Food Allergies 101: Peanuts, EpiPens, and Medical Emergencies

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According to the Food Allergy Research and Education, peanuts are the most common type of food allergy. Image by Texnik.

According to the Food Allergy Research and Education, peanuts are the most common type of food allergy. Image by Texnik.

A family camping trip in Sacramento, California turned into a nightmare for one family due to food allergies.

Natalie Giorgi, 13 years old knew she and her twin sister were allergic to peanuts.

On the last night of camp in the lodge, the lights were dimmed and snacks were available as the entertainment got under way.

Natalie took a Rice Krispy Treat, took a bite and immediately spit it out as she knew something wasn’t right.

She told her mother, who tasted the treat to confirm that it contained peanut butter.

For a full twenty minutes Natalie was fine, then she vomited once and had trouble breathing.

Her father, a physician, administered three EpiPens, but unfortunately that wasn’t enough.

Natalie was pronounced dead at the hospital.

Allergic Reactions: How Do They Work?

When a person is allergic to a certain food, the person’s immune system thinks that this normally harmless food is actually harmful. The first time a person with a food allergy comes into contact with the allergen, no symptoms occur, but the body has been primed and the next time the person comes into contact with that specific food, an allergic reaction will occur.

The body starts producing a specific antibody called immunoglobulin (IgE) to bind to the allergen. This occurs the very first time you come in contact with the food. Antibodies attach to a form of blood cells, called mast cells. These mast cells can be found in airways, intestines, lungs, throat, etc.

The next time a person comes into contact with that specific food, the allergens bind to the IgE which is attached to the mast cells. This causes the mast cells to release chemicals, like histamines. Histamines are what causes the symptoms of an allergic reaction.

Anaphylatic Shock: What Happens?

A severe, potential fatal allergic reaction to a food is called anaphylaxis, or anaphylactic shock.

Anyone who is allergic to any type of food is at risk for anaphylaxis, but those who are allergic to peanuts, tree nuts, fish, and shellfish are more likely to experience anaphylaxis – and those who are also asthmatic are at greater risk, reports the Food Allergy Research and Education.

Anaphylaxis generally occurs within minutes of a person ingesting the problem food; however, it can occur after a few hours. Anaphylaxis can present with the following symptoms, hoarseness, throat tightness, feeling like you have a lump in your throat, wheezing, trouble breathing, chest tightening, and/or tingling in the hands, feet, scalp.

According to the Riley Hospital for Children, over 70 percent of children with anaphylaxis will have respiratory symptoms and over 80 percent of children will have hives or swelling of deep tissue like the skin, lips, or tongue.

According to the Food Allergy Research and Education, about 25 percent of patients have a second wave of symptoms within hours, even after the initial symptoms have subsided. This is why it is critical to get to a hospital to be monitored. People who are at highest risk for a fatal reaction are teenagers and young adults who also have asthma, and those who don’t receive the EpiPen immediately.

In Natalie’s case, the parents did not give the EpiPen immediately – they didn’t administer the treatment until symptoms began, which was 20 minutes after she had the treat.

Once severe symptoms begin it can be too late and the EpiPen may not work. This case brings some confusion for parents as to when to watch and see, and when to give the EpiPen.

Dr. Stanley Fineman, an allergist with the Atlanta Allergy and Asthma Clinic told ABC news, “If you think you might need to use epinephrine, go ahead and use it. You’re better off taking it and not needing it than not taking it and needing it.”

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