The wrong food might kill my son

AS the mother of a teenager who has the allergy reaction, anaphylaxis, I was shocked by the tragic story of Emma Sloan, who died on the street in Dublin after a Christmas meal with her family.

The 14-year-old, who had a peanut allergy, was unaware that her Chinese food contained peanuts. She didn’t have her life-saving Anapen (adrenalin shot) with her.

Allergy specialist and paediatrician, Professor Jonathan Hourihane, of UCC, says it can’t be predicted when someone will have a severe reaction, so always be vigilant.

“Anaphylaxis is the most severe kind of allergic reaction you can have,” he says. “People accuse allergists of being too cautious in recommending dietary restrictions and use of emergency medicines, but this condition can be fatal and we can’t confidently predict who will have a severe reaction next time and who won’t.”

“There are a lot of myths surrounding anaphylaxis, the most common being that each reaction will be worse than the last,” he says. “But this is not supported by any evidence. What probably happens is circumstances change. Factors such as the dose eaten may change, or other health factors, such as menstrual cycle, asthma, getting over-excited, or even the consumption of alcohol can cause anaphylactic reactions to be more severe.”

Hourihane says teenagers are the highest risk group and should be made aware of the dangers. “Teenagers are the forgotten tribe — they are most at risk of anaphylactic shock, as they will recently have become independent and have to take control of their own health issues,” he says.

“This is also a time when they may be trying new foods, and meeting strangers or people who are unaware of their allergy, so, in my view, the most important message to get across to anyone who has an allergy is ‘don’t hide it’ — make sure everyone around you knows what you are allergic to and where your medication is kept.”

The professor of paediatrics is calling for community awareness — making Anapens available publicly, like defibrillators. In the US, President Barack Obama (whose 15-year-old daughter, Malia, has a peanut allergy) has signed the Schools Access to Emergency Epinephrine (adrenaline) Act.

The bill gives students with food allergies access to the drug epinephrine, which can stop an allergic reaction. A similar programme may be introduced to Ireland. But the Department of Health says there are legalities to be addressed.

“Under EU law, adrenaline pens (and other injectable medicines) may only be supplied on foot of a valid prescription,” says a spokesperson. “However, there is provision in Ireland’s Medicinal Products (Prescription and Control of Supply) Regulations to permit pharmacists, in emergency circumstances, to supply certain prescribed medicines without a prescription. ”

“The Department has received a request (from UCC) to permit a pilot study, regarding the administration of adrenaline in the treatment of anaphylaxis by trained anaphylaxis first-responders. A difficulty which arises with regard to the study is the legal basis upon which adrenaline can be administered to a patient, where it has not been prescribed for the patient by a medical prescriber, or other prescriber. The Department is currently seeking legal advice on this matter.”

Since my son was diagnosed at the age of seven, we shop with care to ensure nothing containing nuts comes into the house.

Adolescence has brought new worries. He has moved out from under my watchful gaze, is eating out with his friends and meeting new people. He does not want to alert his peers to his condition, unless necessary.

All I can do is talk to him and be on constant alert. It might sound harsh, but I have to tell him about the reality of what could happen if he were to ingest a nut and no-one was there to help him, or if he ate an ingredient that he hasn’t eaten before.

I purposefully discuss his anaphylaxis in front of his friends, because I won’t be standing next to him in the fast-food joint, or snatching away the shared drink or snack passed round by his mates — I will be counting on them to help him.

And, to be honest, apart from instilling in him the gravity of the situation, I am powerless to do anything else and this really scares me.

* For more information, visit www.anaphylaxisireland.ie