Most allergies are little more than a nuisance. But if a child is extremely allergic, an exposure to their allergen could be fatal. This page will explore allergy deaths in children, including why they happen and what you can do to prevent it.
Why children die from allergies
An allergic reaction is the body’s over-reaction to an otherwise harmless substance. The immune system mistakes the substance for something harmful and goes into attack mode. It’s the biological equivalent of launching nukes in response to a threat threat that isn’t actually there. It isn’t the substance itself that causes the damage, but the body’s sown immune system. When this reaction is severe enough it can induce something called anaphylactic shock, where a child’s airways swell up, leading to death from asphyxiation.
Anaphylactic shock can be caused by any type of allergic reaction, from a bee sting to skin exposure to eating or breathing an allergic substance. But anaphylactic shock is especially worrisome when it comes to severe food allergies, because kids are typically ingesting the substance that causes this reaction. So you’re coating a child’s airways with the allergic substance and concentrating the most extreme reaction in the one area you least want it to be.
A study of the various things that trigger anaphylactic shock found that 26% of cases were caused by peanuts, and 18% were caused by other tree nuts. This was followed by eggs, crustaceans and dairy. About 33% of claims were caused by unspecified or unknown foods.(Reddy, 2017)
Kids who die from food allergies
For children with severe food allergies, an accidental exposure could be fatal. Children die every year from food allergies, like the 7-year-old girl in Virginia who died after having an allergic reaction at school. In the U.S., around 150 people (of all ages) die from food allergies each year. Eighty to ninety percent of these deaths are for peanuts or tree nuts, according to pediatric allergy specialist Robert Wood of the Johns Hopkins Children’s Center in Baltimore. (Szabo 2012)
Most food allergy deaths are preventable
Just because a child is severely allergic that doesn’t mean they’re going to die from an accidental exposure. In fact, most of these deaths are preventable. “Somebody is going to make a mistake,” says Wood. “But we reassure parents that kids are not going to die. These are preventable deaths.” (ibid) When a child does lose their life, it’s usually because of aggravating factors or a breakdown in the response.
According to Wood, those who die from food allergies tend to have 3 things in common:
1. They have nut allergies;
2. They also have asthma;
3. There is a delay in getting them injectable epinephrine.
Preventing child allergy deaths
There are a number of things that can help prevent these deaths:
1. Make sure your child has their epipen with them at all times, and that all their teachers/caregivers know where it is and how to use it. You should have one at home, at school, at child care, and in the car.
2. Note that antihistamines such as Benadryl are intended to treat mild symptoms. These medications will not save a child’s life if they have a severe reaction and go into anaphylactic shock.
3. If you’re a teacher or caregiver and a child is having a severe first-time reaction, any epipen will do. It’s all the same medicine; just a kick-me dose of epinephrine. So if a child is dying and another child’s epipen is available, use it.
4. If you have a severely allergic child, there are now treatment regimens and exposure therapies that can lessen their allergies, helping to prevent such dangerous reactions in the first place. (See our page on severe allergies.)
Advocating to prevent allergy deaths
Many allergy specialists support federal legislation that would let schools keep injectable epinephrine on hand that could be given to any child who has a severe allergic reaction, even if they don’t have a prescription. Since food allergies can develop at any time, around 25% of severe reactions occur in kids with no known allergies. Without epinephrine to prevent anaphylaxis, these kids are at serious risk of death. Please call or write to your local Senator or Congressman and ask them to sponsor legislation that would keep this life-saving medicine on hand at school and child care centers.