Sick notes

More children are at risk from an allergy to peanuts than is commonly believed. And public ignorance can be life-threatening, as Paul Field found out ...

Paul Field
Monday 29 April 1996 23:02 BST
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I have shied away from party games ever since I was 14. Not because I am a killjoy but because one nearly killed me. My forfeit for defaulting on a game was to be pinned down and force-fed a peanut.

I had told my friends several days before the party that I was allergic to peanuts. You name it, roasted, salted, chocolate-coated. But they treated it as a joke and had drunk too much cheap supermarket cider and bottles of Thunderbird wine to care.

However, they were horrified at what happened next. As they forced the single peanut closer and closer to my tightly closed mouth, my face and neck reddened, my lips swelled, my tongue tingled and my throat itched.

I struggled to push them off, but when they saw the panic in my eyes, they retreated anyway, aghast at what they had done. Once the peanut had been removed from my vicinity, I gradually recovered.

Ten years on, I am still encountering the same ignorance to an allergy that last year killed at least five people. Research from St Mary's Hospital, Isle of Wight, due to be published next month, is expected to show that one in 80 children is susceptible to an allergy to peanuts.

As a toddler, my parents never allowed me to eat peanut butter after noticing that if they ate peanuts in my company I cringed at the smell and complained of an itchy sensation in my lips and tongue, and at the back of my throat.

Biting into chocolates containing hazelnuts or coconut made me feel ill, even though I spat them out immediately. As I got older, Iavoided nuts altogether, choosing chocolates carefully out of a box, sticking to pork scratchings in pubs and checking that gateaux were always nut free.

But although I was cautious about what I ate, I never appreciated how dangerous the allergy was until five years ago, when I ate a Malaysian dish which, unknown to me, had peanuts in it. At first, I had the same reaction as I had had at the party. Only this time, within minutes, I felt my throat constricting and breathing became more and more difficult. I gulped down water, thinking it would help as it had done after the party incident.

I was taken to hospital, where I was given an antihistamine and and kept overnight for observation. The episode was treated as a joke by the nurses, who brought me breakfast, teasing me with a bowl of Crunchy Nut Cornflakes. There was no suggestion of referring me to an allergy consultant for tests.

It took the death of a woman in Ipswich for me to make an appointment to see a specialist. A radiographer friend told me that she had taken X-rays of the victim, who had died in the toilet of a Thai restaurant after eating a dish containing peanuts. She told me that I was stupid not to have armed myself with an anaphylaxis kit, containing an adrenaline pen and a packet of Piriton [an antihistamine]. These, she said, could save my life if I were to have a reaction to eating nuts, known as an anaphylactic shock, in which sufferers cannot breathe and lose control of their bodies.

I saw an allergy consultant at the Royal London Hospital who, after sending away a blood sample for tests, told me that my allergy to nuts was so severe it could be life-threatening and gave me a prescription for the kit.

The last thing I want to do now I have got it is to use it, so shopping, having a snack and eating out is a constant problem. In supermarkets, I have to check the ingredients on the side of the pack. My most recent discovery was that Frosties may contain traces of peanut.

The worst problem is in restaurants. Even if I am assured there are no nuts in a dish and that groundnut oil has not been used for cooking, I often become paranoid that I have eaten something containing nuts because of the way staff react to my questions: they always say that they think there are no nuts in a dish. I normally ask them to ask the chef to make sure, but I am seldom convinced that they do.

I have stopped eating Thai, Malaysian and Indonesian dishes, which are big on nuts. And no, I have never dipped my finger into a jar of peanut butter and licked it, which I am told is bliss. If I had, I'm sure that I wouldn't be here today. NUT ALLERGY - A PARENTS' GUIDE Research from the Allergy Clinic at Addenbrooke's Hospital NHS Trust, Cambridge, published last week, revealed a rise in potentially life-threatening peanut allergies among babies and children.

At what age can peanut products be given to babies? Nuts should never be given to children under three because of the risk of choking. Because infants are most susceptible to developing food allergies in the first few months of life, and peanuts are a common allergen (along with eggs, cow's milk, wheat, fish) doctors have usually advised that their introduction is delayed until eight months to one year. However, Cambridge researcher Dr Pamela Ewan now suggests delaying the introduction of peanut butter until age five for "at risk" babies and children - those born into families with a history of allergic disease such as asthma, allergic rhinitis (runny nose) hayfever and allergy-related eczema. Dr Ewan found babies that had already shown allergic reactions to egg, and to a lesser extent cow's milk, more at risk.

What about toddlers who are currently enjoying peanut butter? There is no need to stop eating peanut products in moderation as part of a balanced diet, if there is no adverse reaction.

What about other nut products? These can also trigger allergies. But fewer "at risk" children would be allergic to nuts other than peanuts.

Is there a test for peanut allergy? Tests are used by allergy specialists, but they are not 100 per cent reliable. The best indication is a strong family background of allergy.

Can children grow out of nut allergy?An allergy is usually a lifelong condition although severity may vary over time. There is no cure. The only way to avoid a reaction is to avoid peanuts.

Which foods contain peanuts? Biscuits, breakfast cereal, confectionery and chocolate bars, cakes, gateaux, savoury snacks, satay sauce, stuffing and readymeal Thai and Indian dishes can all contain peanuts. This is not a problem if they are packaged and ingredients labelled. Oriental (Malay, Thai, Indonesian, Indian) restaurants and takeaways often use peanuts and peanut oil for cooking. Peanut oil can also be called groundnut, monkey nut, goober and arachis oil. It may be used in salad dressings, canned sardines, mayonnaise, margarine and other cooking fats. Blended "vegetable oil" may also contain it and arachis oil is used in pharmaceuticals.

What should parents do if they suspect their child has a peanut allergy? Consult the family doctor immediately. Ask for referral to a specialist who will advise if it is necessary to carry adrenaline in case of anaphylactic shock.

Further help from the British Allergy Foundation Helpline 0171 600 6166 (Mon-Fri 10am-3pm). The Anaphylaxis Campaign, telephone 01252 318723.

JANETTE MARSHALL

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