Doctor warns people with peanut allergies to be vigilant

Dr Joe Fitzgibbon

Dr Joe Fitzgibbon

People with peanut allergies are being urged to be extra vigilant when eating out following two recent deaths from food allergy in the UK. One involved a 21-year-old footballer who died after suffering a severe allergic reaction to a curry containing peanuts.

The warning comes from a local doctor with a specialist interest in allergy, fatigue and nutrition who is also the author of a number of health books including Could it be an allergy?

Dr Joe Fitzgibbon, who practises at the Galway Clinic, says the allergy society in the UK notified him about the deaths.

“ I have received notification from the allergy society in the UK of two recent deaths from food allergy as well as several near misses occurring in people with known peanut allergy.

“The alarming thing is that they all reacted to curry from take-away restaurants that they were well used to frequenting. Something has changed in the ingredients. Usually, ground almonds (a relatively safer nut ) is used to thicken the curry base. But due to poor harvests this food has become much more expensive. It appears that ground peanut is being used instead. There may also be language issues in that ground almonds are ground nuts and ground nuts are another name for peanuts.”

He is urging people with peanut allergies to be particularly watchful when eating out. “It is really tragic when a young healthy person dies from a mouthful of food. The problems here [when eating out] are numerous. (1 ) Does the caterer understand the concept of this kind of allergy? Usually not. They will often think the customer is just fussy and what they can’t see won’t upset them. So, they may well pick out the offending food (eg, peanuts out of a Peking duck dish ) and serve the contaminated dish as ‘nut free’. (2 ) Does the caterer/waiter/chef understand the language (simple but increasingly relevant in our multicultural society and frequent travelling habits ) (3 ). Does the caterer know the ingredients in multi-ingredient products which they use?”

Contamination is another issue of concern. “We understand very well the concept of germs and food poisoning. We have colour coded kitchens now to prevent the spread of germs from uncooked foods to cooked foods, for example. We need to adopt the same precautions when dealing with allergen as we do when we deal with germs. If you were sitting in the sun enjoying a meal and a seagull swooped overhead and pooped in your dinner what would you do? Would you (a ) scoop out the poop with a spoon and finish the rest of your meal? Or (b ) discard the entire meal and order a fresh one? The correct answer is (b )!”

He advises allergy sufferers to get a card printed (credit card size ) outlining their allergies, the allergens and the possible life threatening results and to carry it at all times. It should be translated into different languages for people going on holiday.

The most common food allergens are egg, cow’s milk, wheat, soy, peanut, brazil nut, fish, shellfish, mustard, sesame, and celery.

“Together these account for the vast majority of allergies in our society. Other foods may also cause trouble of course, kiwi, strawberry, lentil, etc.”

Up to eight per cent of toddlers have a degree of food allergy but most are of fairly minor significance, according to Dr Fitzgibbon.

“Only a very small proportion will develop into anaphylaxis [a rapidly progressive and potentially fatal allergic reaction to food, medication or insect stings.] The percentage of adults affected is much smaller indicating that children with allergies very often ‘grow out of them’ in time.

“The important thing is to identify what you are allergic to. This can be done safely and quickly with a skin prick test by a doctor with an interest in allergy. Blood tests can also be used but they are less sensitive, take longer.”

The “alternative” methods of diagnosing allergy are dangerously misleading, he claims.

He strongly believes patients with life threatening allergy or potentially life threatening allergy should have a medical assessment.

“What makes an allergy life threatening is (1 ) sudden severe asthma (difficulty breathing ), (2 ) cardiovascular collapse (falling unconcious ) and (3 ) airway obstruction (hoarseness and noisy breathing leading to laryngeal closure ). Patients who have a history of asthma appear to be at greater risk so make sure your asthma is well controlled at all times, especially if you are at risk of anaphylaxis.”

 

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