Most parents worry when they send their children off to school. We wonder: Will she make friends? Will he succeed? Will her teacher be understanding? Will he remember to eat his sandwich at lunch?
But parents of children with food allergies have a deeper worry. Often pushed to the back of our minds, but always there is the worry about our child's fundamental safety in the hands of other adults. We worry that our child might accidentally come in contact with an allergen and have a reaction while we are not there. We worry that our child might die at school.
That's right, I said die. Food allergy deaths may be rare, but they do happen. And they happen in schools. Recently, Ammaria Johnson, a 7-year-old from Virginia, died after eating a peanut that a classmate gave her on the playground at school. Katelyn Carlson, a 13-year-old from Chicago, died last December after eating Chinese take-out in a classroom party.
A 2005 study published in Pediatrics states: "Anaphylactic reactions in schools, although not frequent, are not uncommon events." The study found an average of one case of anaphylaxis per year per school district. (Note this is a case of anaphylaxis, not a death from anaphylaxis. Anaphylaxis is treatable if epinephrine is at hand.) This worked out to about one case of anaphylaxis per 16,000 students per year. In comparison, the rate of cardiac arrest in schools is about 1 per 60,000 students a year. (Note that this is once again not a death rate, but a rate of cardiac arrest which is also treatable.)
Both of the girls who died had known food allergies and both had prescriptions for epinephrine auto-injectors. (Ammaria did not have one at school.) But many children with food allergies do not carry auto-injectors, perhaps because of cost, or because parents do not perceive the risk to be great enough. One-quarter of all cases of anaphylaxis in schools occurs to children who do not have a food allergy diagnosis at all.
The School Access to Emergency Epinephrine Act would allow schools to stock an auto-injector for use in allergic emergencies for children who do not have a prescription for an auto-injector or who have not brought theirs to school. Opponents of the bill argue that the chance of dying of anaphylaxis small, and not worth the cost associated with the purchase and maintenance of auto-injectors. However, most schools have automatic external defibrillators (AEDs) to assist children or staff that experience cardiac arrest, which is much less common than anaphylaxis.
The bill is supported by the Food Allergy and Anaphylaxis Network, the Food Allergy Initiative, the American Academy of Allergy, Asthma & Immunology, and the American Academy of Pediatrics. Manufacturers of auto-injectors clearly have a self-interest in the bill as well.
While the bill is not a complete solution - teachers and staff need to be trained to recognize the signs of an allergic reaction and treat it promptly - it would add a backup layer of protection for children in schools. It is a cost-effective lifesaver - at $120, an auto-injector is much cheaper than an AED device.
What it comes down to, simply is this. We have the means to prevent food allergy deaths in schools. It is easy to administer, low-cost, low-risk, and readily available. No more children should die because of lack of access to this lifesaving drug, or lack of knowledge of how to administer it. The School Access to Emergency Epinephrine Act is a partial solution, but it is a step in the right direction.
THANK YOU for this article. I have a mixture of reactions – from delighted about the new bill to shocked at the death rate. 1 child per district per year??? 12 children during my daughter’s K-12 experience? That’s quite alarming.
THANK YOU for this article. I have a mixture of reactions – from delighted about the new bill to shocked at the death rate. 1 child per district per year??? 13 children during my daughter’s K-12 experience? That’s quite alarming.
The rates of cardiac arrest and anaphylaxis in this article are NOT death rates. Anaphylaxis is treatable with epinephrine, and most of the time it is treated and children are completely fine in a day or so. Cardiac arrest is also often treatable with an AED.
It is uncommon for a child to experience anaphylaxis these days and not be treated promptly. But even one death is too many. Anaphylaxis does not equal death if the proper medicine is at hand, and if people are trained to recognize the symptoms and respond promptly!
I’m a HUGE FAN of the proposed law, it’s a big step in the right direction now that 8% of American schhol age children have a food allergy.
But here’s where the numbers get confusing….They are comparing incidents of Food Allergies with incidents of Cardiac Arrests in school. But if you google and read the story of poor Ammaria’s death, it was catagorized as cardiac arrest. She ate a peanut which caused anaphylaxis, the untreated anaphylaxis caused cardiac arrest, she succumbed to cardiac arrest. Every story I’ve read on the event headlines that she dies of a peanut, but buried near the end is she died of cardic arrest.
The end result is the same, Ammaria is gone forever. But these kind of statistics rob her of her voice to even name her killer from her grave. It was contact with her known allergen – NOT cardiac arrest.
Some researcher will bury themselves in numbers a couple years from now to determine the actual rate of death from food allergies in kids, and Ammaria’s case like so many others will not even surface because it was called a death by cardiac arrest.
There are many different ways this mis catagorization can go, cardiac arrest is only one example. Some would argue that now that ICD-10s are here we can begin more meaningful reporting, but that’s still largley not the case yet and may be quite awhile until they are used effectivley enough to cull accurate data with.
That’s my $.02. A huge THANK-YOU to all that support the new laws and the giant step forward to keeping our kids safe !!