More Schools Stocking Shots That Counter Serious Allergic Reactions

By HealthDay staff, HealthDay Reporter

FRIDAY, Sept. 19, 2014 (HealthDay News) -- More states are passing legislation permitting or requiring schools to stock the medication epinephrine to use for any child having a severe allergic reaction.

Epinephrine auto-injectors are the primary treatment for "anaphylaxis," an allergic reaction that can lead to throat swelling, breathing difficulties, a steep drop in blood pressure and even death.

In people with severe allergies to certain foods, such as peanuts or tree nuts, insect venom or certain drugs, anaphylaxis can occur within moments of exposure to the allergen, explained Dr. Scott Sicherer, a professor of pediatrics, allergy and immunology at the Jaffe Food Allergy Institute at Mount Sinai School of Medicine in New York City.

But if given soon enough, epinephrine can halt the anaphylactic reaction, saving the child's life, Sicherer said.

"An anaphylactic reaction can progress rapidly and can be fatal," he said. "What we know is the theme for individuals who died from it is they did not get prompt epinephrine -- either they were delayed in getting it or they didn't get it at all."

While many parents of children with serious food allergies supply a prescription epinephrine auto-injector (brand names: EpiPen, Auvi-Q) to the school nurse or teacher, not all kids have an epinephrine auto-injector prescribed specifically for them. And, about 25 percent of first-time food allergy reactions happen at school, according to the American Academy of Allergy, Asthma and Immunology (AAAAI). Those parents may not even realize the child has an allergy.

Those statistics, along with a highly publicized case in 2012 in which a 7-year-old Virginia girl died after eating a peanut on the playground, have prompted a recent wave of legislation intended to make epinephrine available to any child in case of an emergency.

Most states now have laws that allow schools to stock epinephrine for general use, according to Food Allergy Research & Education (FARE), a national nonprofit organization. Some states go further, requiring that schools keep epinephrine auto-injectors on hand. Those states include Delaware, Maryland, Michigan, Nebraska, Nevada, North Carolina and Virginia, according to FARE. California Gov. Jerry Brown signed similar legislation this week.

"Legislatures have recognized that schools need to have this emergency capability in case a child or even a staff member has an anaphylactic incident because they have been exposed to something they're allergic to, whether it's food or an insect sting," said Charlotte Collins, senior vice president of policy and programs for the Asthma and Allergy Foundation of America.

Of the remaining states with no current laws allowing epinephrine to be stocked at school, legislation to permit schools to stock epinephrine is pending in most of them. Only two states -- New Hampshire and Rhode Island -- have no current or pending legislation regarding stocking epinephrine in schools, according to FARE.

About one in 13 U.S. children -- or as many as two in every classroom -- have at least one food allergy, according to FARE and the AAAAI. The most common cause of food-related anaphylaxis is peanuts, but other common allergens, including dairy, sesame or tree nuts such as cashews, pecans or walnuts, can also cause severe reactions.

The stock epinephrine movement was helped along by federal legislation signed into law by President Barack Obama in November 2013. The School Access to Emergency Epinephrine Act gives states incentives for passing legislation requiring that schools have epinephrine on hand and training personnel how to use it in case of emergency. Obama's daughter, Malia, has a peanut allergy.

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