I thought peanut allergies were exaggerated, until my son almost - KMOV.com

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I thought peanut allergies were exaggerated, until my son almost stopped breathing

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The O'Sullivan boys after a peanut allergy attack at a St. Louis area hospital (John O'Sullivan, KMOV) The O'Sullivan boys after a peanut allergy attack at a St. Louis area hospital (John O'Sullivan, KMOV)

ST. LOUIS (KMOV.com) -- Halloween is the scariest time of year for me. Not because I hate haunted houses and scary movies (I do), but because both of my kids are allergic to peanuts. The older is 5, the younger, 3. My older child has gotten an EpiPen injection every other year since he's been able to eat.

His younger brother joined him the Emergency Room already this year. One small bite of a supposedly safe treat led to nausea, vomiting, hives, and the scariest symptom, the closing up of his throat. When you can't breathe, it's an emergency.

Yes, of course we read the product labels. No mention of peanuts. But one small bite of a peanut containing product was enough.

The question I get all the time is: Why are there so many more kids with peanut allergies these days? "This is a great question and sort of the "million dollar" question in allergy right now" says Dr. Josie Vitale of St. Louis' Asthma, Allergy and Sinus Care Center. Right now there is no clear answer, but

Data does track an increase in peanut allergies among young children in the United States.

According to a study by food allergists at Mount Sinai Hospital in New York, the number of children with a peanut allergy jumped up threefold, from .4 percent in 1997 to 1.4 percent in 2010. Food allergies affect an estimated 5 percent of children under the age of 5 in the U.S., according to the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

So what happens when a young child who is allergic to peanuts actually eats one? Well they could die. This is not something where the symptoms are just eyes watering and a runny nose. My 5-year-old's throat starts to constrict, the vomiting starts and I'm forced to jab him in the thigh with a needle to stop the attack. As for the 3-year-old, in his first attack, he did not react until 2 hours after eating the treat as we were about to walk out of the ER. He chose that time to tell me his "tummy hurt" and then projectile vomited all over me. Also he broke out in hives all over his body before the nurse had to inject him with epinephrine.

This potentially deadly reaction, called anaphylaxis, can happen with a child's first exposure to peanuts. And unless it's stopped by an injection of epinephrine (adrenaline), anaphylaxis can kill.

So that little EpiPen we carry around with us everywhere we go is pretty important. This year Mylan, the pharmaceutical company that makes EpiPen, was accused of up-charging its prices. The lifesaving drug, saw its price skyrocket 600 percent since Mylan acquired EpiPen in 2007. At that time the EpiPen cost around $100 depending on where you purchased your prescription. Before the outcry from Congress and State's Attorneys General in the last few months, the price of an EpiPen two-pack surged to more than $600 this year. And earlier this month, Mylan disclosed a $465 million settlement with the U.S. Department of Justice over the defrauding of Medicaid by mis-categorzing the EpiPen so the company would see a higher rate of reimbursement from the Federal government. Right after Mylan executives were getting called in front of Congressional hearings to testify on the rising price of EpiPen, the company announced it will soon offer a generic version of the life-saving treatment. The generic cost: $300 per two-pack. The latest update from Mylan in early October stated the cheaper generic would be available by the end of 2016, after initially saying it would be ready in just a few weeks.

But back to that question of why? Why are we seeing so many more kids who are allergic to peanuts? "There are a lot of theories but this is an area of robust research that continues to be investigated" said Vitale. Again, there is no concrete silver bullet answer, but there are a few theories.

ONE: THE HYGIENE HYPOTHESIS

This idea is that modern medicine has become so good at preventing natural infections and that the immune system is not having to deal with many of the issues it dealt with decades ago. Vitale confirms "The Hygiene Hypothesis is thought to be one possible explanation for why atopic diseases (such as asthma and environmental allergies) are increasing in general." The theory suggests that the increase in use of antibiotics and "clean living" leaves immune systems in a heightened state where they are more likely to attack harmless proteins such as those in certain allergenic foods. In the case of peanuts, an allergy occurs when your immune system mistakenly identifies peanut proteins as something harmful.

TWO: THE ROASTING EFFECT

The increase could also deal with how modern peanuts are processed. Because peanuts are roasted, it could be making it into a more allergenic food. Some experts theorize that the oil in peanut butter might make it more allergenic. The roasting process changes the sugar and makes the protein easier to digest and easier for the immune system to attack.

THREE: WE HAVE BETTER DOCTORS

Vitale says "there is the question of whether we are just better at detecting and diagnosing peanut allergy." With advances in modern medicine, there may not actually be an increase, Allergists could just be better at detecting it and more parents are aware of peanut allergies and are getting their children tested.

FOUR: THE DOCTORS IN THE 90'S ARE BEHIND IT

The prevailing theory in the late 90's was for parents to put off having their young children try any high risk foods until they turned 1 year old.  For years, the American Academy of Pediatrics advised parents to avoid giving their babies peanuts in order to protect them from developing allergic reactions. That now out of date theory was backed up by a study in 2000 when the AAP issued guidelines that children should put off having milk until age 1, eggs until 2 and peanuts, shellfish, tree nuts and fish until 3.

WHERE ARE WE GOING FROM HERE?

There are new studies trying to isolate the exact causes of food allergies and how to prevent them.  One garnering a lot of attention from Allergists right now is a LEAP Study that highlighted the significant benefits of early introduction of peanut in decreasing the incidence of peanut allergy.  But Vitale told us "for patients with known egg allergy or severe eczema, it is recommended that they be tested for peanut allergy by an allergist prior to introduction at home." The study also shows the lower rates of peanut allergies in Israel, where a common infant snack is made of peanuts.  "One thought is that children in other countries where early introduction of peanut is prevalent appear to have lower rates of peanut allergy" said Vitale.

Based on recent findings, the AAP in 2008 changed its advice and now does not say parents should avoid feeding their babies peanuts. They haven't concluded yet whether giving peanuts to infants early in life is a better choice, but given the latest data, experts believe that it's something that parents should discuss with their pediatricians and allergy specialists.  Dr. Vitale does not recommend all parents get their children tested for allergies. She explained "testing children without history of a clear reaction to a food would lead to an over-diagnosis of food allergies. Patients would be labeled food allergic and advised to avoid despite the fact that if never tested, they may go on to tolerate that food just fine. In siblings of patients with food allergy, it is often up to the discretion of the parent. Siblings of patients with food allergy do have an increased rate of food allergy, but it is not 100%. Some parents prefer to try the food on their own with siblings and others prefer to have their children tested first. I do not recommend one approach over the other and understand the rationale behind both."

And as for if you are pregnant, Vitale confirms there is a difference of opinion compared to years past, "in moms without food allergy, it is recommended that they try to regularly consume peanut, tree nuts and other allergenic foods while pregnant. Breast-feeding exclusively for the first four to six months is also recommended. That being said, I did both and my son still has a food allergy!"

The American Academy of Allergy, Asthma & Immunology is a place you can turn for more questions about trying to prevent food allergies in children. Also Vitale's practice, Asthma, Allergy and Sinus Care Center, has just started oral desensitization (OIT) to peanut and will soon be adding additional foods.  They are the only group in St. Louis currently offering this therapy. But Vitale reiterates "It is not a "cure" for peanut allergy and certainly not the right choice for all patients and families. But it is currently the only available option to help kids with peanut allergy tolerate peanut." For other purely local St. Louis Allergy issues, a good local resource is "The Asthma and Allergy Foundation of America's" St. Louis Chapter (AAFA)
With Halloween’s Trick-or-Treating candy tradition, some may be wondering what they can do to raise awareness about food allergies during this time of year. You can check out the Teal Pumpkin Project. It’s all about making sure you have non-food treats to give out to kids suffering from allergies.  All you have to do is place a teal pumpkin in front of your home to let Trick-or-Treaters know you have non-food treats on hand.

As for my boys, a peanut allergy won’t keep them down.  Since we found out about the 5-year-old’s allergy when he tried Peanut Butter at a year-and-a-half of age, we have worked to make sure he is aware of his allergy.  And because of his older brother’s allergy we made the decision to have the 3-year-old tested by an allergist.  We now have everyone in the family trained like one of Pavlov’s dogs; whenever they hear the word “peanut” everyone yells “No No!”

John O'Sullivan is an Executive Producer at KMOV and the father of two small boys with peanut allergies
Copyright 2016 KMOV (Meredith Corporation). All rights reserved

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