Complete information on peanut allergy

Peanuts, one of the most loved snacks, can cause severe allergies in many people. The allergy is prevalent among 1.3 % of the population Peanuts cause type I hypersensitivity reaction in those people susceptible to peanut allergy and can lead to symptoms that are sever in nature.

Allergy caused due to consumption of peanut results in the maximum number of deaths due to food allergy. According to food allergy network, the following are the leading causes of food allergies that can cause serious symptoms

S.No	Food Type
1	Peanuts
2	Shell fish
3	Fish
4	Tree nut
5	Eggs

There is an estimated 60% chance for those who have peanut allergy to develop tree nut allergy. Tree nuts include walnuts, cashew nuts, almonds and many others.

An allergic reaction towards peanuts may be caused due to any one of the following reasons:

• If the individual has a first degree relative who is susceptible to food allergies, then there is a higher chance of having peanut allergy.
• Studies have also indicated a relation between using soy milk and soy milk products and peanut allergy
• Similar studies on peanut allergy have also stated that exposing children to peanuts at an earlier age build better resistance to peanut allergy.
• Babies born 3 weeks ahead are 10% more likely to be affected by peanut allergy according to Professor Crandon Woodie of Harvard Medical School.
• This type of food allergy is more commonly found among children than adults
• People who tend to have peanut allergy outgrow it, however recurrence is a possibility.
• People with eczema(Atopic dermatitis) have been found to have food allergy

There are 3 modes of peanut ingestion that has been found to cause peanut allergy and they are

1. Direct ingestion: Peanuts when ingested as such or as derived products can be termed as direct ingestion.
2. Indirect ingestion: Peanuts when ingested as a result of inadvertent lacing of a food product is termed as indirect ingestion. Sometimes a food that normally does not contain peanuts may be exposed to peanuts or its products like flour or oil due to improper handling. Allergy caused due to ingestion of such foods make it difficult to ascertain the root cause.
3. Inhalation: When peanut products like peanut flour or peanut oil from oil sprays are inhaled the symptoms will set in and give rise to peanut allergy.

The defense mechanism of the body reacts to the proteins present in the peanuts and mounts an immune response that increases the level of histamine in the body. The histamine increase results in the symptoms of peanut allergy.

The symptoms for peanut food allergy could vary from mild to severe. The mild form of allergy is characterized by the presence of urticaria or hives along with swelling and redness of the skin. These peanut allergy rashes are evident soon after ingestion. The area around the mouth and throat will be itchy and a tingling sensation will be felt. The chest will feel tight and diarrhea, stomach cramps, nausea and vomiting are other symptoms. The nose may be runny or stuffy and this may be associated with shortness of breath or wheezing.

In certain cases, peanut allergy could become very severe and lead to anaphylactic shock. This is characterized by the airways becoming constricted and a difficulty breathing as the throat swells up. The peanut allergy may cause dizziness or loss of consciousness. Rapid pulse and very low blood pressure are other symptoms of anaphylactic shock caused as a result of peanut allergy.

Nearly one third of the patients who suffer from this allergy are affected with fatal or near fatal anaphylactic shock. An increase in peanut allergy among children have been reported in the U.S

Complete avoidance of peanut is the only option to prevent peanut allergy, however peanut is usually used as an adulterant in many different food and it would be difficult to establish whether a particular dish is laced with peanuts. The contents of all processed food items should be checked for the presence of peanuts and products made in a factory that makes peanuts should also be treated with caution. Even very small traces of peanuts could cause an allergy in some people so extreme care should be taken to avoid peanuts at all costs.

Anaphylactic shock which is seen among a few patients with peanut allergy can be treated with epinephrine. Epinephrine helps the body revert to normal.

• Constriction of blood vessels happens quickly
• The heart rate increases
• Muscles in the lung are relaxed
• The swelling around the face and throat stop

A study on peanut desensitization by injection was carried out in 1996 to help people with peanut allergy to get used to the peanut allergen. Small increases in doses of the allergen were given to the patients. However one of the patients died due to laryngospasm as the level of increase in dosage was incorrect due to a pharmacological error. This resulted in the study being stopped and no further study was conducted.

Adenbrooke's hospital in Cambridge England claims success in oral peanut desensitization, where small amounts of peanut protein were provided to eight children with peanut allergy. This method adopted a safer method of oral rush immunotherapy.

Dr Mohammed Ahmedna from North Carolina Agricultural and Technical state university has developed a method wherein allergen free peanuts could be produces. The taste and the texture remained the same.

Laws about peanut allergy include the following that have been passed to aid and benefit those who suffer from peanut allergy.

1. Food Allergen Labeling and Consumer Protection Act (FALCPA) 2004 ( public law 108-882 , title II)
   According to this act, 8 major food item should be labeled using common names that the general public would understand. These 8 allergens include peanuts, milk, egg, fish, shellfish, tree nuts, wheat and soybeans.
2. American with Disabilities Act(ADA)
   Americans who suffer from food allergies including peanut allergy are included in this ADA. When they eat at a restaurant, they can ask for certain reasonable modifications that would avoid the use of peanuts. However, these modifications to the meal need to be reasonable and only to avoid the usage of peanuts.
3. Sec 504 of the rehabilitation act
   This act states that those with food allergy, including peanut allergy, should not be subjected to discrimination or bias under any program or activity receiving federal grants.
4. US State laws
   Many US states allow children to take prescribed epinephrine to school as a precaution

Many of these laws especially the Food allergen Labeling and Consumer Protection Act are peanut butter allergies and case laws that have been enforced to ensure protection after trauma experienced by many people suffering with peanut allergies. Peanut and tree nut allergy in children are a cause of great concern and these laws are expected to protect them.

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