Half of kids with peanut allergy don't have Epi-Pen

By Anne Harding

NEW YORK (Reuters Health) - Children with peanut allergies may run the risk of not receiving life-saving treatment for a severe allergic reaction called anaphylaxis because they don't have their epinephrine autoinjector with them at school, Canadian researchers report.

"When we say take the Epi-Pen on you at all times it means literally on you, and not in an office or somewhere else that might give you a false reassurance," Dr. Moshe Ben-Shoshan of McGill University Health Center in Montreal, a study author, told Reuters Health.

Studies have shown that the main factor in whether an anaphylactic reaction is fatal is whether or not the person was carrying an epinephrine self-injector with them, he added. Ideally, a person should get a shot of epinephrine within 10 minutes of the start of an anaphylactic reaction.

Ben-Shoshan and his colleagues investigated whether children with peanut allergy had Epi-Pens readily available to them at school by surveying 271 Quebec schoolchildren, all with documented peanut allergy.

Four of the children had not been prescribed an autoinjector at all, while 48 percent of the group didn't carry the device with them. More than three quarters of the children who didn't have an Epi-Pen on hand kept it in the school nurse's office, but just 18.5 percent of these offices were staffed by full-time nurses.

It's not clear at what age children can be trusted to give themselves a shot, Ben-Shoshan noted. "For now, every parent has to decide for himself." But no matter what the child's age, having the Epi-Pen with them will make it more accessible to a person trained to recognize and treat anaphylaxis, he and his colleagues say.

On the other end of the age spectrum, the researcher said, teens may be at increased risk of failing to keep an Epi-Pen on hand. "The problem is usually with teenagers because they don't want to carry things on their body that will make them less fashionable," he said, noting that adolescents also have a sense of "omnipotency" that may make them less concerned about their risk.

Thirty-five states in the US have enacted legislation allowing peanut-allergic students to carry their Epi-Pens with them at school, according to Ben-Shoshan, but no such laws are on the books in Canada.

SOURCE: Annals of Allergy, Asthma & Immunology, June 2008.