Karen Leister currently serves the Chatham, NJ community as the school nurse at Southern Boulevard School and as the school district’s Nursing Team Leader. She spoke about food allergies at the January 17 Kiwanis breakfast meeting. Her career spans 27 years and she has receive awards in the fields of food allergy and anaphylaxis.
Karen learned about food allergies at an early age because she is allergic to fish. Allergies run in the family – her brother is allergic to sesame. Two of her children also have allergies. Karen developed a keen interest in the field and now has a detailed understanding of food allergies and related emergency treatments.
Food allergies are on the rise in the whole population and especially among children. Thirty-four (6.8 percent) of the 496 students at Southern Boulevard School have severe food allergies. Adult staff statistics are much lower, about 4 percent. These percentages reflect the national trend. She went on to talk about managing food allergies in and out of the school environment. She asked if anyone in the audience has food allergies in their families and many Kiwanis members shared what food they are allergic to.
The incidence of peanut allergy doubled between 1997 and 2002. It is not known exactly why the incidence of allergies is growing. Anaphylaxis is a very serious allergic reaction that has a rapid onset and can result in death -aid is needed quickly. Approximately 50,000 to 125,000 emergency room visits are caused each year by allergic reactions.
Symptoms of a reaction are swelling, hives, eczema, and rash (like a sunburn). Many other more serious symptoms exist. These are a reaction of the body’s immune system. The body generates histamines to rid the body of allergens and the histamines cause serious reactions.
Karen showed a model of the Mast cell (see above photo), the white blood cell that is implicated in the allergic reaction. She explained how the cell works and what histamine does to the body.
Eight foods in the United States cause 90 percent of the anaphylactic reactions: peanuts, tree-nuts, fish, shellfish, milk, eggs, wheat, and soy. In Canada, a ninth food is sesame. Allergies can be outgrown. (Children with asthma also frequently have food allergies.)
Benadryl is an antihistamine medicine which works against histamines. It is administered orally for less severe reactions and requires about 20 minutes to take effect. Epinephrine is administered using an EpiPen for severe reactions where urgent treatment is needed. Karen showed how it is administered into leg muscle. 911 must be called when an EpiPen is administered.
She also explained other conditions, like lactose intolerance, which are not strictly allergic reactions.
In school, children are taught to read labels. No label? No thank-you. Even non-food products need to be examined for allergens. Cross-contamination is a problem in food preparation. To illustrate the importance of reading labels, Karen gave commercial food packages to members of the audience and asked them to look for allergens in the ingredients. For example, Ritz bits cheese crackers contain peanuts.
Karen told about a student (who is allergic to milk) who drank Gatorade and discovered after reading the label that it contained milk. Gatorade had changed their product offering to include three different drinks: before, during and after exercise. The “after” contains milk to supply protein. Karen had to administer an EpiPen to the boy. You have to read the label all the time.
Preparations for treatment are needed. You need to have your medication with you all the time. You need to be able to recognize the symptoms. You need to have a food allergy action plan. Medic “alert jewelry” is a good idea.
The school provides a safety net under kids who have food allergies. Eating is always supervised. EpiPen designees are assigned and trained. Health classes cover food allergies. Teaching and other staff are trained. Individualized student health-care plans are prepared. Emergency health-care plans are written. Food sharing is prohibited. Parents are sent “holiday reminder”.
The Southern Boulevard School chose strategies that maintain a safe environment. They also teach the students simple strategies that they can use outside of school. There is a safe snack basket in every class, and peanut-free pal zone (table in the cafeteria). Children are taught to continue to manage their own allergies after they graduate from school.
Mary Anne Maloney (L) thanked Karen (R) for teaching Kiwanis about food Allergies.
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