In an article headlined, “It’s Just Nuts,” writer Patricia Pearson builds a case around her opinion that school accommodations for food allergies, particularly restrictions on peanut products, are nothing but a panic-driven, unnecessary over-reaction.

As a special education assistant and the mother of an child with anaphylaxis, I cannot let Ms. Pearson’s article go unchallenged. It contains too many incorrect conclusions that could impact whether an important health issue is taken seriously. It leaves Chatelaine readers questioning what is right and what is reasonable. It portrays the parents of kids with allergies as fearful and neurotic, when in fact,  we are asking for accommodations that medical professionals and school boards have deemed appropriate.

Chatelaine’s article ignores that the inclusive, community approach to protecting children with serious food allergies has been a vast improvement, and is working well. What can be difficult to grasp, is that the steep rise in food allergies is a new phenomenon. Researchers tell us that between 6 and 8 per cent of kids have now have food allergies. Conservatively, that’s the equivalent of half the population of New Brunswick. They live with the unpredictable risk of anaphylaxis, the serious form of allergic reaction that can cause shock, suffocation and heart attack in a frighteningly short period of time. There have been cases of brain damage and, tragically, even death.

It is the fast and severe nature of such reactions, combined with the fast-growing incidence food allergies and the need for total avoidance of a food allergen that have led to precautions in our schools.

Ms. Pearson fails to understand that such measures are not about inconveniencing her by depriving her son of peanut butter for one meal of the day. It’s about protecting children from anaphylaxis, no matter what food is involved. She belittles the low number of deaths from anaphylaxis, without realizing that it is exactly due to the approach of taking precautions rather than letting allergic emergencies happen that protects our kids from becoming statistics. Not that there haven’t been tragedies. It’s curious that in all her talk about schools and allergies, Ms. Pearson never mentions Sabrina Shannon. In 2003, at the age of 13, following a devastating anaphylactic reaction to an inadvertent exposure to cheese curds in her cafeteria (she was milk allergic), Sabrina died. It’s hard to believe that Chatelaine’s writer wouldn’t have come across Sabrina’s story in her research. When Ontario created the world’s first legislation mandating risk-reduction measures and emergency training to protect students with food allergies in their schools, it was named “Sabrina’s Law” in remembrance.

Even if anaphylaxis never caused death, the need to minimize reactions would still be of paramount importance. A reaction is terrifying, excruciating and stresses the body. It is also traumatic for school staff and other children to witness. Is a sandwich worth that risk?

In 2007, I was part of a committee in British Columbia that developed the Education Minister’s directive to the province’s schools about food allergies. In order to understand the scope of the issue, the government requested that school districts complete a survey on anaphylactic policies and incidents from 2005 onward. Almost half the districts that responded had experienced one or more anaphylactic reaction serious enough to warrant the filing of a critical incidence report. The anaphylaxis management policies pre-dating the directive ranged from non-existent to minimal to comprehensive – a far cry from the careful, commonsense approaches that Ms. Pearson claims were in evidence.

Regulations surrounding food allergy are based on education and awareness, stressing training for school staff, access to epinephrine auto-injectors, strategies to reduce the risk of reaction and communication with the school community. Each plan for each child is unique, reflecting the child’s needs and the school’s environment. Hand-washing, lunchroom seating, and cleaning practices are all examples of appropriate risk-reduction measures. But there is no escaping it – children like Ms. Pearson’s son are being asked to “please enjoy your peanut butter sandwich at home”.

Peanut butter is sticky, hard to clean, and ends up smeared over shared school supplies, toys and playground equipment. One teacher with a class of 20 little kids cannot possibly be expected to manage the risk. My 12-year-old son has had three accidental exposures to peanut since his diagnosis. Two occurred at his school when he was 6 years old. Young children cannot be expected to protect themselves without support. Peanut often causes serious reactions with a very small amount of protein, and it’s over-represented as a cause of fatalities when compared to other allergens.

While Ms. Pearson dismisses the fact that a new study finds slightly less than 2 per cent of Canadian kids have peanut allergy, she ignores that this is one of the highest rates in the Western world. Further, I would argue that the welfare of about 90,000 kids is worth bothering about.

I spend most of my days in a classroom and have never met a child who did not want to help keep kids with allergies safe once they understood the issue. I find that rational explanations almost always turn hostile parents of non-allergic pupils into cooperative supporters. Ms. Pearson is an exception, and that Chatelaine would publish such a distorted view is truly disturbing. My hope is that children at risk of anaphylaxis gain support and understanding in the community at large. They certainly didn’t find either in the pages of Chatelaine.

Pamela Lee lives in Vancouver. She is a special education assistant and an associate editor of Allergic Livingmagazine. She originally submitted a first draft of this article to Chatelaine to consider publishing. The magazine’s editor rejected the piece, replying that “there are no plans to publish a rebuttal article.”

Related Reading
• Can this be Chatelaine? by Gwen Smith
• Food Allergy Backlash – Why Is It Occurring?

• Ontario’s legislation – Sabrina’s Law, the precedent-setting anaphylaxis legislation
• Alberta policy – ASBA Allergy and Anaphylaxis Policy Advisory
• British Columbia – Ministerial Order: British Columbia Anaphylaxis and Child Safety Framework
• Manitoba – 2008 law / Bill 232: The Public Schools Amendment Act (Anaphylaxis Policies)
• New Brunswick policy – Health Support Services policy for anaphylaxis
• Nova Scotia guidelines – schools follow Anaphylaxis in Schools & Other Settings Handbook
• Ontario: For Teachers and Principals – Ontario e-workshop
• Elementary Teachers Federation of Ontario resource – Members Advisory on Sabrina’s Law
• Prince Edward Island – Minister’s Directive: Procedures for Dealing with Life-Threatening Allergies

United States

In addition to the federal FAAMA, several states have published (or are about to publish) statewide school food allergy guidelines: Massachusetts, Connecticut (law), Mississippi, New Jersey (law), New York (law), Tennessee (law), Texas (new law) Vermont (law), Washington, Arizona, West Virginia, Colorado (law), Missouri, Illinois and Ohio. Below are links to those guidelines; plus other regional anaphylaxis policies.

• FAAMA – Food Allergy and Anaphylaxis Management Act: expert explains the new federal act.
• CDC on guidelines being developed under FAAMA, see Sect. 112.
• AAFA’s Annual Report on the State of Asthma and Allergy Policies for Schools; updated for 2011.
• Arizona state guidelines – Supporting Children with Life Threatening Food Allergies: School Resource
• California – Sect. 49414 of the state Education Code
• California State PTA Food Allergy and Anaphylaxis in Schools Resolution; Helpful California school resources via the San Diego Food Allergy support group
• Colorado law – Senate Bill 226: School Children’s Asthma and Anaphylaxis Health Management Act
• Connecticut law – Act Concerning Food Allergies and the Prevention of Life-threatening Incidents in Schools.
• Guidelines for Managing Life-Threatening Food Allergies in Connecticut. Schools, resulting from the law.
• Connecticut law – Act Concerning the Use of Anaphylaxis Medical Devices while at School
• Florida school districts policy review and state position.
• Illinois Food Allergy Guidelines: school boards required to implement policies based on these guidelines.
• Aug. 2011 – Illinois passes law allowing schools to stock and use epinephrine auto-injector.
• Kansas epinephrine law – House Bill 2008: Administration and Maintenance of Epinephrine in Schools
• Maryland law – House Bill 26: Public Schools – Children with Anaphylactic Allergies: Reduction of Risk; 2009 guidelines
• Massachussetts doesn’t have law, but guidelines are among the best – Managing Life Threatening Food Allergies in School
• Michigan – Senate Bill 233: proposed amendment to the Revised School Code
  
• Mississippi guidelines – Managing Food Allergies in Mississippi Schools
• Missouri 2009 law - School Allergy Policy Law
• New Jersey law – Anaphylaxis Law and Guidelines for Schools
• New York State law – Allergy and Anaphylaxis Management Act of 2007, and the 2008 guidelines. New York State medication authorization form.
• New Mexico – individualized health care plan, IHP.
• Ohio – Leglislation that simply requires schools to have a food allergy policy; food allergy policy requirements and guidance.
• Pennsylvania – House Bill 1148: proposed Dept. of Education Wellness Policy.
• Rhode Island law – Sect. 18: Rules & Regulations (2009) for School Health Programs.
• Tennessee law - Brentson’s Law
• Texas state-wide law became effective Sept. 1, 2011.
• Vermont law – Act 158: An Act Relating to Life-Threatening Allergies & Chronic Diseases in Schools. and DOE guidelines.
• AAFA’s description of  Vermont model.
• Virginia – Loudoun County Public Schools excellent policy: Caring for Students with Food Allergies in School.
• Washington law – Legislation requiring uniform allergy and asthma prevention and training.
• West Virginia Dept. of Education guidelines for food allergies.
• Wisconsin guidelines on food allergy and anaphylaxis.
• For a list of states with laws or regulations allowing students to carry and/or self-administer epinephrine at school, see FAAN’s website.

Schools & Allergies Resources Hub – click here

Photo of Sabrina Shannon

If you know of any new laws or guidelines that we’ve missed, let us know at: editor@allergicliving.com

To: Ms. Maryam Sanati, Editor-in-chief, Chatelaine
Ms. Patricia Pearson, Writer
Re: Chatelaine article “It’s just nuts”

I hope you received the Sabrina’s Law documentary about my daughter who died in 2003 at the age of 13 after suffering a fatal allergic reaction. I sent two copies a couple of weeks ago, to the attention of Ms. Sanati, after reading the article “It’s Just Nuts,” which was in the December issue of Chatelaine magazine.

I was completely disheartened by the lack of empathy, sarcastic tone, ridiculous comparisons, and missing facts. I was especially concerned that readers would be left with the impression that the piece was well-researched and painted an accurate picture of what’s going on in Canadian schools and the wider community. It is far from the truth. You say that “schools and parents are cowering in fear,” yet in my travels across North America, I have seen schools working together to keep all children safe.

I wish you had known my beautiful daughter, Sabrina, and I wish I were writing to you today for another reason. Instead, I am writing in hope that you will join me in keeping my promise to my daughter: to educate. While she was on life-support, I told Sabrina that I would do everything possible to prevent a similar tragedy from happening to another family or child.

Had my daughter been alive today, and read “It’s Just Nuts,” she too, like many of your readers, would have been dismayed by such a heartless article. She would have been very disappointed by the adults who wrote and published this piece. She would have told you that children deserve the support of their communities. At the tender age of 10, Sabrina made a radio documentary for CBC Outfront with my sister, Kathleen Whelan, called “A Nutty Tale”. Please listen to it - http://www.cbc.ca/outfront/webfeatures/sabrina/sab_shell.html

You will hear the voice of a creative and knowledgeable youngster using humour, not mockery, to advocate for those at risk of anaphylaxis. It has been listened to around the world and used as a teaching tool. You can tell from her voice that Sabrina did not let her allergies define her, though she did work hard to self-protect and teach others. Today, she may have been a talented writer contributing articles to Chatelaine magazine.

Ms. Pearson is correct in suggesting that peanut allergy has had greater attention from schools and the public in general. This is due to the fact that peanut is one of the most common causes of allergic reactions and death from anaphylaxis. It is also one of the most reported allergies within the school system. Ask any principal. While I agree that more needs to be done to educate the public about other food allergens, “It’s Just Nuts” failed in its attempt to provide any clarity around food allergy, a complex health issue.

In fact, it did more to confuse your readers. The article suggests that food allergies are a myth and there is “over-blown panic” within the community; that parents and schools are “over-reacting” in their efforts to protect kids with food allergies. It is easy to be an armchair critic about the way others manage a health condition when you do not live with it 24/7. While my daughter ended up being one of the few who died from an allergic reaction, my hope is that you’ll see her as more than just a statistic.

Mother-to-mother, let me share Sabrina’s story.

Sabrina’s death from anaphylaxis, while rare, has nothing to do with death from lightning strikes. I found this comparison hugely offensive and ask that you please be considerate of people who have lost children as a result of anaphylaxis. As mothers yourselves, I hope that you would both understand how awful it is to lose a precious child. I cannot describe the devastation that Sabrina’s death caused to my family, her many friends, and her classmates who witnessed the horror of seeing their friend die. Sabrina was my only child.

Unlike lightning strikes, anaphylaxis is not an unpredictable force of nature. Prevention and safety plans can and should be put in place. Knowledge goes a long way to keeping children safe and they have the right to be safe and feel safe while at school. That is what Sabrina’s Law is about. I remember feeling very strongly after Sabrina’s death that if all of the right measures had been in place – epinephrine, emergency preparedness and, 911 – maybe she would be alive today. My sentiments were echoed by Dr. Andrew McCallum, then Regional Supervising Coroner for Eastern Ontario, who sent recommendations to the schools in Eastern Ontario.

Ms. Pearson, my daughter (like most food-allergic kids) knew enough not to “lick her desk,” but that peanut and other food particles could trigger a reaction if there was a transfer of residue from hand to mouth or from a utensil. The day she died, she ate plain French fries thought to be safe, which had been contaminated by a small amount of dairy not visible to the eye.

Tongs which had been used to serve her fries had previously been used to serve French fries with poutine. Without early treatment with epinephrine, her allergic reaction to dairy escalated quickly, causing her throat to close and shut off oxygen to her brain. She was unconscious within minutes. After a day on life-support at the Children’s Hospital of Eastern Ontario, Sabrina died, surrounded by people who loved her very much. My worst nightmare had come true.

As the author of “It’s Just Nuts,” Ms. Pearson, you hold the power of the pen to share your views as a freelance writer. Please use it responsibly. Ms. Sanati, as the Editor-in-chief of Chatelaine, you have the ability to reach millions of people with the right facts, by choosing what goes into print. Instead of creating controversy, let’s try to build bridges, not walls.

I am sharing my letter with Sabrina’s father, Mike Shannon, and the many others I have had the privilege of meeting since Sabrina’s death. These individuals have made efforts to improve management plans in schools, create safer products and environments for those at risk of anaphylaxis, and increase public awareness. They are school communities, politicians (Premier Dalton McGuinty, Kathleen Wynne, Minister of Education, Cheryl Gallant, MP Renfrew-Nipissing-Pembroke, Gerard Kennedy, MP Parkdale-High Park (former Ontario Education Minister), Dave Levac, MPP Brant, John Yakabuski, MPP Renfrew-Nipissing-Pembroke); government representatives (Health Canada, Canadian Food Inspection Agency, and Veterans Affairs Canada); the allergy and medical community (Canadian Society of Allergy and Clinical Immunology, AllerGen), Anaphylaxis Canada, Allergy/Asthma Information Association, Association québécoise des allergies alimentaires, Canadian MedicAlert Foundation, Food Allergy & Anaphylaxis Network, Food Allergy Initiative/Robert Kennedy Jr., Allergic Living magazine, Niagara Anaphylaxis Support & Knowledge and other local support groups, CHEO); industry (King Pharmaceuticals Canada, Paladin Labs, food manufacturers, Canadian Peanut Bureau, Dairy Farmers of Canada, Egg Farmers of Canada); and Canadian and American documentary producers (Lank/Beach Productions, The National Film Board of Canada, Merit Motion Productions, Sharona Schwartz, and Dr. Sanjay Gupta).

Though the article failed to recognize the important work of this wider community over the years, I continue to appreciate the progress that has been made by these organizations and others, too many to mention here. It is too bad that Chatelaine chose to omit many of the good news stories.

Clearly, more work needs to be done to increase Chatelaine‘s understanding of the efforts of such a diverse group, all focused on a common goal: protection of people with severe allergies, especially children.

In closing, I would ask Rogers, the publishers of Chatelaine magazine, to consider the impact of articles such as “It’s Just Nuts”. You have a moral obligation to provide balance and proper facts when highlighting children’s health issues. I urge you to publish another article on food allergy, this time with accurate information and in a respectful way.

I will follow up with you by phone as I would really like to speak with you, Ms. Sanati. I have learned from experience that by talking, misunderstandings and misinformation can be clarified. Now, more than ever, I would like to offer my continued support in educating.

Sincerely,

Sara Shannon
Sabrina’s Mom and Food Allergy Advocate

See Also:

• Sabrina’s Law: School Allergy Laws and Policies
• Can this be Chatelaine? by Gwen Smith

Sara and her former husband, Mike Shannon, lent Sabrina’s name and her indomitable spirit to that legislation. On that terrible last day of September 30, 2003, Sara had made this promise to her daughter: she would do everything possible to prevent another child from dying of anaphylaxis. That promise has become her mission.

Not content with Sabrina’s Law just for Ontario kids, Sara is promoting similar legislation in other provinces and across the United States. She has transformed herself from a down-to-earth woman from little Pembroke, Ont. – a person who was shy before a microphone – to a passionate advocate who speaks from the heart.

Sara has crisscrossed North America, making innumerable friends among allergy support groups as she spreads the message of why schools need anaphylaxis policies that are enshrined in law. Otherwise, she feels, another tragedy like Sabrina’s is waiting to happen. In February, 2007, she traveled to Pennsylvania to meet with allergy mothers from across America and to watch the signing of a law that finally gives children there the right to carry epinephrine auto-injectors at school.

In 2006, she appeared on TV in Seattle to raise awareness of the risks of anaphylaxis and to fire up a local allergy support group about the possibility of school legislation; she’s helped a legislation lobby get started in Texas and has written to U.S. senators and Canadian premiers, appealing to them as parents.

The Food Allergy Initiative, an organization that gives out millions in allergy research grants, picked Sara to receive the prestigious Daniel Patrick Moynihan award for public service at its New York gala in December of 2006. Presenting was Robert F. Kennedy Jr., the father of a food-allergic child.

“It’s so important that we get a Sabrina’s Law
passed in another province or state; these
children need to be protected.”

While appreciative and honored, Sara adds that “balls are wonderful, but we’ve still got to make this a law, we’ve got to make it real.” She berates herself that she’s not doing enough: “It’s so important that we get a Sabrina’s Law passed in another province or state; these children need to be protected. If I could do this full-time, I would go full force.”

But Sara is always doing more than she admits. She worked with two Winnipeg documentary makers to bring “Sabrina’s Law,” the film, to Canadian television in the fall (of 2006). She has her sights on British Columbia and Alberta as the provinces she would most like to have adopt an anaphylaxis law. “If we could just get another of the big provinces on board ….” she says.

Asked what has affected her the most through her journey, Sara answers that it’s the dedicated parents in the allergy community and, of course, their kids. “I’ll never forget being at a conference in Toronto and this little girl came up and gently touched my arm. She said to me, ‘thank you’. Our children are so important, that’s what touches me the most.”

First published in Allergic Living magazine, Spring 2007 (c) Copyright AGW Publishing Inc.
To comment, write: editor@allergicliving.com

To subscribe or order a single issue, click here.

For School Anaphylaxis Legislation and Policies, click here.

TORONTO – April 7, 2009 – How far should our schools go to protect the health and safety of our children? This is the great debate that Allergic Living magazine raises in its Spring ’09 cover story: “Backlash Boards the Bus.”

When medical sociologist Dr. Nicholas Christakis heard that students evacuated a bus at his children’s school because of one solitary peanut, he was appalled. But he didn’t just raise objections with the principal. Instead he wrote a column in the British Medical Journal that branded ALL school anaphylaxis measures as a form of “epidemic hysteria,” and raised the spectre of neurotic parents and educators feeding off each other’s fears in an endless cycle of anxiety.

In its Spring issue, Allergic Living discovers that Christakis struck a chord, that he is far from alone in his opinions that food allergies have cascaded into the realm of societal myth. The topic has become an international media debate with Harper’s, Time, The New York Times, the National Post and numerous bloggers all weighing in. Yet, to the parents of hundreds of thousands of children in Canada with dangerous – and very real – food allergies, the views being expressed are often frightening, divisive and hurtful.

The highly contentious debate prompted Allergic Living editor Gwen Smith to zero in on the heart of the matter in the latest issue: Why do people love to hate food allergies? The magazine finds widespread attention to Christakis’s opinion is having a polarizing effect, with those in the contrarian camp now suggesting that school anaphylaxis precautions are doing more harm than good, while allergy advocates emphatically defend the need to protect vulnerable allergic students.

A Mayo Clinic study released in December found that food allergic reactions in the U.S. resulted in 50,000 emergency room visits, up from 30,000 in 1999. Can anyone reasonably argue that food allergies do not present some measure of health concern?

The shadow of doubt is perhaps rooted in frustration over small inconveniences and isolated situations, such as the school bus incident, which are exactly that: isolated. Smith contends that what’s getting lost in the hyperbole is the rationale and the reasonableness of food allergy measures. The fact is: they save lives.

Click to view an excerpt of Backlash Boards the Bus in the Spring issue of Allergic Living.

Also in the Spring issue: The science behind oral allergy syndrome. About 10 per cent of Canadians have a confounding condition that causes intense reactions to fruits and vegetables. Read all about it.

Allergic Living is available by subscription (www.allergicliving.com) and at Chapters outlets, Shoppers Drug Mart and London Drugs.

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For more information about this article, or to arrange an interview with Allergic Living editor
Gwen Smith, call Beth Sulman at 416-628-5602 or bsulman@hccink.com

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