Preparing the Classroom for Food Allergies

(BPT) - After a year of remote learning, students will hopefully be returning to in-person classes this fall. Of the estimated 56 million children who attend elementary, middle and high school each year in the US,¹ approximately two students per classroom have food allergies² – and up to one in four children have their first food allergy reaction at school.³

This year the Biden Administration signed the Food Allergy Safety, Treatment, Education and Research Act (FASTER Act) ⁴ into law, making sesame the ninth major allergen, alongside peanut, tree nuts, soy, wheat, egg, cow’s milk, fish and shellfish.⁵ So, now is a good time to review how to help keep the classrooms safe for children living with life-threatening allergies.

According to the United States Food and Drug Administration (FDA), sesame allergies can be particularly pesky because they may be hidden behind labels such as "natural flavors" or "spices.”⁶ Under the FASTER Act, however, sesame must be declared on food labels beginning January 1, 2023⁷ – providing those with a life-threatening sesame allergy the information needed to help remain safe and confident in their environments.

“The FASTER Act is an important step forward in raising awareness of life-threatening allergies in and outside of the classroom,” said Kelly Barlow, BSN, RN, President of Wisconsin Association of School Nurses. “While foods such as peanuts, tree nuts, wheat and shellfish have long been recognized as potential causes of anaphylaxis, identifying sesame as the ninth major allergen can help prevent allergic emergencies at school – especially since 25% of schools reported that they did not employ a school nurse.”⁸

To prepare for the upcoming school year, Nurse Barlow recommends that children living with life-threatening allergies visit their pediatricians to receive routine immunizations and refill their epinephrine auto-injectors – because epinephrine is the only medication that can reverse anaphylactic symptoms.⁹

It’s also important that children with life-threatening allergies have an Anaphylaxis Emergency Plan and share it with their teachers, school nurses, and other academic officials, so that everyone knows what to do if an allergic emergency occurs.

One important part of an Anaphylaxis Emergency Plan is that children with life-threatening allergies should carry an epinephrine auto-injector, such as AUVI-Q^® (epinephrine injection, USP), a pocket-sized epinephrine auto-injector with innovative features. AUVI-Q is the only epinephrine auto-injector with a voice instruction system to guide step-by-step through administration on how to administer a potentially life-saving dose of epinephrine in an emergency, allowing trained and untrained teachers, nurses, and caregivers to administer AUVI-Q.¹⁰ AUVI-Q is for immediate self (or caregiver) administration and does not take the place of emergency medical care. Seek immediate medical treatment after using AUVI-Q.

Visit www.auvi-q.com to learn more and talk to your doctor to see if AUVI-Q is right for your family. To create an Allergen Profile Card to share with teachers, nurses, coaches and after school caregivers, visit https://activities-hub.auvi-q.com/create-profile-card.

Kelly Barlow is a paid spokesperson for Kaléo.

Indication

AUVI-Q^® (epinephrine injection, USP) is a prescription medicine used to treat life-threatening allergic reactions, including anaphylaxis, in people who are at risk for or have a history of serious allergic reactions.

Important Safety Information

AUVI-Q is for immediate self (or caregiver) administration and does not take the place of emergency medical care. Seek immediate medical treatment after using AUVI-Q. Each AUVI-Q contains a single dose of epinephrine. AUVI-Q should only be injected into your outer thigh, through clothing if necessary. If you inject a young child or infant with AUVI-Q, hold their leg firmly in place before and during the injection to prevent injuries. Do not inject AUVI-Q into any other part of your body, such as into veins, buttocks, fingers, toes, hands, or feet. If this occurs, seek immediate medical treatment and make sure to inform the healthcare provider of the location of the accidental injection. Only a healthcare provider should give additional doses of epinephrine if more than two doses are necessary for a single allergic emergency.

Rarely, patients who use AUVI-Q may develop infections at the injection site within a few days of an injection. Some of these infections can be serious. Call your healthcare provider right away if you have any of the following symptoms at an injection site: redness that does not go away, swelling, tenderness, or the area feels warm to the touch.

If you have certain medical conditions, or take certain medicines, your condition may get worse or you may have more or longer lasting side effects when you use AUVI-Q. Be sure to tell your healthcare provider about all the medicines you take, especially medicines for asthma. Also tell your healthcare provider about all of your medical conditions, especially if you have asthma, a history of depression, thyroid problems, Parkinson’s disease, diabetes, heart problems or high blood pressure, have any other medical conditions, are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. Epinephrine should be used with caution if you have heart disease or are taking certain medicines that can cause heart-related (cardiac) symptoms.

Common side effects include fast, irregular or ‘pounding’ heartbeat, sweating, shakiness, headache, paleness, feelings of over excitement, nervousness, or anxiety, weakness, dizziness, nausea and vomiting, or breathing problems. These side effects usually go away quickly, especially if you rest. Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

Please see the full Prescribing Information and the Patient Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

References:

1. National Center for Education Statistics (NCES). Back to School Statistics. Retrieved June 21, 2021, from https://nces.ed.gov/fastfacts/display.asp?id=372.
2. Centers for Disease Control and Prevention. Food Allergies. Retrieved June 21, 2021, from https://www.cdc.gov/healthyschools/foodallergies/index.htm.
3. McIntyre CL, Sheetz AH, Carroll CR, Young MC. Administration of epinephrine for life-threatening allergic reactions in school settings. Pediatrics 2005; 116(5):1134-1140.
4. The White House. Bills Signed: S. 164, S. 415, S. 422, S. 578. Retrieved July 21, 2021, from https://www.whitehouse.gov/briefing-room/legislation/2021/04/23/bills-signed-s-164-s-415-s-422-s-578/.
5. Allergy & Asthma Network. Sesame Allergy and Food Labels. Retrieved June 21, 2021, from https://allergyasthmanetwork.org/news/sesame-the-9th-food-allergen/.
6. U.S. Food & Drug Administration. Statement from FDA Commissioner Scott Gottlieb, M.D., on the FDA’s new consideration of labeling for sesame allergies. Retrieved July 21, 2021, from https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-fdas-new-consideration-labeling-sesame-allergies.
7. U.S. Food & Drug Administration. Food Allergies. Retrieved July 21, 2021, from https://www.fda.gov/food/food-labeling-nutrition/food-allergies.
8. Willgerodt, M.A., Brock, D. M., & Maughan, E.M. (2018). Public School Nursing Practice in the United States. Journal of School Nursing, 34(3), 232-244.
9. Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol. 2020;145(4):1082-1123. doi:10.1016/j.jaci.2020.01.017
10. AUVI-Q [Prescribing Information]. Richmond, VA: kaleo Inc.; https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=6180fb40-7fca-4602-b3da-ce62b8cd2470&type=display.