http://www.sciencedaily.com/upi/index.php?feed=Science&article=UPI-1-20050708-17
195300-bc-us-allergies.xml

WASHINGTON, July 8 (UPI) -- Biological weapons may be a distant concern
for most Americans, but some struggle to avoid them every day -- in the
form of canned tuna laced with milk protein, fruit popsicles
manufactured with dairy-contaminated equipment or enchilada sauce
containing hidden peanut protein.

According to the American Academy of Allergy, Asthma and Immunology, up
to 8 percent of children and 2 percent of adults in the United States
suffer from food allergies.

For people with severe allergies, consumption of minute amounts of an
ordinary food such as milk, peanuts or shellfish commands the immune
system to unleash a full-scale assault on the rest of the body. This
can lead to consequences such as skin eruptions, asthma attacks,
gastrointestinal problems and potentially fatal systemic allergic
reactions called anaphylaxis.

Anne Munoz-Furlong, founder and chief executive officer of the Food
Allergy and Anaphylaxis Network in Fairfax, Va., said at a recent
briefing for reporters that dealing with food allergies can impact
areas of life as far-reaching as grocery shopping, schools, child care,
dining out, socializing, traveling and even family relationships.

The only current method for averting food-related anaphylactic
reactions is avoiding the foods responsible -- a process that entails
careful reading of food labels and being wary of possibilities for food
cross-contamination.

Even label reading is not as simple as it sounds, according to an AAAAI
pamphlet, because many common allergens are listed on labels under
uncommon aliases. For instance, milk can masquerade as casein,
caseinates, rennet casein, lactalbumin, lactalbumin phosphate,
lactoglobulin or lactulose.

"Shopping went from about a half-hour process to a three-hour process,"
Hugh Sampson, director of the Jaffe Food Allergy Institute at the Mount
Sinai School of Medicine in New York City, said at the briefing. He was
describing his experience after his child was diagnosed with an egg
allergy.

Munoz-Furlong said a food-labeling law is scheduled to take effect in
January to make the identification of allergen-containing foods easier,
although it will take another year for the changes to be fully
implemented.

Many children outgrow their food sensitivities, but a recent rise in
the incidence of peanut allergies shows the problem of food-related
anaphylaxis will become increasingly prevalent in the United States.
Sampson said he conducted procedurally identical studies in 1997 and
2002 to determine U.S. rates of peanut allergies. He found the rate in
children younger than age 5 doubled during that time.

About 80 percent of allergic reactions in children are due to milk,
eggs and peanuts, and though they will often outgrow allergies to milk
and eggs, only 21 percent do so, the AAAAI pamphlet said.

The reason for the increase in peanut-allergy rates is unknown. Sampson
said the Chinese eat as many peanuts per capita as Americans do but
have virtually no problems with allergies, while the United States has
the highest peanut-allergy rate in the world. He suggested the U.S.
method of processing peanuts by dry roasting, rather than boiling and
drying, could play a role.

There are various theories regarding the rise in allergy rates. The
"hygiene hypothesis," for example, holds that the sanitary conditions
of modern life contribute to increased allergy rates because immune
systems are inadequately stimulated. Another possibility is the
environment is becoming more allergenic. For instance, pollens in
polluted cities seem more potent than varieties in rural areas, Sampson
said.

He also noted that some people are only allergic to shrimp when they
consume alcohol at the same time, because alcohol increases the
absorption of proteins. Likewise, some people react allergically to
foods only if they exercise within two or three hours of eating the
food, for reasons unknown -- and some people can eat a food without
incident for years and suddenly develop an allergy.

"You get the right combination at some point and then you become
allergic," Sampson said.

Carlos Camargo Jr., an associate professor of medicine and epidemiology
at Harvard Medical School, said at the briefing there have been
difficulties obtaining food-allergy research funding from the Food and
Drug Administration and the National Institutes of Health. He said
researchers want to study genetic traits, but the NIH wants them to
gain a better understanding of what they are seeking before granting
funding.

Camargo described the FDA as "struggling to do its job" under pressure
from companies that do not want potentially negative research conducted
about their products.

"It really has to come from the federal and state government, and
donations to organizations like FAAN," he said.

Munoz-Furlong said the government allocates only $5 million to $7
million per year for food-allergy research, compared with $1 billion
for diabetes research. According to the American Diabetes Association
Web site, 6.3 percent of the U.S. population has diabetes.

Along with the funding issue, another obstacle to food-allergy research
is the lack of a universal definition for anaphylaxis.

"It's very hard to study something if you can't define it in a
consistent way," Camargo said.

In a recent study, Camargo defined the condition was either the
involvement of two or more organ systems (skin, respiratory,
cardiovascular, gastrointestinal) or hypotension, which is systolic
blood pressure below 100 millimeters of mercury. Anaphylaxis can occur
in response to insect stings and medications, as well as food
allergies.

The confusion over defining the disease often results in inadequate
medical treatment, he said.

Through reviewing patient charts at an assortment of major American
hospitals, Camargo found, on average, only 16 percent of people who
visited emergency rooms for food-related anaphylaxis were prescribed
EpiPens, which contain injectable epinephrine that can be used to buy
time while awaiting medical treatment in event of a future anaphylactic
reaction.

Only 12 percent of ER patients exhibiting anaphylaxis were told to
visit an allergist.

Many patients were not even advised to avoid the specific food that had
caused their reaction. This might sound obvious, Munoz-Furlong said,
but many people who have died from anaphylactic reactions had visited
emergency rooms many times previously for the same condition without
ever being told their allergies could kill them.

Jonathan Bernstein, associate professor of medicine at the University
of Cincinnati Medical Center, told briefing attendees that possible
avenues for research include studying when and how to introduce
potentially allergenic foods to babies and what at-risk mothers should
eat during pregnancy and breastfeeding.

"I think from the patient perspective, until we find a cure and we
increase the funding for research, we've got to keep these people
safe," Munoz-Furlong said. "So, funding for education so that teachers
can be prepared, physicians can make the right diagnosis, emergency
room staff know what to do and what to tell the patient when they leave
-- it's got to be a two-pronged approach, with the research to find the
cure but also the education and awareness to keep these people safe."

Eva A. Sylwester is an intern for UPI Science News. E-mail:
sciencemail@upi.com