• Food Allergy Backlash: Anaphylaxis advocates accused of “nut hysteria” in the media and medical journals. [Read more]
• Pollen-Fruit Cross-Reactions: Raw fruits or veggies make your mouth itch and burn and itch? Spring hay fever is likely the cause. Plus: a chart on cross-reacting fruits, vegetable, spices and more.
• A Life Without Fruit: Living with oral allergy syndrome. [Read more]
• Immune-Boosting, allergy-safe recipes: include Watercress and Pea Soup, Shiitake and Bean Power Salad; Super Citrus Chicken and Blueberry Compote.
• Asthma in Springtime.
• Celiac Disease: Pure oats open doors for the gluten-free.
• Allergy news: “Ming’s Law” on restaurants and allergies passes; AL airlines campaign update [Read more]; Starbucks reaction raises questions; allergists object to B.C. changes on naturopaths. [Read more]
• Breathing Space: The Lung Association on 3rd hand smoke perils. [Read more]
• Columns: Ask the Allergists, Gluten-free Girl and more. [See Columns]
• Parting Shots: The boy who couldn’t find daycare.

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In Lexington, Kentucky, a girl in the eighth grade was arrested on felony charges in April after she put peanut butter cookie crumbs in an allergic classmate’s lunch box. (The allergic student did not eat the contaminated lunch, and did not suffer a reaction.) While clearly not the first time an allergic person has been threatened with their allergen, cases usually don’t escalate to this level, says Anne Muñoz-Furlong, the founder and CEO of the Food Allergy & Anaphylaxis Network.

Following the arrest, media outlets such as the Wall Street Journal, The Globe and Mail, and various radio stations ran reports about allergy bullying. In fact, the website Wordspy.com, which tracks “newly coined” phrases, added “food allergy bullying” to its lexicon at the end of April.

Laura Bantock, who leads an anaphylaxis support group in Kamloops, B.C., knows that bullying is something many allergic kids have experienced. “I do hear of kids being taunted. To an allergic child, being threatened with the thing that they’re most afraid of, whether it’s peanut or milk, to them the perception is a very serious threat.”

Muñoz-Furlong says that food allergy bullying arises because some people aren’t aware that a speck of food could kill. “It just doesn’t seem normal that you say, ‘I could die from having a little bit of milk, or having a peanut butter sandwich.’ And because so much attention gets given to that child, so many plans and restrictions are in place, sometimes that makes the person a target for kids who don’t understand or perhaps resent the attention, or are skeptical that this is a real issue.”

Education does seem to work to help curtail bullying. Bantock’s 14-year-old daughter, Tess, an aspiring singer-songwriter who is at risk of anaphylaxis to peanuts, nuts and soy, was taunted earlier this year by some boys in her grade. “They threatened me with peanut butter. I don’t know if they had any, but they said they did,” she says. She told her teacher who, with the help of her parents and the school, explained to the boys the seriousness of food allergies. Tess believes they just hadn’t realized how threatened she felt. “They’re nice to me now. They asked me some questions about my allergies, because they were curious,” she says.

As someone who has experienced bullying, she is happy that the authorities in the case in Kentucky are taking it seriously. That teenage bully was charged with felony wanton endangerment, and will face her charges in juvenile court. “Sometimes you wonder, ‘does the government care?’” Tess says. “I don’t think prison is what you want to do – but education, or perhaps community [service] hours to help people to understand.”

First published in Allergic Living magazine, Summer 2008
(c) Copyright AGW Publishing Inc.

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IT DOES sound, if not “hysterical,” then at least over the top. One single peanut is noticed on the floor of a school bus and the 10-year-old riders are all told to get out immediately, because of food allergy risks.

The anecdote appears in an opinion article, written by Dr. Nicholas Christakis, a professor of medical sociology at Harvard Medical School, and published last December in the British Medical Journal. Christakis uses the bus incident, which took place at his children’s school in Massachusetts, as a starting point for this thesis: accommodations made for food-allergic students are an unnecessary “charade” based on fears that “represent a gross over-reaction to the magnitude of the threat.”

As an expert on how health conditions affect others in one’s social network, Christakis goes a big step farther, raising the spectre that school responses to food allergies bear “the hallmarks of mass psychogenic illness.” In other words, what used to be called “epidemic hysteria”: the eruptions of fear in towns, schools or hospitals based on the threat of contamination involving, the professor says, “otherwise healthy people in a cascade of anxiety.”

His article quickly grabbed the attention of news outlets around the world. He was interviewed by Time magazine, The New York Times, the Los Angeles Times and Canada’s National Post. Media articles were circulated on websites. The blogosphere had a field day. Suddenly it was fashionable to dismiss food allergy as a made-up phenomenon.

Parents seeking accommodations for kids at school were no longer taking sensible precautions – they were portrayed as hysterical, anxiety-ridden and even needing to “feel special”. Food allergy groups and parents of kids living with the risk of anaphylaxis were put on the defensive, while leading allergists only got to add their brief comments on the media debate as responses to Christakis’s statements.

The fallout from one editorial was remarkable. Yet in writing of needless hysteria, Christakis in fact increased the anxiety within the food allergy community. The widespread attention has had a polarizing effect on those on either side of the school accommodations issue, and now, after many advances have been won to protect students at risk of anaphylaxis, at least one major Canadian newspaper is asking: “Can schools bring back the humble peanut?”

Backlash, however, is not entirely new. “There have always been people who are doubtful that food allergy even exists,” says Anne Muñoz-Furlong, founder of the Food Allergy and Anaphylaxis Network (FAAN), the Virginia-based non-profit that focuses on awareness, education and research.

Of course, the condition is real, it can result in severe and even fatal reactions, and it is more common than ever. The Centers for Disease Control and Prevention in the United States last October reported an 18 per cent increase in the number of children with food allergy from 1997 to 2007. Meantime, a study from the Mayo Clinic in December found that anaphylactic reactions to food are responsible for 50,000 emergency visits each year in the United States, up from a previous estimate of 30,000.

With a rise in food allergies, particularly in children, has come a heightened awareness of the need to keep kids with the condition safe when they are away from their parents. School, of course, is where they spend the bulk of their “away” time, and where foods and snacks are part of daily life. This has led to advocacy, followed by measures to reduce the risk of allergic reactions, mandated by law in places such as Ontario, New Jersey and New York state.

“There are a lot of schools that are dealing well with these allergies,” says Laurie Harada, executive director of Anaphylaxis Canada. “And they’re not all hysterical and living in fear. It has become a part of their norm.” Muñoz-Furlong agrees, pointing out that evacuating a bus due to a peanut is a rare and extreme example. “In the U.S., we have two million school-age children with food allergies. They go to school, they participate in class parties and field trips, they’re on the bus and they are mingling – just like every other child.”

***

ALL THE SAME, the backlash has grown. The current rumblings date back to January 2008, when Harper’s magazine published an article in which writer Meredith Broussard did not mince words. “The rash of fatal food allergies is mostly myth,” she wrote, “a cultural hysteria cooked up with a few ingredients: fearful parents in an age of increased anxiety, sensationalist news coverage and a coterie of well-placed advocates whose dubious science has fed the frenzy.” She slammed FAAN for its fatality statistics that estimate 150 people a year die from food allergies, but neglected to mention that those figures, which emanated from a Mayo Clinic study in Minnesota, were derived using widely accepted methods.

When Christakis came forward to similarly cast doubt on the wisdom of school accommodations, his words carried considerable weight in the media, since he wrote as a Harvard professor and physician, and did so in the august BMJ. Within the scientific community, however, his views quickly became divisive.

In a letter to the BMJ, Dr. Jonathan Hourihane, a well-regarded Irish pediatric allergist, took issue. Hourihane said, for instance, that the professor had distorted the question of false positive allergy tests: “There is no such thing as ‘meaningless’ allergies to nuts, or else we have to accept the terms ‘meaningless’ asthma and ‘meaningless’ cancer,” he wrote.

Kania, who lives in Victoria, remembers this incident two years ago as “horrible”; he had wanted to make a good impression on the first day. He turned down the birthday cake because of his peanut allergy, but Kania, then 21, didn’t say that. “There were 30 bigwigs standing around and I did not want to be out of place.” In hindsight, it would have better if he had just been upfront about his condition.

Kania’s awkwardness with allergy in an office situation is hardly unusual. While great strides are being made in spreading allergy awareness and precautions in the schools, there is much less support and few allergy-friendly policies in the grownup working world of the business lunch, the office party (with its trays of mystery hors d’oeuvres) and the catered conference. Allergic Living spoke to employees with both food and environmental allergies in a variety of professions to discover how they coped on the job. Some are vocal with their bosses and colleagues about their conditions, but many are not.

Those with environmental allergies or asthma triggers (ranging from dust and mould to VOC paints and other chemicals) often suffer their symptoms in silence in their workplaces. And when it comes to food allergies, many who are at risk of anaphylaxis admit they have taken dangerous chances rather than stand out among their peers.

Raising the Subject

Tracy Hill had wanted to keep her allergies to fish and shellfish quiet at work, “whispered,” she says. Hill, 42, is a radiation therapist at a hospital in Thunder Bay, Ontario. Then one day at a conference, she had a life-threatening reaction to some Mexican food, resulting in an ambulance ride to the hospital. “That taught me a lesson,” she says. “Although I don’t like to draw attention to myself, it’s way better to have that conversation than have a big scene with an EpiPen in your leg and the stretcher coming.”

Dr. Mitch Persaud, a Saskatoon allergist, encourages patients to tell colleagues about their allergies from the get-go rather than waiting until they’re breaking out in hives and wheezing. He says some patients avoid doing so because they feel that their allergies are under control. “I don’t think that’s the approach,” he says. “Mistakes can occur any time.”

When a job requires working with customers, raising the topic of your allergies may require a degree of finesse. Peter Burnside, a 47-year-old Toronto salesman, travels continuously for work and eats as many as 15 meals a week in restaurants, often with clients. When his allergies to nuts, peanuts and barley come up, he tries to explain briefly and then steer the conversation back to his clients. “I wouldn’t want the first thing they think to be, ‘Hey, he’s allergic to nuts.’ Rather, ‘he’s got a great product’ – that’s what you want them to think.” Burnside adds: “You definitely don’t want to appear weak.”

Similarly, Colleen Serban, a 30-year-old photographer from Kenora, Ontario, told Allergic Living that she has to be concerned about whether her hayfever and asthma will cost her business. She strives to avoid photographing clients outdoors during the spring and fall because her medications sometimes cause her hands to shake. “I don’t want them to think I’m not able to do the job.” Serban also photographs weddings and feels embarrassed asking what’s on the menu for dinner shortly after she has landed a contract. She doesn’t want to leave the bride feeling: “I just hired her, and now she wants to decide what our meal is.”

June Traptow can relate. She, too, is a photographer and owns a studio in Red Deer, Alberta. Traptow, 49, has allergies and intolerances to nuts, dairy, gluten and eggs, and is often left scrambling for safe food at the catered events she attends to network with other business owners. She is concerned that when such peers and potential clients learn of her allergies, they may think she’s difficult to please. When they watch her at a meal – perhaps sending back a salad with croutons – some will also become paternal. “They want to look after my food problems, and that becomes an issue of credibility,” she says.

Dr. Donald Stark, an associate professor at the University of British Columbia and a Vancouver allergist, agrees that “people who don’t have allergies aren’t always particularly sympathetic to the allergy sufferer.” They may assume incorrectly, “it’s just a runny nose or a few hives, what are you making a big fuss about?” But he says the only safe route for the person with allergies and/or asthma is to get past the embarrassment and to inform bosses and colleagues about such a condition. Persaud, the Saskatoon allergist, advises the patient with food allergies to explain the allergy basics to co-workers in a pleasant and non-confrontational manner. He says it’s important to let them know that reactions can be life-threatening, and to ask for co-operation to avoid exposure to an allergen in the workplace. As well, he suggests that at least one other person in the office know where the allergic person keeps the epinephrine auto-injector.

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