Peanut Allergy Tragedy: What Can Be Done Next Time?

Natalie-giorgi

Natalie Giorgi

I heard the news on TV in passing: a child dies of peanut allergy in California. I thought to myself,

“Oh no, not another mistake causing a child to lose their life to a food allergy.”

Later, I learn the details from the Internet and I’m even more stunned: a precious, strawberry blonde 13-year-old girl with a warm smile, Natalie Giorgi, ingests a homemade Rice Krispies bar that has peanut butter in it. Within minutes her life is in jeopardy and eventually lost.

She had all the X factors that should have saved her. Her family was with her at the family summer camp. Her father is a doctor, and gave her Epinephrine (Adrenaline) within minutes of her realizing she didn’t feel well after eating the Rice Krispie treat. Unfortunately, she went into anaphylactic shock (the most severe type of allergic reaction) and her airway closed up and she suffocated.

This horrendous scenario doesn’t happen often, but there are more close calls then anyone of us will ever realize, unless, of course, we have a family member who has a deadly food allergy. If this is the case, we know the fear first hand.

What can be done for the next Natalie Giorgi?

Families who deal with this allergy yell to ban the food. No more peanuts anywhere? Ban all tree nuts (why not shellfish, while you’re at it.) Probably not going to happen anytime soon. And I doubt this will solve the problem anyway.

My solution is to protect the immune system. Let’s take the fear out of the children and families who have food allergies by fooling their immune system into not over-reacting to the specific food. How can this be done? In my mind there are two relatively safe ways (not perfect, but safe enough that the benefit outweighs the risk in many cases.)

xolair

1. Once or twice a month patients take Xolair injections–a monoclonal antibody that binds to IgE (the allergy antibody) in allergic patients. It may not work in all cases, but many children would certainly benefit. It is approved for moderate to severe asthma, but has not been given the approval for food allergy, which is a shame. I had a very interesting patient several years ago that was highly allergic to tuna fish and salmon. She couldn’t even go out to a restaurant that served these fish because the smell would trigger an asthma attack. She was a teacher and she couldn’t go near student lockers because sometimes a child had a tuna sandwich in there and if she got a whiff, her asthma kicked in. One time her grandfather hugged her after eating a tuna sandwich an hour before, and sure enough she got hives on her neck. I used Xolair in this patient to help her asthma. There was a wonderful side effect: she no longer had allergic reactions around tuna or salmon. Of course I didn’t recommend she try eating these fish, but just being able to go out to a restaurant with her husband was a wonderful feeling. Interesting case, right?

2. Sublingual Allergy Immunotherapy for the food allergy. Sublingual therapy consists of taking drops under the tongue. It’s a treatment that is extremely user-friendly, and it

Water-drops

Allergy drops—safe and effective

involves no injections. Major studies done at Duke Medical Center show it to be an effective treatment. Researchers concluded that it was effective and safe, yet they still hold back recommending this treatment in daily practice. Why? I’m not sure. The common explanation is that they need more studies to confirm the findings. I agree that more studies would be great, but what about now?

In my book, Dr. Dean Mitchell’s Allergy and Asthma Solution, I have a section on Food Allergies which states that sublingual therapy is on the cusp of a great breakthrough. That was published 6 years ago!

More than ever we need the researchers to move the treatment of food allergies out of the medical centers and into the medical offices where the most children can be helped.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

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