2023-06-24 05:00:00
More and more children are struggling with a life-threatening allergy. The inflation of intolerances makes it a struggle for many parents to be taken seriously. “When my daughter came back to school after a terrifying admission, bullies had left peanuts on her couch.”
‘Forbidden at camp: Snickers and M&M’s’ headlined Nieuwsblad this week. Kazou asks the participants of a number of camps not to bring food with peanuts, because children who reported a serious allergy when registering. Admittedly, that message struck a chord.
I also attack school notebooks and camp medical records with fluorescent frames and large exclamation marks to underline the seriousness of the problem and stand out from the manuals that teachers and leaders are bombarded with. My preschooler has anaphylaxis, a life-threatening allergy. We know what the first peanut did to him, we don’t dare think what the second peanut could do. He was three years old when he reached for the nuts that a waiter had put on the table with the drinks. It was summer, the sun was shining, we were in Spain. My son started coughing profusely. Choked, I thought – precisely to avoid that, we never gave him nuts. But it didn’t stop with coughing: his eyes swelled up, he couldn’t swallow anymore, saliva ran down his chin, he made strange noises, vomited. He was never unconscious, but ‘gone’. Finally, he fell asleep with his mouth open. He pulled himself through. I only knew afterwards: that we could never have reached the first hospital in the area in less than an hour. We were lucky.
The diagnosis that the pediatrician made afterwards, an anaphylactic shock caused by peanut, was clear. The blood test confirmed a severe allergy. There are several scientific definitions for an anaphylaxis, but they all include the word “life-threatening.” In the language of my toddler: his body attacks his body. It’s a kamikaze issue.
Steady rise
More and more children are struggling with this. Anaphylaxis is on the rise. There are no recent Belgian figures, but the available scientific literature from different countries comes to the same conclusion. For example, a British study published in 2015 in the Journal of allergy and clinical immunology showed that the number of emergency admissions due to anaphylaxis increased by more than 600 percent over a period of 20 years. That’s times six. ‘The number of children with a food allergy is steadily increasing’, confirms Professor Dominique Bullens, child allergist at UZ Leuven. It is not clear how that is. ‘Our intestinal flora has changed under all kinds of influences. There is a decreasing tolerance and an increasing number of cases of food allergies. Cesarean sections could play a role in this (during a vaginal birth, a baby comes into contact with important bacteria that have an impact on the development of the intestinal flora, ed.), just like antibiotics. It’s a theory, but that doesn’t mean it’s a solution.’
To be clear: it is not only peanuts that can cause a serious allergic reaction. ‘We found cases of anaphylaxis in which cow’s milk, cashew nuts, hazelnuts, fish, but also kiwi or tomatoes were the culprit.’ The source is very dependent on age. In children, food accounts for more than half of all allergic reactions. Anaphylaxis from wasp stings, bee venom, or drugs is much more common in adults. There is also immunotherapy against this, which is not yet feasible or affordable for peanuts or nuts.
For small children, the danger lies in a small jar or a crackling piece of paper. Peanuts like to be irresistibly packed in brightly colored jackets with sugar or as crunchy snacks with paprika flavour. How do you explain to a toddler that peanuts also like to hide in words that sound completely different, such as peanut oil, groundnuts, groundnuts or – again too tempting – monkey nuts? And that they are not really nuts, but legumes?
Even worse are adults who don’t get the seriousness. ‘There is a problem in Belgium’, says Bullens. ‘First of all, allergists are still not recognized in our country. As a result, you get here and there experts who are not really experts. There is a proliferation of diagnoses and advice that often do not make sense from people who call themselves nutrition coaches or nutritionists, but there are also doctors who are too quick to think that they have an expertise in allergy. You don’t want to know what we all hear.’ The inflation of intolerances creates noise and the risk of relativism. Everyone has something that digests poorly, gives stomach ache or keeps throwing up endlessly. In a classroom, a teacher can start thinking “another one” too quickly. Or compare the severity with the instructions or questions in the notebook of a child who does not actually have anaphylaxis. ‘Even laymen do not have enough knowledge about allergies.’
Anxiety attacks
Nell Bogaert (19), a law student in Ghent, can speak to this. As a child, she missed many birthday parties due to her peanut (and then) egg allergy. ‘If my mother felt that a boyfriend’s parents weren’t taking her seriously, she kept me home. At sea classes or forest classes she had to give me food for a whole week at the request of the school that didn’t want to take any risks. She was always very careful, but three years ago things went wrong. ‘On holiday in Canada we were eating at a restaurant. After two bites I felt my mouth twitch and I lost consciousness.’ Her mother cold-bloodedly administered two epipens. These are syringes of adrenaline that patients are prescribed for emergencies. The downside is that they are expensive and often need to be replaced as the adrenaline expires after a year. The advantage: they save lives because they save time for the emergency services. Bogaert was taken to hospital by ambulance. ‘After that anaphylactic shock, I had a hard time for a long time. I was afraid to go out to eat. I notice that an allergy is still too often underestimated. I’m now in a room where peanut butter is very popular. When I ask my roommates not to leave their dirty knives lying around, they mostly laugh about it. It is sometimes difficult for me to explain how dangerous that is for me. I also think that people rarely, if ever, know what to do when someone goes into anaphylactic shock. In that case, however, I am not able to administer an epipen to myself, I am dependent on others.’
Geertrui Berghmans also encounters a lot of misunderstanding. Her 14-year-old daughter has anaphylaxis. From a very young age, research indicated an allergy to hazelnuts, cow’s milk, peanuts, eggs and white fish. She ended up in the emergency room for the first time as a baby. “We didn’t really realize what was happening until four emergency doctors suddenly gathered around her. Frightening.’ For years, the allergy seemed to be under control through great caution. That changed a good year ago. “Mommy, my lips are tingling and swelling,” my daughter said at a KSA dinner party. There was a bowl of peanuts on the table, a friend had eaten some and had come to my daughter’s phone. When she used it herself afterwards, it seemed as if her allergy was triggered again. Since then she has been in extreme distress three times after M&M’s or Snickers were treated in her neighborhood without eating them herself. A few weeks ago, she finally ended up in emergency after someone in her class brought tonsils. She then spent four hours on a drip and afterwards was unable to go to school for a few days, exhausted from the medication. She also had anxiety attacks. Back at school, bullies had put peanuts on her couch, a sick joke. They are teenagers, they don’t understand the impact. We notice that it is already difficult to explain the seriousness to the school.’
Easter eggs with praline
Schools are crucial places. It is with great trepidation that I will pack the practice pen again in September, together with leaflets about anaphylaxis and exclamation marks in the school notebook. Still, I have nothing but praise for our son’s teacher, who always took the allergy seriously and also had other teachers practice with an epipen to administer adrenaline in an emergency. The school still has the Easter bunny bring eggs with praline for children with a nut allergy, because they are not allowed to open the bags until they get home. That requires iron discipline from a child.
Ann Van Impe also feels a lot of understanding at school, but thinks it is a pity that she cannot get a ban on peanuts in her toddler’s class. ‘As a result, he always has to eat alone next to the teacher. The school also wants him to wear a fluorescent vest on the playground so that everyone can keep an eye on him at all times.’
Professor Bullens often hears those stories. ‘Why is your child more important than my child,’ a father asked the mother of a patient who had asked the class not to bring peanuts to school anymore. He came round when he realized that a life was at stake. There are also peanut-free schools, but I’m not in favor of generalizing that concept because it can divert attention from other sources of allergy. Recently I was on a Brussels Airlines flight where it was announced that no peanuts or tree nuts would be sold. Passengers were asked not to open the bags they had brought themselves in order to take into account the allergy of someone who was flying along.’
Bullens believes that our country can certainly do more. ‘In many countries, the ingredient lists at restaurants are more correct than at home. So you can eat out there safer and more relaxed. In addition, as allergists, we would also like epipens to be available in schools and, above all, that teachers would dare to use them. Now the fear of medicines has gone too far: we have to prescribe permissions for everything. Adrenaline is life-saving medication, at worst a child is a bit agitated if it turned out not really necessary afterwards. The alternative is worse. But unfortunately we can’t sell that to schools.’
#MMs #Dangerous #standard