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Lisa is writing from Kingston. She recently discovered that her four-year-old son is allergic to peanuts. There was a frightening experience where her child not only developed itching rashes and had swollen lips and tongue, but he just could not breathe. Thankfully, his doctor gave him some injections which resolved the condition before they even reached the hospital. But it was a truly frightening experience. Lisa asks Check Up how she can prevent another attack. She has heard that the allergy may not be curable, but is there any possibility of a cure?

Peanut allergy is a type of food allergy to peanuts. It is a serious allergy which can result in fatalities and must always be taken very seriously. The symptoms include itchiness, hives, swelling, eczema, sneezing, asthma, swelling of the face and tongue, diarrhoea, nausea and vomiting, dizziness, fainting, cardiac arrest and abdominal pain.

Prevention is not really fully documented and involves ‘forethought’. The pregnant woman would need to ingest peanuts as well as give it to her child in some form before he/ she is one year old maybe a little peanut butter. This is thought to give partial immunity to peanut allergy, as it does not always prevent the disorder. Peanut allergy is a common form of fatal or near-fatal allergy, and once identified must be taken seriously. People with peanut allergy may also develop cross reactivity to other nuts, peas, and, occasionally, some other legumes.

When even one parent has peanut allergy, it is acceptable to have young infants between 11 months and age four consume peanut protein. This has been found to delay or prevent peanut allergy from occurring. There is also no need to avoid peanut exposure during pregnancy or while breastfeeding if the unaffected parent is the mother.

There is no cure for peanut allergy other than strict avoidance of peanuts and food containing peanut. Because of this, an affected person (and family) will need to be careful what is purchased commercially. Even foods fried in the same pan or drinks from a blender, after it was used with a peanut blend, can cause an attack. However, sometimes the allergy will just go away in childhood all by itself. Studies show that in up to 20 per cent of children, this allergy will eventually resolve.

It is best for Lisa not to keep nuts at home, and to wash properly after eating any nuts outside her home if she will soon be needing to interact with her child. Casual skin contact is less likely to trigger a reaction but, for example, getting peanut butter in the eyes can trigger a reaction. Not all reactions are severe, but it is important to realise that it is unpredictable when a severe reaction will occur. Because of this, it’s important to obtain an Epi-pen, which should be kept in the child’s environment at all times, at home or at school. The teacher should be made aware of the situation and advised when the shot should be given by the school nurse. Generally speaking, it’s best just to avoid all nuts, as sometimes there is cross reactivity.

This allergy places a significant burden on all family members who must be educated about the need to keep even the smallest amounts of peanuts away from the affected child or adult. In addition to the Epinephrine auto-injector, antihistamine syrups and tablets should always be kept nearby and given at once if there’s any suspicion that exposure to peanuts has occurred. The vast majority of peanut allergic persons will tolerate being around peanuts as peanut does not travel through the air. But exposure to peanuts through saliva (from kissing) can trigger a reaction.

When you’re purchasing foods, do check the labels. Never assume that a product doesn’t contain peanuts! Check every time. And discourage your child from sharing lunch pans at school, which they commonly do. Peanut is common in baked goods and ice cream, energy bars, chocolate candies and salad dressings.