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Death of a Child

The following article was first published in the Victoria Times-Colonist of British Columbia on April 16, 2007

Thirteen-year-olds aren’t meant to have obituaries. The recent one for Carley Kohnen read that “she passed away tragically at Summit Park, Victoria.”

Carley, who was allergic to dairy products and peanuts, attended Lansdowne Middle School. The bubbly teen had been hanging out at the mall with her friends after school. She ate a burrito and then the group headed over to the park. Soon, Carley began struggling to breathe.

With her EpiPen in her locker at school, the friends called the ambulance, desperate to get help. But in an anaphylactic reaction, the severe form of allergic response, every second is precious. There just wasn’t enough time to save Carley.

Her death is shocking and tragic. But what British Columbians need to realize are two things: It didn’t have to happen and, if changes aren’t made to better protect allergic kids, it is likely to happen again.

Anaphylactic reactions can be prevented, through constant vigilance. This means reading ingredients on every label of every food package to avoid your allergy triggers.

It means always asking servers questions about menu items, and obeying the cardinal rule of the food-allergic: Never eat without your EpiPen auto-injector at hand – just in case an allergen has contaminated your food.

But vigilance and the teenager are an uneasy match. As Carley’s grieving father told the Times Colonist [1], teens – even allergic ones – think “they’re indestructible.”

His daughter, unfortunately, was not an anomaly. Teenagers are by far the most vulnerable group to fatality from food-allergic reactions. An Ontario study published in 2000 reviewed 20 deaths from reactions to peanuts and tree nuts. Most were girls aged 14 and 15.

A U.S. study has just been published in the April issue of the Journal of Allergy and Clinical Immunology. It examines 31 food allergy deaths, from which these stark facts emerge: Most were teenagers, and most were not carrying their auto-injectors and had eaten foods away from home.

The risk has also significantly increased because of the sheer volume of kids living with serious food allergies. In May 2004 the Mount Sinai Medical Center in New York published a groundbreaking study that identified a doubling of food allergy in five years. Dr. Hugh Sampson, the lead author, concluded that “nearly four per cent of Americans are afflicted … a prevalence much higher than appreciated in the past.”

That’s 11 million people, with the highest incidence in children. In Canada, researchers estimate a prevalence that’s just slightly less: About one million Canadians have food allergies.

As a society, we can do more to protect the legions of kids who today live with the risk of anaphylaxis. Parents of allergic kids instill the food-allergy rules. But once children are of school age, these rules need reinforcement from teachers and fellow students and friends.

The school’s culture is a kid’s culture. It needs to encourage them as teenagers to speak up about their allergies, to avoid risk-taking with food just as they learn not to get into a driver’s seat after drinking. The culture can help to drive home that they must always protect themselves. Many B.C. schools have anaphylaxis guidelines, but they are not consistent and consistently good throughout the province.

That’s why a private member’s bill – the B.C. Anaphylactic Student Protection Act, known as Bill M 210 – deserves to be passed. On March 28, David Cubberley, the New Democrats’ education critic, introduced the bill. It requires that every school board:

* Establish an anaphylactic policy with strategies to reduce exposure to allergy triggers;

* Have a plan for communicating information about life-threatening allergies to staff, students and parents;

* Offer staff regular training on serious allergies, including the use of an auto-injector.

It is fair, workable legislation, modeled after Sabrina’s Law in Ontario. That law is named for Sabrina Shannon, another 13-year-old who died of anaphylaxis – after eating French fries in her school cafeteria.

But instead of Bill M210, Education Minister Shirley Bond is proposing a “policy advisory group” to begin looking at anaphylaxis in B.C.’s schools. This is inadequate. It fails to address the new reality, the soaring incidence of food allergy in the schools and the level of risk. There is a need – now – for province-wide preparation for anaphylactic emergencies.

To be able to think fast in an anaphylactic crisis, an educator needs to be confident about when and how to use the EpiPen with its sheathed needle. It’s easy to use, but people often delay using it. That’s dangerous: Carley and Sabrina succumbed swiftly. So did another teen in Edmonton last year, and others in the United States.

Sabrina’s dad, Mike Shannon, today lives in Victoria and has spoken in support of Bill M 210. There are now too many parents in this city who have lost daughters to anaphylaxis, too many devastated young friends.

It’s time to develop a comprehensive anaphylaxis approach in the schools, in the hope that this may raise awareness just enough to prevent more tragedies. Legislation is needed to protect students with allergies. All it takes is the political will.