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Slate's Medical Examiner: Peanut Allergies


From NPR News, it's Day to Day. Time for our regular look at health issues. Today's topic, the danger of kissing. Dear listeners, this is not to spoil your mood in the run up to Valentine's Day, but be warned, if your significant other suffers from peanut allergies, your kisses could be lethal. Day to Day's Madeline Brand spoke with Dr. Sydney Spiesel. He's a Connecticut Pediatrician who writes on medical issues for the online magazine Slate.

BRAND: So, I know peanut allergies are very, very serious, but really, can you have an allergic reaction just by kissing someone who's eaten a peanut butter sandwich?

Dr. SYDNEY SPIESEL (Pediatrician and Medical Reporter, Slate Magazine): You certainly can. And, in fact, tragically, a couple of month's ago, there was a fifteen-year-old girl in Canada who kissed her boyfriend, who, sometime earlier, had eaten a peanut butter sandwich, and she just collapsed as a result of anaphylactic shock, which is the most intense form of an allergic reaction. And she died. And, in the United States alone, somewhere between 50 and 100 patients die every year after accidental exposure to this allergen.

BRAND: And would this go for other allergies, or just for those caused by peanuts?

Dr. SPIESEL: There are a few other allergies that are, that have the capacity to be equally lethal. For example, certain kinds of fish allergies are, are very, very dangerous, and I even once almost lost a patient to a fish allergy. In terms of numbers, the profoundly, tremendously allergic patients are more likely to be peanut allergies than anything else.

BRAND: Well, what's going on here, because I remember when I was in school, nobody I knew had a peanut allergy, and there were no precautions, but now, it seems that in every classroom there's a child with some sort of nut allergy.

Dr. SPIESEL: You know, I'm sometimes skeptical of reports that one condition or another is getting more frequent, because sometimes that's just ascertainment error. We're just more focused or more aware of it, but I really believe that there's very, very good evidence that peanut allergy is increasing, and frankly, we don't know why that should be. I mean, peanuts are common snacks in the United States, and have been since time immemorial. And I don't see any increase in peanut allergies in places where there are a lot peanuts, like Georgia.

BRAND: Well, what should be mindful of, so that we don't unintentionally expose someone to peanuts if they have an allergy, or any nuts, if they have an allergy?

Dr. SPIESEL: Well, I think there are really critical issues, here. For one thing, people really need to be aware of when they might be exposed, so that restaurants should never us peanut butter as some kind of secret ingredient. There are many stories of kids who will eat chili, and where somehow, in this restaurant, peanuts are the secret ingredient, and they're had fatal reactions to it.

I think schools need to think out their policies about permitting or forbidding peanut products in the lunch room. We already see airlines, for example, not including peanuts as their snacks. And the issue is that some people are so sensitive, that even exposure to a little tiny bit of dust that contains peanut proteins can set them off.

The other thing that's terribly important, that people who are known to be peanut allergic need to carry epinephrine. These auto-injectors that you just slam into your leg, and it gives you an injection of epinephrine. And you need to take an antihistamine instantly and most often, in fact, virtually always, they need to be carted off to an emergency room to keep watching, to make sure there isn't some delayed reaction.

BRAND: Dr. Sydney Spiesel writes the Medical Examiner column for the online magazine Slate. And thank you for joining us.

Dr. SPIESEL: Thank you very much.

CHADWICK: And again, thanks to Madeline Brand for the interview.

(Soundbite of music)

CHADWICK: I'm Alex Chadwick. Stay with us on Day to Day from NPR News. Transcript provided by NPR, Copyright NPR.

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