Severe Allergies in the Classroom

The American Academy of Allergy, Asthma and Immunology (AAAAI) and the Food Allergy & Anaphylaxis Network (FAAN) are asking every parent of a child with food allergies or a known insect sting allergy to alert their child's school to the condition and have an action plan ready.

A potentially life-threatening allergic reaction, called anaphylaxis, can be triggered by exposure to one or more allergens, including foods, insect stings, drugs, and latex products. Anaphylaxis can affect multiple areas of the body (such as skin, respiratory tract, gastrointestinal tract and the cardiovascular system). Symptoms can include severe headache, nausea and vomiting, sneezing and coughing, hives, swelling of the lips, tongue and throat, itching all over the body, and anxiety. The most dangerous symptoms include difficulty breathing, a drop in blood pressure, and shock-all of which can be fatal.

"All school staff must be made aware of the potentially severe nature of an anaphylactic reaction," said S. Allan Bock, MD, and Chair of the AAAAI's Anaphylaxis Committee. "Parents need to work together with teachers, coaches and school nurses to avoid triggers and act quickly if a reaction occurs." To protect your child, and prevent anaphylaxis, the AAAAI and FAAN encourages parents to take the following steps before the school year begins:

-- Work with an allergist/immunologist to identify your child's triggers and reinforce these to your child. If possible, provide your child with a medical bracelet or necklace that identifies his or her specific allergy.

-- Tour your child's school or childcare facility before school starts, and meet with the staff to inquire about policies regarding foods and other potential triggers brought into the classroom.

-- Provide staff with information and resources to educate them about your child's allergy. Have your child's allergist/immunologist provide clear, written instructions on recognizing a reaction early and administering medication in case of a reaction. Inform staff to call 911 immediately if a reaction occurs.

-- Teach staff when and how to properly administer medications such as injectable epinephrine, encouraging them to handle the medication and ask questions. Explain to them that they cannot delay in administering medication to your child, and that they are obligated to assist your child and to include him or her in normal school activities. Children with a history of anaphylaxis should carry epinephrine with them at all times.

STRICT AVOIDANCE IS KEY

"There is no cure for anaphylaxis, so strict avoidance of triggers is the only way to keep a severe reaction from occurring," said Anne Munoz-Furlong, Founder & CEO of FAAN. "For children with severe allergies, even a small exposure can lead to anaphylaxis." The most common triggers for anaphylaxis are:

-- Foods -- Any food can trigger an allergic reaction, but the most common are: peanuts, nuts from trees (e.g., walnut, cashew, and Brazil nut), shellfish, fish, milk and eggs. It is important to talk to cafeteria staff and your child about what foods to avoid and not to trade food with other children.

-- Stinging Insects -- Venom of stinging insects such as yellow jackets, honeybees, paper wasps, hornets and fire ants can cause severe and deadly reactions. Recess exposes children to stinging insects. Teach your child where they are commonly located and how to avoid them.

-- Medications -- Any medication can trigger a reaction, but the most common drugs that cause anaphylaxis are antibiotics and anti-seizure medications. The school nurse should be aware of what medications your child is allergic to and should have epinephrine available in case of a severe reaction.

-- Latex -- Products made from natural latex (from the rubber tree) contain allergens that can trigger reactions in sensitive individuals. Inspect the toys in your child's classroom and inform their teacher about this allergy.

-- Exercise -- Although rare, exercise can trigger anaphylaxis after eating certain foods before beginning the activity. Inform your child's physical education teacher of this allergy, and check to see if your child can participate in physical activity before the lunch hour.

"For students, studies show that the most severe allergic reactions, especially to food, occur in the classroom," said Munoz-Furlong. "Parents, school administrators, teachers, and the school nurse need to develop an action plan before the school year begins to keep these students with allergies safe."

CONSULT WITH AN ALLERGIST/IMMUNOLOGIST

If your child has ever had an allergic reaction, or has a history of severe allergies, seek the care of an allergist/immunologist for a follow-up evaluation and to discuss treatment and environmental control options before the school year begins. An allergist/immunologist is the best-qualified medical professional trained to manage the prevention, diagnosis and treatment of allergic disease.

Once an allergy trigger is identified, an allergist/immunologist can provide detailed information about avoiding the substance. They also will prescribe self-injectable epinephrine, which temporarily reverses the allergic reaction. If a reaction occurs, inject epinephrine and call 911 immediately.

The AAAAI is the largest professional medical specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,000 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate to the public by providing educational information through its Web site at http://www.aaaai.org.

The Food Allergy & Anaphylaxis Network (FAAN) is a Virginia-based, nonprofit organization representing the 11 million Americans who have food allergies. Established in 1991, FAAN's mission is to raise public awareness, to provide advocacy and education, and to advance research on behalf of all those affected by food allergies and anaphylaxis. For more information, visit the FAAN Web site at http://www.foodallergy.org or call (800)-929-4040.

American Academy of Allergy, Asthma and Immunology

http://www.aaaai.org.
http://www.foodallergy.org