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The professor particularly raised the ire of allergy researchers by suggesting that keeping peanuts and other allergens out of schools is doing more harm than good. “The wholesale avoidance of nuts contributes to the problem by resulting in children who, lacking exposure to nuts, are actually sensitized to them,” Christakis writes.
But to back up his statement, he used a study that looked at allergy prevention in infants – and whether a young child who is at risk of food allergy might build tolerance over time through eating rather than avoiding peanuts. The study, which is not considered conclusive, is not relevant to school-age children who already have food allergies, and who are under doctors’ orders to strictly avoid their allergens.
“He really twisted that study to make it seem like it applied to his theme,” says Dr. Robert Wood, chief of pediatric allergy and immunology at Johns Hopkins Children’s Center in Baltimore.
But if allergists and those living with food allergies were dissecting the Christakis article, others outside the affected community found his words rang true. Joel Stein, a high-profile humor columnist for the Los Angeles Times, wrote that Christakis’s column proves what he’s long thought: food allergies are made up by yuppie parents to make themselves feel special.
Broussard, author of the Harper’s article, jumped back into the fray, reprising her views online in The Huffington Post, contending that FAAN has purposely inflated fatality statistics in order to create an allusion of food allergy danger.
By the tail end of January, Christakis’s theory had found a kindred spirit in Dan Gardner, an Ottawa Citizen columnist who has written a book about irrational fears. At the start of an editorial on food allergy, he suggests that a bully in Washington state who had smeared an allergic teen’s face with peanut butter didn’t deserve a four-day assault conviction – since the judge’s premise that the attack “could have been fatal” was a myth. The focus of his piece? “Why so many parents of children with nut allergies live in a constant state of fear.”
Anaphylaxis Canada’s Harada wrote a persuasive letter to the editor, pointing out that school policies weren’t an over-reaction, that bullies using food as a weapon deserved prosecution, that with anaphylaxis even a tiny amount of an ingested allergen can cause a reaction (and yes, sometimes death), and that the number of children at risk of anaphylaxis is increasing.
But amid the growing chorus of doubters, it was hard to get noticed or heard. Parents, especially those who’ve witnessed a child in the throes of a serious reaction, were left to wonder: Why do people love to doubt this disease?
PERHAPS doubt and some backlash is inevitable – given that these allergies revolve around food. What sustains us? Food and drink. How can something as nourishing as tree nuts, for instance, so tasty and healthy to a majority of people, set off a cascade of dangerous symptoms of anaphylaxis? Viewed through the eyes of those unfamiliar with food allergy, it does seem hard to fathom that one group can’t eat what’s perfectly safe for the rest.
Harada also notes the social significance of food to humans. “Food is very emotional,” she says. “It comes into play in all aspects of our life: when someone’s born, and when someone has died; when you celebrate, and when you grieve.”
Dr. Mike Pistiner, a pediatric allergist in Leominster, Massachusetts, also thinks the rapid rise in the incidence rates of food allergy accounts for some of the conflict. “It may have turned into an issue faster than everyone else was ready to grow with it,” he says. “There may be people who are still dug into the concept that it doesn’t exist because it was so much less of an issue 20 years ago. But I do contest that if one of these parents’ children had a food allergy, they would very quickly see that it was very much real and it wasn’t in anybody’s head.”
Pistiner would know something about that: his 6-year-old son was diagnosed with a tree nut allergy two years ago and his family’s life quickly changed. “Many social situations focus around food,” he notes. Everything from eating in restaurants, visiting friends and family, birthday parties and play dates now require more questions, conversations, and worry. “What’s hard is when the families of children without food allergies don’t accept that this is life for the families with kids with food allergies.”
The diagnosis of any significant medical condition will alter a person’s life. But what sets food allergy apart is the need for the cooperation of others: whether that’s a separate pan at a restaurant or asking non-allergic children to wash their hands after eating or to avoid certain foods in their lunch bags.
“The one thing with food allergy,” says Pistiner, “is that it involves other people’s children. In some cases, it involves changes in classroom celebrations, and schools having policies of being ‘peanut aware’. Those have an impact on the kids without food allergy.” Harada agrees. She believes a lot of the resistance to accepting food allergies as serious stems from asking someone not to eat something, or not to bring something to school.
Managing food allergies requires participation from the community, which includes people who may not be convinced that changes are necessary. Because of this, the schools that deal with them best have clear, consistent policies in place that have been developed by people on all sides of the issue.
The school bus example given by Christakis “was an unfortunate incident,” says Pistiner, who has trained school nurses on practical food allergy management in the professor’s home state of Massachusetts, as well as New York and New Jersey. “But that’s not the way most schools are dealing with this.”
Dr. Susan Waserman, an allergist in Hamilton, Canada, is of the view that most parents, children and schools in North America are handling food allergies in a reasonable fashion. “You can always find people who are extremely anxious, who go overboard,” she says. “But by far, the majority of my food-allergic patients cope well and their responses are appropriate.”
Some anxiety does come with the diagnosis – it’s just that most allergy experts do not see the mass hysteria that Christakis identifies. Even if there is trepidation inherent in learning to cope, Muñoz-Furlong reminds us of the basics: “This is a medical condition, diagnosed by a physician. This is not parents deciding one day – ‘I think I’ll say my child is allergic to peanuts.'” She adds, “I think what these reporters are missing is that every one of the parents who has a kid with a food allergy wishes they didn’t.”
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