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Nut allergy fears becoming hysterical: BMJ

By Stephen Daniells , 10-Dec-2008

Fears over the dangers of peanut allergy, a potentially deadly allergy for certain people, are becoming sensationalist and hysterical, according to a Harvard professor.

A level-headed approach is needed before the situation spirals out of control, wrote Professor Nicolas Christakis from Harvard Medical School in the British Medical Journal.

The food industry is already bound by certain regulations, depending on the country, to highlight possible allergens in a food product, such as the EU’s Labelling Directive 2000/13/EC.

But Prof Christakis said that such an approach, however well intentioned, may actually “fan the flames, since they signal to parents that nuts are a clear and present danger.

“This encourages more parents to worry, which fuels the epidemic. It also encourages more parents to have their children tested, thus detecting mild and meaningless ‘allergies’ to nuts. And this encourages still more avoidance of nuts, leading to still more sensitisation.

“The cycle of increasing anxiety, draconian measures, and an increasing prevalence of nut allergies must be broken,” he said.

Peanut allergies are rising in humans, with an estimated 2.5 million people in Europe and the US now vulnerable to the food allergy.

There is no current cure for food allergy and vigilance by an allergic individual is the only way to prevent a reaction but a peanut allergy can be so severe that only very tiny amounts can be enough to trigger a response.

Current recommendations in many countries, such as the UK and the US, for would-be mothers are to avoid peanuts during pregnancy, breastfeeding, and infancy.

However, a recent study comparing incidence of peanut allergy in Jewish children in the UK and Israel (where no such recommendations exist) showed that children in the UK were 10 times more likely to suffer from peanut allergy than their Israeli counterparts.

Findings in the Journal of Allergy and Clinical Immunology showed that 69 per cent of Israeli children were consuming peanut, while only ten per cent of the children in the UK were eating peanuts.

Mass hysteria?

“Measures to control nuts are instead making things worse in a cycle of over-reaction and increasing sensitisation,” said Prof Christakis.

One example cited in the BMJ article involved the evacuation and decontamination pf a school bus in the US following discovery of one peanut on the floor. The school bus was full of ten year olds, who could arguably have been told simply to not eat food off the floor.

The "gross over-reaction to the magnitude of the threat" is very similar to mass psychogenic illness (MPI), said Prof Christakis, previously known as epidemic hysteria.

Outbreaks of MPI involve healthy people in a flow of anxiety, most often triggered by a fear of contamination, he said. Being around individuals who are anxious heightens others' anxiety.

Lightning bolts are equally as dangerous

In attempt to add perspective, the Harvard professor notes that 150 people die each year from food allergies in the US. On the other hand, 100 people die from lightening strikes, 45,000 die in automobile accidents, and 10,000 are hospitalised for traumatic brain injury from playing sport.

“We do not see calls to end athletics,” he said.

“There are no doubt thousands of parents who rid their cupboards of peanut butter but not of guns,” he added. “And more children assuredly die walking or being driven to school each year than die from nut allergies.”

Source: British Medical Journal
2008; 337: a2880
“This allergies hysteria is just nuts”
Author: N.A. Christakis

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