Can the future of peanut allergy be predicted in infants with egg and milk allergy?

10 May 2010: Early results from a study of more than 500 infants with egg or milk allergy indicate that they are highly likely to test positive for allergic antibodies that are specific to peanuts. This unexpected finding suggests that these infants are at risk for developing peanut allergy later in life and should be evaluated by a health care professional before introducing peanuts into their diet.

The findings appear in the May issue of the Journal of Allergy and Clinical Immunology. These are the first published results from the clinical group of the Consortium of Food Allergy Research (CoFAR), a major food allergy research program supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health.

Eggs, milk and peanuts are the three most common allergenic foods for infants. An infant who already has a milk or egg allergy is known to be at risk for later developing a peanut allergy. Another risk factor for peanut allergy is moderate to severe eczema (atopic dermatitis). This is the first systematic study, however, of the natural development of these three food allergies in very young children.

This observational study has enrolled infants between 3 and 15 months old. All have immunoglobulin E (IgE) antibodies to egg or milk. Some of these infants have known clinical allergy to eggs or milk, some have moderate to severe eczema, and some have both allergy and eczema. None of the infants has known peanut allergy. These infants will be followed until 5 years of age to see if their allergy to milk or eggs continues or resolves, and to see if they develop an additional allergy to peanuts.

As part of the initial assessment of the infants, the CoFAR investigators measured the level of IgE antibody to peanuts. They made two unexpected observations: More of the infants have elevated levels of IgE antibody to peanuts than the investigators had anticipated, and some of these infants have such high levels that they may already be allergic to peanuts without their parents being aware of it.

The researchers encourage parents of children with egg or milk allergy to talk to their doctor before incorporating peanuts or peanut products into their child's diet.

Source: www.niaid.nih.gov


Article: SH Sicherer et al. Immunologic features of infants with milk or egg allergy enrolled in an observational study (CoFAR) of food allergy. Journal of Allergy and Clinical Immunology. DOI: 10.1016/j.jaci.2010.02.038 (2010).

Allergy Awareness Week kicks off 16-22 May

The theme for this year’s Allergy Awareness Week (16-22 May) is ‘Allergies — no walk in the park’.

Do you find that one of the hardest parts of dealing with an allergy is having people take it seriously? For most of us, once our - or our kids' - allergies are diagnosed and managed, we look like anyone else (although more healthy I think!). So the focus is then on convincing people that it is, indeed, a condition that must be taken seriously.

The aim of Allergy Awareness Week is draw to people's attention the significant impact allergies have on individuals and families.

Can you help?


In order for Allergy Awareness Week to be a success, we need you — members of our allergic community — to get behind us by:

• Contacting your school or community library to see if they can put up a display
• Volunteering yourself to be interviewed by your local media to highlight the impact allergies have on your life. This can be any type of allergy, and the focus is on how the support of those around you made the difference.

If you can help Allergy New Zealand with schools and libraries, please email mail@allergy.org.nz.

If you can help with our media campaign, please email me inga@allergy.org.nz.

The best way to show the rest of our communities that we need their support is to show how this makes the allergic journey so much easier to travel. So if you have some good experiences, please share them below and hopefully it will inspire others to pass on the goodwill.

Inga Stünzner
Information and Communication
Allergy New Zealand

Travel to Fiji - a call for help!

We received an email through our website about travelling to Fiji and dealing with a food allergy.

Do you have any suggestions?

"I have booked a holiday in fiji. I assumed a 'five star' resort with many resteraunts would be able to accomodate food allergies. They tell me they cannot accomodate such dietry requirements (egg, dairy and nut free except coconut)and have not yet let me know if they can provide a kitchen for me...

They also advise me that the nearest hospital is three hours away and that helicopters do not operate after sunset.

If anyone has personal experiance with Fiji I would be glad to hear from them. As far as I am concerned we are going (complete with emergency drugs and staple foods). Please can you advise me on five star resourts and their usual abilities?? Where to go from here??
Appreciate your response. Holiday is in July/August 2010".

If you have any suggestions (constructive), please post away.

Easter egg hunting

Easter (religious aspects aside) is about children having a lovely time, hunting for Easter eggs.

But for parents who have children with food allergies, it's also a hunt, albeit one that begins months before and is often associated with large doses of stress! Searching for a safe chocolate Easter egg can sometimes feel a little like searching for the Holy Grail.

I belong to our Central Auckland support group, and thanks to two of our members, we have been alerted to the fact that K-Mart is stocking Kinnerton Easter eggs.

This information has led to a flurry of activity - I collided with a fellow member at the St Lukes K-Mart as stampeded the aisles in search of this egg, only to leave empty handed and gutted when there was nothing there.

But another super-chocolate-sleuther called up K-Mart, put the hard questions to them and discovered the eggs are being stocked, but only a few at a time. The wonderful member found out the barcode and passed this on to the rest of our group.

Give your local K-Mart a call if you are looking for an egg that is dairy, egg, wheat and nut free (it contains soy lecithin, which the majority of people with soy allergy can tolerate, but check this with your specialist first).

Here is the information: “Egg and Bar Casket”, and the sku/bar code is 5010775166646. They are $16.50 each.

If K-Mart sees the demand for Kinnerton chocolate, hopefully they will stock it all the time.

Happy Easter Egg hunting — and hopefully your kids will enjoy it too when it's their turn.

If you know of any other chocolate and where to get it, post away!


Inga Stünzner
Information Officer
Allergy New Zealand

First blog for the year! Food bans!

We're half way through February, so it seems a little redundant to say 'Happy New Year'.

A couple of weeks ago, this article appeared in the Australian newspaper, The Sunday Telegraph "Schools banned food list has gone nuts".

http://bit.ly/cWUiqs

Out of this story, the Herald on Sunday ran a similar article "Kids lunch box time bombs".
http://bit.ly/aoB7Vr

It's important to differentiate between schools and early childhood education centres, as the general consensus is that removing highly spreadable and allergenic foods, such as peanut butter, egg sandwiches or yoghurt (if there is a child with peanut, egg or milk allergy) is appropriate for younger children.

If you have a school-aged child at risk of anaphylaxis (and not just to food), how has your school managed this?

Geographic variation may give clues to food allergy

“Geographic variation may provide insights into some of the causes of food allergy in Australia”, states a Canberra based allergy specialist in separate articles published in the December edition of Annals of Allergy Asthma and Immunology and online in the journal Pediatric Allergy and Immunology.

Working with Drs Sunday Clark (University of Pittsburgh), and Carlos Camargo (Harvard Medical School), Dr Raymond Mullins, a Canberra-based allergy specialist, examined nation-wide prescription rates for infant hypoallergenic formulae (given to babies with multiple food allergies), EpiPen devices (used to treat life-threatening allergic reactions) and hospital admissions for serious allergic reactions (anaphylaxis).

They found that hypoallergenic formulae and EpiPens were prescribed much more often to young children in southern compared to northern sunnier regions of Australia. Hospital admissions for anaphylaxis were also more common in southern regions. The authors examined a number of factors to try to explain their findings including regional differences in income, employment, housing density, socioeconomic status, housing or population density, or access to medical care.

“The only thing that fell out was latitude (distance from the equator), and thus indirectly intensity of sun exposure and indirectly, ability of the skin to make vitamin D from sunlight”.

“Our findings likely represent real regional differences in rates of food allergy and anaphylaxis in Australia. Taken together with similar findings in the USA, this raises the possibility that lesser sun exposure and lower vitamin D levels might be one of several factors playing a role in triggering food allergy”.

“Indeed, a similar geographic pattern has been described with other immune system related diseases such as multiple sclerosis and type I diabetes” say Mullins. “We also know that vitamin D influences the developing immune system in many ways and that low levels are seen in many individuals in Australia. And in the last few years, low vitamin D levels have been implicated in increasing the chance of getting hay fever and asthma as well”.

But the authors caution against over interpreting their study. “This is not the answer to the food allergy epidemic we have seen in the last decade. If confirmed to play a role, vitamin D will likely be one of many factors playing a role in food allergy development. And it’s important that people don’t discard the “safe-sun” message that has prevented so many skin cancers in Australia”.

“Allergic disease in general, and food allergy in particular, is a major public health issue in Australia. ‘Generation A’ – the ‘allergy generation’, has already been born. We need to identify causative factors to help with the development of preventive strategies to stem the ongoing increase, and we need to encourage clinical studies to better treat those with already established disease. It’s early days yet, but our results lay an important foundation for further work on vitamin D and allergy.”

Surviving Christmas Feasting

Christmas is synonymous with feasting, particularly with our family (although I have firmly told myself that the feast is for one day only – or three – but not the whole season!).

I am happy to say that it hasn’t been an issue so far for us at our family gatherings (our extended family gatherings range from 30 to 50 people on Christmas Day). But I know that for others it’s not so easy.

We have just run a feature in the summer issue of Allergy Today on Surviving Christmas, so if you haven’t received the magazine subscribe now and have a jolly good read (I say!).

Here are a few pointers on eating out safely taken from the feature:


1. Let your friends and colleagues know you have a food allergy and what to do if you have a severe reaction. Make sure you take your medication with you, and show your friends where you keep it.

2. Contact the restaurant in advance, if possible, and avoid their peak times. It can be very difficult for staff to take care of your needs when they are extremely busy.

3. Explain your allergy to the manager and discuss the menu.

4. Simple meals with no sauces are usually the safest, for example pan-fried steak, with a side of steamed vegetables.

5. Remind all staff that all ingredient labels must be checked for the presence of the food you’re avoiding.

6. Ask about cross contamination controls in the kitchen: is your meal being prepared with clean utensils, saucepans, chopping boards etc? Have oils used for deep frying been used for frying other foods?

7. Check your meal before eating it.

8. If you had a successful meal, don’t forget to thank the staff. A simple thank you goes a long way!

What are some of your experiences with catering for your, or your child’s, food allergy?

I am particularly interested to hear how adults with food allergies manage to negotiate the Christmas do.

So post away!