Managing Food Allergies In The School System

Sep 4, 2014

The most common allergens- fish, shellfish, wheat, peanuts, soy, tree nuts, milk, and eggs.
Credit therootofhealth.com

Original air date 9-03-14

For some parents, the beginning of the school year has scarier implications than a child riding the bus for the first time or not finding the right classroom. Food allergies are on the rise, and in USD 259 Wichita Public Schools, students and staff and parents have to be more vigilant than ever. KMUW’s Abigail Wilson has more…

Children at Wichita’s Bostic Elementary are deciding what to have for lunch. They stand in a straight line, wearing red, white, and blue uniforms--neatly tucked in polo shirts and perfectly tied tiny shoes. But for some children, the lunch line and the cafeteria can be scary places--because they have food allergies.

One Wichita student is sharing his story. Sean Whalen is 13 years old. He is confident and smart; more sociable than your average teenaged boy. The lanyard he wears around his neck holds a Robinson Middle School ID card.

Sean has a peanut allergy.

“I haven't had a reaction in quite a while,” Sean says. “But I’ve had minor reactions and it's not good.”

Sean was first diagnosed with an allergy when he was 6 months old.

Vanessa and Sean Whalen.
Credit Abigail Wilson

“What happens when I have a major reaction is sometimes I get hives on my face, blotches on my stomach,” he explains. “I start to swell up - my face starts to swell up and then my neck starts to swell up - and I can't breathe. I'm short of breath.”

As an infant, Sean was found to be allergic to wheat, dairy, egg and peanuts. His mother Vanessa gives a relieved smile remembering the diagnosis.

“The nurse practitioner called me later and asked me if I wanted some Zoloft to go along with that diagnosis because she thought, ‘Oh my goodness, you’re going to have a hard road here.’ But it ended up that he really held onto the egg allergy and the peanut allergy for quite some time,” she says. “He still has the peanut allergy but the egg allergy went away at about age three. But it was very scary from that point on because then you have to try to keep him safe.”

The last time Sean had a full-blown allergic reaction was about five years ago. His family calls it the “Christmas tree incident” because they were at a Christmas tree farm when his reaction began. Sean ate a cookie, and it went downhill from there.

“That was my fault because I was like 'I want that cookie, but I know it's right by a peanuty item. but I want that cookie. I’m going to get that cookie.' And that ended badly.” Sean says.

When the reaction started, Sean says he took some Benadryl. But he was far from in the clear.

“Later that night I had a secondary reaction,” Sean explains. “It was kind of delayed and that was the worst. It was scary--just imagine waking up in the middle of the night and you cannot breathe. And you just have to rush to the ER and get treated.”

USD 259 - Wichita Public Schools reported around 1800 documented food allergies already this school year, and the number is expected to rise. And even though the law allows it, USD 259 doesn’t stock epinephrine in schools. That means students who have life-threatening allergies, like Sean, are expected to supply their own doctor-prescribed EpiPens and be accountable for their allergies. The school district has taken steps to help eliminate allergic reactions though, especially in the cafeteria.

Megan Fogarty in her office.
Credit Abigail Wilson

The mini pizzas, salads, sandwiches and all of the other food served daily in USD 259 is prepared, cooked, and refrigerated in this massive bustling warehouse just off K-96 on Hydraulic. Red hot ovens line one wall. A walk-in freezer the size of a small apartment is on another.

“Most of the students can avoid their allergen or their food intolerance just by choosing a different food," says Megan Fogarty, the district’s registered dietician. "So our kids with nut allergies, egg allergies, lactose intolerance, it’s pretty easy for them. With our students who have gluten intolerance, then that’s where we do need to send out a couple of substitute items for lunch and rice or corn based cereals at breakfast for them to have.”

Inside the freezer at the USD 259 warehouse.
Credit Abigail Wilson

Fogarty says the district serves a lot of food that comes pre-made to the warehouse, reducing the chance of cross contamination from food which kids without allergies are able to eat.

“For instance, our peanut butter and jelly sandwiches are a packaged product so that’s generally going to just that student. No one’s spreading peanut butter with a knife or on a cutting board or anything like that so we run a pretty low risk,” she says.

According to a report last year from the Center for Disease Control or CDC, the number of children with food allergies in the U.S. rose 50 percent between 1997 and 2011. So why such a steep increase?

Dr. Laura Veras displays two different brands of epinephrine auto-injectors she prescribes to patients.
Credit Abigail Wilson

Dr. Laura Veras works at the Via Christi Allergy and Immunology Clinic in Wichita.

“Basically you can be allergic to anything, but the major food allergens are milk, egg, wheat, soy, peanuts, tree nuts and seafood, both fish and shellfish,” says Veras.

One thing most people don’t know is that peanuts aren’t technically nuts.

“They’re actually not in the same family as tree nuts,” she says. “They’re actually in the legume family, so they’re more related to beans.”

Tree nuts include walnuts, almonds, hazelnuts, cashews, pistachios, and Brazil nuts. She references a popular theory on the increase in food allergies called the hygiene hypothesis.

“In the developed world, because your environment is so clean and you’re not exposed to pathogens or parasites that normally children are fighting off, your immune system actually shifts to a response that might not be beneficial for you,” she says.

Dr. Veras says the research on the increase in food allergies extends to the method of delivery for babies. Babies born by C-section are more likely to be sensitized to foods.

“That little moment of the baby going through the birth canal and being exposed to mom’s bacteria, it’s actually helpful in training the immune system properly to be less reactive to things that are not going to be important, like a food allergy,” says Dr. Veras.

Credit Abigail Wilson

Other factors such as growing up around livestock and just simply playing in the dirt can affect the occurrence of a food allergy too, Veras says. In early childhood, boys are more likely to have food allergies but after puberty, more girls present an allergy. But in Sean’s case, his severe peanut allergy isn’t likely to go away.

“A child that is allergic to peanut has a 20 percent chance of outgrowing their peanut allergy. It’s not impossible, but if you compare it to milk and egg, it’s significantly lower,” says Dr. Veras. “The other thing is that peanut and tree nut allergies are actually risk factors for more sever allergic reactions.”

But Sean says he’s learned his lesson, and even though he’s not excited about it, he will use his EpiPen in the future. Fingers-crossed, he won’t have another severe reaction, and thanks to his self-discipline, the odds seem in his favor.

“I’m careful about it. I check every label. That’s a routine for me. Every time we go to the store, if I want something new I check the label and make sure it’s safe,” he says. “It’s not that hard because it’s kind of daily life. I’ve lived with it for a while now.”

Checking labels and watching for cross-contamination is something Sean will likely have to do for the rest of his life. As will the nearly 6 million children in the U.S. who have food allergies.

Food is made in the USD 259 warehouse.
Credit Abigail Wilson