Food allergies have increased over the past two decades and currently affect 5-8% of all children. The most common food allergies in children are peanut, tree nuts, milk, egg, seafood, wheat and soy. There is no cure for food allergies and while many treatment options are being researched, none are currently approved for widespread use. There is no safe amount of food that children with food allergies can consume and even trace amounts can cause an allergic reaction. Food allergy reactions occur rapidly, usually within minutes or 1-2 hours after ingestion, and can include hives, swelling, difficulty breathing/swallowing, vomiting, passing out, and in rare cases, death.
Management of food allergies entails strict avoidance of the food and accessibility to an epinephrine auto injector in case of accidental ingestion causing a severe allergic reaction, called anaphylaxis. Every meal or snack represents a potential exposure to a food allergen. To prevent accidental ingestion, labels of packaged foods must be read every time, food handlers need to be aware of safe preparation practices and avoid shared utensils or equipment, and children need to always ask if a food is safe before eating it, even while at a friend's house or grandma's. Unfortunately, accidental ingestions occur, so children with food allergies need to have immediate access to medications, especially epinephrine auto injectors, to promptly treat any reaction. All caregivers, including school personnel, babysitters, and family members, need to be versed in the recognition and treatment of an allergic reaction.
Over the past few years, increased attention has been placed on management of food allergies inside the school setting. After all, children spend a large portion of their waking moments, including meals, inside school. Excellent resources have been developed by the Centers for Disease Control and others to not only increase awareness, but to help school administrators and personnel better understand food allergies, including ways to reduce risk of accidental ingestion.
Despite great strides in the recognition and management of food allergies in schools, little is known about the same provision of services at summer camps. In many ways, summer camps should be treated the same as schools given the large number of children in attendance, consumption of meals and snacks throughout the day, and presence of a number of different personnel. In other ways, summer camps may be more challenging than schools in regards to management of food allergies. Camp counselors are likely younger and less educated compared with school teachers. In addition, the diverse physical layout and rural location of many summer camps may limit the ability to monitor children for development of food allergy reactions and promptly administer necessary treatment. The brief duration of most camps also decreases the ability of camp personnel to get to know campers very well.
There is no reason that current food allergy management recommendations for schools cannot be applied to the camp setting. Families of children with food allergies who attend summer camp should provide the camp with a current epinephrine autoinjector and written food allergy treatment plan every season. Communication is incredibly important, so caregivers should discuss their child's food restrictions, review signs/symptoms of an allergic reaction, and review use of epinephrine with camp administrators/personnel before dropping their child off. Camps should provide food allergy training for all personnel at the start of each season, including review of symptoms, treatment, and safe food preparation practices. Lastly, the medical community should focus research efforts to better understand the ability of summer camps to manage children with food allergies and also to determine the prevalence of food allergy reactions occurring at summer camps.
As schools let out and families being their fun summer adventures, it is a good time to remind everyone with food allergies about the importance of maintaining vigilance and preparation.
Dr. David Stukus is an allergist in the Section of Allergy and Immunology at Nationwide Children's Hospital. Dr. Dave, as his patients call him, is passionate about increasing awareness for allergies and asthma. Follow Dr. Dave on Twitter @AllergyKidsDoc for great allergy/asthma tips!