Raise your hand if you like peanut butter. Most of us raise our hands, but some are forced to keep theirs down. They’re allergic.
Food allergies affect nearly 10 percent of children younger than 4-years-old, and the peanut allergy causes the most severe reactions. Exposure to even trace quantities of peanuts can lead to a fatal reaction called anaphylaxis, causing breathing problems and heart arrhythmias that can lead to sudden death.
Only 20 percent of kids grow out of it, so if it’s not you, chances are someone around you deals with a peanut allergy. There are more people with peanut allergies than ever before. Rather than make jokes about those missing the joy of PB&J, let’s see what we can do to help.
Paranoid over Peanuts. Thanks to George Washington Carver (who found 300 new uses for the legume) we now have peanuts everywhere, and some sufferers aren’t sure how close in contact they can get.
Thirty kids, ranging from 4 to 15, with documented peanut allergies were challenged by casual exposure to peanut butter. Their previous reactions stemmed from being kissed by someone who ate peanut butter, being near PB&J sandwiches, even being exposed to peanut breath.
In the study, dishes were prepared with a scoop of peanut butter and placed alongside tuna and mint extract to hide the peanut odor. Other dishes replaced the peanut butter with soy butter as a placebo test. The dishes were covered with gauze and held to the kids’ noses for 10 minutes. For an hour, they were watched for reactions.
No one exposed to the peanut butter had a reaction. One person reported an itch on the roof of the mouth, but it was provoked by the placebo test and resolved spontaneously. Based on this, researchers found it unlikely that the smell of peanuts triggers an allergic reaction.
Another large study of 4,685 peanut-allergic individuals found only 1 percent reported reactions to airborne peanut dust, 91 percent reported ingestion was the culprit. This should be somewhat reassuring that the smell of peanuts is likely not harmful.
Butter Clean Up. A pinch of nuts on the tongue is enough to cause a reaction. The common peanut, Arachis hypogaea, has eight different protein allergens named after its scientific name, from Ara h1 to Ara h8. Some people are allergic to one, and some to all eight, so wiping up the peanut butter becomes important. A study showed liquid and bar soap cleans Ara h1 just fine, but antibacterial hand-sanitizer left traces on 6 of 12 hands. Most household cleaning agents were sufficient in cleaning tables.
Symptoms alert. Reactions typically occur within 20 minutes of exposure and can range from itchy skin (most common) to GI complaints (least common). Asthma reactions (coughing, wheezing) or anaphylaxis are the most serious. Ingesting nuts is the most common cause, and rarely does skin contact cause a problem.
A third of people will have a second reaction from the exposure 1-8 hours after the first reaction has resolved. Allergic people should wear MedicAlert bracelets and have injectable epinephrine (e.g., EpiPen) readily available.
If you’re peanut allergy free, do what you can to help those less fortunate avoid the risks and just enjoy the jelly.
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Written by Michael Huckabee, Ph.D., professor and director of the University of Nebraska Medical Center physician assistant program
University of Nebraska Medical Center