Food Allergies

What is a Food Allergy? Immunological response to food (allergic reaction) Body protecting itself – release of histamine Affects multiple body systems: GI Respiratory Skin Cardiovascular Exposure can cause serious problems or death Some affects are visible (hives, coughing, vomitting) and some are not (drop in blood pressure)

Gastrointestinal Tract Symptoms Allergy symptoms can occur seconds to hours after ingestion of the allergen Most common symptoms: swelling, sneezing, nausea, GI distress Skin Swelling of lips, tongue & face Itchy eyes Hives Rash Respiratory Tract Itching or tightness of throat Shortness of breath Dry or raspy cough Runny nose wheezing Gastrointestinal Tract Abdominal pain Nausea Vomiting diarrhea Symptoms of food allergies vary between individuals but the most common are swelling, sneezing, nausea, digestive problems, hives or swollen airways. Others include itchy eyes, hives, skin rash, tightness of the throat, shortness of breath, runny nose, abdominal pain, nausuea, vomiting and diarrhea.

Intolerance vs. Allergy Reaction to the chemicals in food No immune system response No serious (life-threatening) side-effects Bloating, gas, abdominal discomfort Public impression Parental interaction Many people believe that food allergies and food intolerances are the same thing

The Big 8 What the experts say Eight foods account for 90% of all reactions

Peanut Allergy Specific 1/250 of a peanut is enough to trigger a reaction (cutting a peanut in half 125 times!) Hourihane, J. J Allergy Clin Immunol 1997 Severe allergies are typically life-long High cross-reactivity to tree nuts (almonds, walnuts, etc.) Although some do outgrow peanut allergies, those individuals tend to have meticulous avoidance, no history of anaphylaxis, smaller skin/blood test results, fewer food allergies in general. Peanut allergic individual are strongly recommended to avoid all tree nuts as well

What is anaphylaxis? Most severe allergic reaction Involves multiple systems at the same time Potentially fatal, especially if medication is not given promptly (at first signs) Most severe Hives and vomiting, difficulty breathing and swelling, any combination Most fatalities that occurred when medication was given was the result of medication not being given soon enough. If you suspect a child is having a reaction…you must give medication. You can not wait to see if the reaction will get worse or bad enough. In fact, for some children, if you suspect they have ingested an allergen, even if signs of a reaction have not yet been seen (you saw them eat a bite of PB&J), medication should be administered. Although each individual plan may differ, in general you do not want to see if a reaction will progress before you make a decision about medication. It can progress to quickly and time is precious Why is this important for you to understand: some schools require medication be kept in the nurses station or a locked cabinet. People feel kids should NOT be allowed to carry medication with them…THIS IS S PROBLEM…6 minutes to run to the nurse’s station, find the key, ect. FEAST story of changing the Epi-pen due to expiration

Avoiding Cross-Contamination Food proximity (same plate, same bag, same platter) Using the same utensil Using the same area/surface Not cleaning the area/plate/utensil thoroughly Using the same cooking material/machine (toaster) Transfer of allergens (nut falling into a plate, but plate not getting clean) Notice sources of cross-contact here… NAME SOME Cross-contamination at risk foods: NAME SOME

What to do Require thorough hand washing and teeth brushing especially if you suspect a student has eaten peanuts/nuts Clean eating and working areas carefully Discourage food sharing Have “safe” snacks and treats from family Do not allow homemade goodies or home prepared foods (e.g. apples cut at home)

Label Reading Food Allergen Labeling and Consumer Protection Act (FALCPA) As of January 1, 2006, labels must list common language for the top 8 allergens Reading labels carefully can save a child’s life Foods can be analogous to poison Top 8 allergens must be clearly stated in ingredient list. May have Contains statement May have cross-contamination statement

Standard Label From the picture on the box, it does not appear that there are nuts in this product. Is it safe?

“Contains” Statements

Warning Labels May also say “manufactured in a facility that also processes peanuts”

How Can We Keep Customers Safe Know your ingredients Sanitize frequently Use proper equipment