1. Food Allergies

2. What is a Food Allergy?
Immunological response to food (allergic reaction)
Body protecting itself – release of histamine
Affects multiple body systems: GI
Respiratory
Skin
Cardiovascular
Exposure can cause serious problems or death
Some affects are visible (hives, coughing, vomitting) and some are not (drop in blood pressure)

3. Gastrointestinal Tract
Symptoms
Allergy symptoms can occur seconds to hours after ingestion of the allergen
Most common symptoms:
swelling, sneezing, nausea, GI distress
Skin
Swelling of lips, tongue & face
Itchy eyes
Hives
Rash
Respiratory Tract
Itching or tightness of throat
Shortness of breath
Dry or raspy cough
Runny nose
wheezing
Gastrointestinal Tract
Abdominal pain
Nausea
Vomiting
diarrhea
Symptoms of food allergies vary between individuals but the most common are swelling, sneezing, nausea, digestive problems, hives or swollen airways. Others include itchy eyes, hives, skin rash, tightness of the throat, shortness of breath, runny nose, abdominal pain, nausuea, vomiting and diarrhea.

4. Intolerance vs. Allergy
Reaction to the chemicals in food
No immune system response
No serious (life-threatening) side-effects
Bloating, gas, abdominal discomfort
Public impression
Parental interaction
Many people believe that food allergies and food intolerances are the same thing

5. The Big 8 What the experts say
Eight foods account for 90% of all reactions

6. Peanut Allergy Specific
1/250 of a peanut is enough to trigger a reaction (cutting a peanut in half 125 times!) Hourihane, J. J Allergy Clin Immunol 1997
Severe allergies are typically life-long
High cross-reactivity to tree nuts (almonds, walnuts, etc.)
Although some do outgrow peanut allergies, those individuals tend to have meticulous avoidance, no history of anaphylaxis, smaller skin/blood test results, fewer food allergies in general.
Peanut allergic individual are strongly recommended to avoid all tree nuts as well

7. What is anaphylaxis? Most severe allergic reaction
Involves multiple systems at the same time
Potentially fatal, especially if medication is not given promptly (at first signs)
Most severe
Hives and vomiting, difficulty breathing and swelling, any combination
Most fatalities that occurred when medication was given was the result of medication not being given soon enough. If you suspect a child is having a reaction…you must give medication. You can not wait to see if the reaction will get worse or bad enough. In fact, for some children, if you suspect they have ingested an allergen, even if signs of a reaction have not yet been seen (you saw them eat a bite of PB&J), medication should be administered. Although each individual plan may differ, in general you do not want to see if a reaction will progress before you make a decision about medication. It can progress to quickly and time is precious
Why is this important for you to understand: some schools require medication be kept in the nurses station or a locked cabinet. People feel kids should NOT be allowed to carry medication with them…THIS IS S PROBLEM…6 minutes to run to the nurse’s station, find the key, ect.
FEAST story of changing the Epi-pen due to expiration

8. Avoiding Cross-Contamination
Food proximity (same plate, same bag, same platter)
Using the same utensil
Using the same area/surface
Not cleaning the area/plate/utensil thoroughly
Using the same cooking material/machine (toaster)
Transfer of allergens (nut falling into a plate, but plate not getting clean)
Notice sources of cross-contact here… NAME SOME
Cross-contamination at risk foods: NAME SOME

9. What to do
Require thorough hand washing and teeth brushing especially if you suspect a student has eaten peanuts/nuts
Clean eating and working areas carefully
Discourage food sharing
Have “safe” snacks and treats from family
Do not allow homemade goodies or home prepared foods (e.g. apples cut at home)

10. Label Reading
Food Allergen Labeling and Consumer Protection Act (FALCPA)
As of January 1, 2006, labels must list common language for the top 8 allergens
Reading labels carefully can save a child’s life
Foods can be analogous to poison
Top 8 allergens must be clearly stated in ingredient list.
May have Contains statement
May have cross-contamination statement

11. Standard Label
From the picture on the box, it does not appear that there are nuts in this product. Is it safe?

12. “Contains” Statements

13. Warning Labels
May also say “manufactured in a facility that also processes peanuts”

14. How Can We Keep Customers Safe
Know your ingredients
Sanitize frequently
Use proper equipment