty eat crustless, prepackaged peanut-butter sandwiches shipped from out of state, said Diane Duncan-Goldsmith, the district's food services director.
All this begs the question: What can students such as Andrew Fung enjoy?
On tap for today, according to the school menu, is a pork rib sandwich.
Reporter Grant Schulte can be reached at (515) 699-7020 or [email]email@example.com[/email]
On Apr 3, 2007
Here's the link.
Warning-- if you read the comments, some of them are predictably upsetting.
On Apr 3, 2007
I live in Iowa, so I know if I read the comments and they're all negative, I'm going to be so ashamed of my state.
On Apr 3, 2007
Sure the comments are disheartening...but so was the public discrimination about blacks until Rosa Parks refused to give up her seat on the bus.
The most heartening thing about this is that schools in Iowa are listening... that wasn't true as much as five years ago.
We have some gusty parents creating change.
[This message has been edited by cathlina (edited April 03, 2007).]