December 29, 1996 in Nation/World

Peanut Allergies Can Kill Children Schools Divided On How To Protect Kids From Lunch

By The Spokesman-Review

When he was a ninth-grader, Paul Manzardo had a winter holiday he’ll never forget.


“I spent Christmas Eve, Christmas Day and the next day in the hospital,” says the Coeur d’Alene man.

The culprit? Tiny pieces of peanut that dropped onto a doughnut. He ate them unknowingly, and his body began shutting down.

A growing number of people have food allergies, and reactions to peanuts are among the most severe. They can kill. The problem is getting national attention, thanks in part to a debate over what schools should do to protect allergic children.

There’s no debate about the seriousness of the problem.

Allergies typically cause hives and itching. Peanuts can send people into anaphylactic shock, which kills one time out of 10.

Survivors describe its onset as “this feeling of impending doom,” says Manzardo’s allergist, Dr. John Strimas.

“Usually, the first thing is either a little itching of the hands and feet, or itching in the throat, mouth, tongue,” says Strimas. “Then they’ll have more generalized itching and break out in hives. All this is happening fast.

“There’s a swelling of the tongue and throat, difficulty breathing. The lungs may start to tighten up. They’ll have abdominal cramps, diarrhea. Blood pressure falls.

“Eventually, the brain dies because of lack of blood flow.”

The only treatment is the injection of epinephrine, also known as Adrenalin. Some allergic people carry a pen-sized injector of the drug for emergencies. It must be used within 30 minutes.

At least five of every 100 people have food allergies. Common allergens include tree nuts, such as almonds and pecans, and peanuts, which are a legume.

The number appears to be increasing. A study in Baltimore found that the number of children allergic to peanuts doubled from 1984 to 1994.

Researchers are trying to find out what makes the popular food potentially deadly. Unlike many other food allergies, few people outgrow this one.

“Peanut allergy tends to be a long, if not a lifetime, problem,” says Strimas. “It becomes a project for a family to protect kids from peanuts and, as they get older, to teach them to deal with it.”

Manzardo’s lessons began early. He was 2 years old when he ate a peanut at the circus, went into shock and was whisked to the hospital.

As it turned out, he was allergic to a variety of foods. By the time he was kindergarten age, his parents were giving him responsibility for various medications. When he was old enough to date, they cautioned him against kissing any girl who’d just eaten peanuts.

“I never ate school lunches,” he says. “I always brought a brown bag to school.”

Peanuts are the leading cause of fatal food reactions in children. This year alone, at least three school children across the nation have died of peanut allergies.

There’s been little public attention to the issue in the Inland Northwest. But the debate over how schools should protect allergic children has been hot in the eastern United States.

Some schools have established “peanut-free” zones in cafeterias. A school in Ontario, Canada, banned peanut butter and other peanut products.

The issue has been especially controversial in Massachusetts, where two schools tried bans. Officials backed off after parents objected that their children were being deprived of a healthy food.

“Their heart was in the right place, but they quickly found out that’s not the way to address the problem,” says health activist Anne Munoz-Furlong.

Munoz-Furlong founded the Virginia-based Food Allergy Network after finding no one to help with her daughter’s food allergies. Bans don’t work, she says, because they are selective, sending the message that a peanut ban is worthwhile, but “your children with milk allergies or egg allergy aren’t important.”

Some parents of children with peanut allergies also oppose the bans, Munoz-Furlong says. “They want their children to be treated as normal.”

What does work? Education and preparation are the basis of a program created by the Food Allergy Network and endorsed by the National Association of School Nurses.

The program covers such topics as how to reduce risks in the cafeteria, how to eliminate problem foods from crafts projects and how to deal with teenagers and peer pressure.

“School districts should have almost a fire-drill type action if an allergic reaction does occur,” says Munoz-Furlong.

After the peanut controversy became national news, the American School Food Service Association sent its members an alert. It recommended the Food Allergy Network’s $75 information packet, and noted:

“Parents of a child with food allergies would work with the food service manager to identify any items and ingredients that could cause the child to have an allergic reaction.”

Inland Northwest food service directors contacted by a reporter say they haven’t heard specific concerns about peanuts, but they count on parents to let them know about allergies.

“We occasionally get calls from parents, saying ‘This is on the menu, can you give me some information about how it’s made?”’ says Rick Skinner, food service manager for Spokane’s public schools.

Cafeterias will provide an alternative food, if they have a note from the child’s doctor explaining the allergy and recommending menu substitutes.

“If they have a really severe, life-threatening allergy, they need to work closely with the food service supervisor,” says Patricia Ruyle, director of lunch programs for the Idaho Department of Education. “We can’t take complete responsibility.”

Responsibility for his diet has long been a fact of life for Manzardo, who is recreational sports coordinator at North Idaho College.

He’s outgrown allergies to dairy products, eggs and pollen, although he remains allergic to dogs, cats, dust and tree nuts such as walnuts and pecans. At age 27, he still won’t get near a peanut.

He knows better than to eat desserts at an office party, because he can’t be sure what’s in them. He avoids Thai food, which is heavy on peanuts.

His wife is careful not to leave crumbs around when she munches peanuts. His mom still calls from Michigan when she learns of some new food product that contains an allergen.

When he was growing up, he says, “My parents were paranoid I would get sick.”

But he’s learned to live with allergies. “If you grow up with it,” he says, “it’s not a big deal.”

, DataTimes ILLUSTRATION: Graphic: A peanut-free diet

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