Not so nuts about nuts

SOME might argue that their loved oneâ€â„¢s cooking could kill them but while a dodgy chicken curry might result in a dicky tummy for a few days, there are perfectly normal, everyday foods that can put people in the Emergency Department or, at worst, put their lives at serious risk. The past decade has seen plenty of dubious experts telling us that weâ€â„¢re allergic to anything from pork chops to chickpeas and while there are many genuine food allergy tests that can be carried out, there are plenty of others that give results akin to banning you from anything in the fridge and send you shopping to the speciality aisles. Galway paediatrician Dr Edina Moylett is an expert in allergies in children and is currently involved in a study on peanut allergies in children and how food allergies are managed in schools. There arenâ€â„¢t any specific numbers to say how many people suffer from food allergies in Ireland but she believes they are similar to the UK and mainland Europe. And, for some unknown reason, allergies are on the rise. According to Dr Moylett, about 25 per cent of people perceive they are allergic to a food but when they are properly tested, only three per cent will be diagnosed with an actual food allergy. About five per cent of children will suffer from a food allergy and the most common are milk and eggs, which usually present within the first six to 12 months. â€Å“Itâ€â„¢s unusual for a child to develop a milk allergy after the age of five. Other foods can present as problem and there is a genetic predisposition for certain food allergies,â€Â says Dr Moylett. Common symptoms of an allergic reaction to a food are hives, a rash, vomiting and more serious symptoms can be swelling around the eyes or lips and difficulties in breathing. Anaphylaxis is a rare but life-threatening reaction to a food that can happen in children but is more prevalent in teenagers and adults. Parents, she says, need to be aware of that risk and that a child could develop an anaphylactic reaction. A person might have always been allergic to a certain food, but unless they have actually eaten it, then they wouldnâ€â„¢t have realised it. Tuam schoolboy Tommy Lyons always hated the smell of peanuts and perhaps it was his bodyâ€â„¢s instinctive way of warning him to stay away from them. After a family meal at a Chinese restaurant about 18 months ago, the now seven-year-old complained that his mouth felt tingly. He took a drink but it didnâ€â„¢t ease the sensation and his mother Fiona noticed that his face began to puff up. His throat was itchy and within a few seconds he was bent over in pain. The family went home and later that night Tommy got sick. It was a few days before Christmas and their doctor advised to keep Tommy away from nuts over the holidays. An appointment with an allergy consultant, Dr Joe Fitzgibbons in Galway, confirmed through skin and blood tests that Tommy had a severe allergy to peanuts. â€Å“I suppose he never really had peanuts up to that because he never liked the smell of them,â€Â says mum Fiona, who has worked with the rest of the family to make their house a nut-free home. Fiona says that while Tommyâ€â„¢s first allergic reaction wasnâ€â„¢t life-threatening, there is a risk that any subsequent one could be worse, and even fatal. The family is extremely vigilant about the food that comes into their home and Tommy is his best protector - reading all of the packaging before it goes into the trolley. â€Å“Heâ€â„¢s great for looking at the labels and he double checks everything. He has taken on the responsibility himself now, because heâ€â„¢s old enough to understand,â€Â says Fiona. Tommyâ€â„¢s school has been very supportive and all his friends and relatives are aware of his allergy. He doesnâ€â„¢t lose out on treats and the family have found plenty of nut-free versions of foods and bake a lot at home. â€Å“We keep life as normal as possible. We just make people aware of Tommyâ€â„¢s allergy. He carries an epi-pen with him at all times and also wears a wristband and pendant highlighting his allergy,â€Â says dad Kieran. Dr Moylett and some of her students are looking into the knowledge and awareness of allergies in primary schools in Co Galway. Questionnaires were sent to about 100 schools in the city and county asking about the number of students with known allergies, if there was medication in the school, does the school have an action plan in place and whether staff are trained in how and when to use it. â€Å“Weâ€â„¢re still gathering data, but from the information we have received to date, all of the schools are interested in attending an education session on learning more about allergies and how best to deal with them,â€Â she said. Dr Moylett says the number of people with allergies is increasing, especially around peanuts and tree nuts. The majority, about 80 per cent, of children with milk and egg allergies will grow out it as they get older but this isnâ€â„¢t the case for those with nut or shellfish allergies, they are pretty much allergies for life. Dr Moylett understands the fears of parents who have a child with a food allergy. â€Å“Many of them are scared, and understandably so. While your children are a baby, they are with you but once they get older and are no longer in your safe environment or control, concerns are heightened. This is why itâ€â„¢s important to educate people to empower them to deal with situations should the need arise and it also reassures parents whose children are at school that the school knows what to do in an emergency,â€Â she remarked. â€Å“Real life is not nut-free,â€Â says Dr Moylett. Children with nut allergies quickly learn how to cope with their allergy and get used to taking precautions with food. Galway is fortunate to have an allergy clinic but there is a long waiting list as it caters for patients in the entire western region. â€Å“We try to give an appointment according to the severity of an allergy and priority cases are seen within four to six weeks while those who have suffered a mild reaction are usually seen within three to four months,â€Â explains Dr Moylett. She stressed that a fatal reaction to a food is extremely rare in children but that it is still possible. â€Å“Some people are very proactive but I have had some parents give a child with a nut allergy a nut bar in the clinic,â€Â she recalls. Food allergy testing has had its fair share of crazes and itâ€â„¢s an area that seems to attract pop-up shop types of service. Dr Moylett points out that allergies are diagnosed on a patientâ€â„¢s history and confirmed by using special skin and blood tests, which are carried out by a consultant or GP. Food intolerances are often perceived as the same as food allergies but they do not pose any serious risk to the person. As there is no cure for a nut allergy, strict avoidance is the only way to deal with it. Fiona and Kieran have found some food labels easier than others to see if a product is genuinely nut-free. Kieran feels that some manufacturers are covering themselves by putting a get-out clause, such as â€Å“cannot guarantee nut-freeâ€Â on the packaging. Going out to eat is also challenging because even trace amounts of nuts can happen as a result of cross contamination. Kieran would favour a uniform, absolutely nut-free label that food manufacturers would have to use. At the moment EU law states that manufacturers must list nuts as an ingredient but the law doesnâ€â„¢t cover the risk of cross contamination. The Lyons have found that ingredients change from time to time and that a previously nut-free product might not be that in six months time and so they look at the labels each and every time, just to be sure. They have found great support from Anaphylaxis Ireland and Tommy has attended a number of their childrenâ€â„¢s workshops in Dublin. They have met other families in Dublin and locally. â€Å“Itâ€â„¢s nice to know there is someone else in a similar situation. You always pick up information or tips from other parents too,â€Â says Fiona.