Food Allergies in Schools
Introduction
A food allergy is an abnormal immune response to a certain food that the body reacts to as harmful. An estimated 4% to 6% of U.S. children of children under age 18 have food allergies.1–3 Although reasons for this are poorly understood, the prevalence of food allergies and associated anaphylaxis appears to be on the rise.
Although any child can be at risk for food allergies, children are at greater risk if they are younger than age 3 or have a family history of asthma and allergies, a genetic predisposition to allergic disease, or elevated allergen-specific serum immunoglobulin levels (IgE concentrations).
Common Food Allergens
Eight types of foods account for 90% of all food-allergy reactions: cow’s milk, eggs, peanuts, tree nuts (such as walnuts, pecans, hazelnuts, almonds, cashews, pistachios, and macadamia nuts), fish, shellfish, soybeans, and wheat.4–6
Symptoms of Food Allergy
Symptoms of an allergic reaction to food can range from mild to sudden and severe and commonly include one or more of the following7:
- Hives
- Tingling in the mouth
- Swelling in the tongue and throat
- Difficulty breathing
- Abdominal cramps
- Vomiting or diarrhea
- Eczema or rash
- Coughing or wheezing
- Loss of consciousness
- Dizziness
Anaphylaxis is a sudden, severe allergic reaction that involves various areas of the body simultaneously or causes difficulty breathing and swelling of the throat and tongue. Anaphylaxis can result in death.
Treatment and Prevention of Food Allergies
Some types of mild food allergies are treatable with an antihistamine or bronchodilator. Severe, or anaphylactic reactions, require epinephrine. At present, there is no cure for food allergies. The best method for managing food allergies is prevention by way of strict avoidance of any food that triggers a reaction.10
School Environment
Food allergies are a particular concern in the school environment. Studies show that 16%–18% of children with food allergies have had allergic reactions to accidental ingestion of food allergens while in school.7,8 Moreover, food-induced anaphylaxis data reveals that 25% of anaphylaxis reactions in schools occur among students without a previous food allergy diagnosis.7,9
School personnel should be ready to effectively manage students with known food allergies and should also be vigilant and prepared to respond effectively to emergency needs of students who are not known to have food allergies but who exhibit allergy-related signs and symptoms.
Spotlight On...
Safe at School and Ready to Learn: a Comprehensive Policy Guide for Protecting Students with Life-Threatening Food Allergies [pdf 4.5M]
National School Boards Association
Food Allergy and Anaphylaxis: A NASN Tool Kit
National Association of School Nurses, with support from CDC
References
- Branum AM, Lukacs SL. Food allergy among US children: trends in prevalence and hospitalizations [pdf 313K]. NCHS Data Brief, No. 10. Hyattsville, MD: National Center for Health Statistics; 2008.
- Liu AH, Jaramillo R, Sicherer SH, Wood RA, Bock SA, Burks AW, Massing M, Cohn RD, Zeldin DC. National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005–2006. Journal of Allergy and Clinical Immunology 2010;126(4):798–806 e13.
- National Institute of Allergy and Infectious Diseases. Report on the Expert Panel on Food Allergy Research, June 30 and July 1, 2003, National Institute of Allergy and Infectious Diseases, National Institutes of Health [pdf 231K].
- Sampson H. Food allergy. Journal of Allergy and Clinical Immunology 2003;111(2):540–547.
- Sicherer SH, Muñoz-Furlong A, Murphy R, Wood RA, Sampson HA. Symposium: Pediatric Food Allergy. Pediatrics 2003;111(6):1591–1594.
- U.S. Food and Drug Administration. Food Allergies: What You Need To Know. Silver Spring, MD: U.S. Department of Health and Human Services.
- Sicherer SH, Furlong TJ, DeSimone J, Sampson HA. The US Peanut and Tree Nut Allergy Registry: characteristics of reactions in schools and day care. Journal of Pediatrics 2001 Apr;138(4):560–565.
- National Institute of Allergy and Infectious Disease. Food Allergy: An Overview. Bethesda, MD: National Institutes of Health; July 2007. NIH Publication No. 07-5518.9.
- Nowak-Wegrzyn A, Conover-Walker MK, Wood RA. Food-allergic reactions in schools and preschools. Archives of Pediatric and Adolescent Medicine 2001 Jul;155(7):790–795.
- McIntyre CL, Sheetz AH, Carroll CR, Young MC. Administration of epinephrine for life-threatening allergic reactions in school settings. Pediatrics 2005 Nov;116(5):1134–1140.
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