From the Allergic Living archives; this popular article was published in the magazine in 2009.
IT DOES sound, if not “hysterical,” then at least over the top. One single peanut is noticed on the floor of a school bus and the 10-year-old riders are all told to get out immediately, because of food allergy risks.
The anecdote appears in an opinion article, written by Dr. Nicholas Christakis, a professor of medical sociology at Harvard Medical School, and published in December 2008 in the British Medical Journal. Christakis uses the bus incident, which took place at his children’s school in Massachusetts, as a starting point for this thesis: accommodations made for food-allergic students are an unnecessary “charade” based on fears that “represent a gross over-reaction to the magnitude of the threat.”
As an expert on how health conditions affect others in one’s social network, Christakis goes a big step farther, raising the specter that school responses to food allergies bear “the hallmarks of mass psychogenic illness.” In other words, what used to be called “epidemic hysteria”: the eruptions of fear in towns, schools or hospitals based on the threat of contamination involving, the professor says, “otherwise healthy people in a cascade of anxiety.”
His article quickly grabbed the attention of news outlets around the world. He was interviewed by Time magazine, The New York Times, the Los Angeles Times and Canada’s National Post. Media articles were circulated on websites. The blogosphere had a field day. Suddenly it was fashionable to dismiss food allergy as a made-up phenomenon.
Parents seeking accommodations for kids at school were no longer taking sensible precautions – they were portrayed as hysterical, anxiety-ridden and even needing to “feel special.” Food allergy groups and parents of kids living with the risk of anaphylaxis were put on the defensive, while leading allergists only got to add their brief comments on the media debate as responses to Christakis’s statements.
The fallout from one editorial was remarkable. Yet in writing of needless hysteria, Christakis in fact increased the anxiety within the food allergy community. The widespread attention has had a polarizing effect on those on either side of the school accommodations issue, and now, after many advances have been won to protect students at risk of anaphylaxis, at least one major newspaper is asking: “Can schools bring back the humble peanut?”
Backlash, however, is not entirely new. “There have always been people who are doubtful that food allergy even exists,” says Anne Muñoz-Furlong, founder of the Food Allergy and Anaphylaxis Network (FAAN, which is now FARE), the Virginia-based non-profit that focuses on awareness, education and research.
Of course, the condition is real, it can result in severe and even fatal reactions, and it is more common than ever. The Centers for Disease Control and Prevention in October 2008 reported an 18 per cent increase in the number of children with food allergy from 1997 to 2007. Meantime, a study from the Mayo Clinic in December found that anaphylactic reactions to food are responsible for 50,000 emergency visits each year in the United States, up from a previous estimate of 30,000.
With a rise in food allergies, particularly in children, has come a heightened awareness of the need to keep kids with the condition safe when they are away from their parents. School, of course, is where they spend the bulk of their “away” time, and where foods and snacks are part of daily life. This has led to advocacy, followed by measures to reduce the risk of allergic reactions, mandated by law in places such as New York state, New Jersey, and Ontario, Canada.
“There are a lot of schools that are dealing well with these allergies,” says Laurie Harada, executive director of Anaphylaxis Canada. “And they’re not all hysterical and living in fear. It has become a part of their norm.” Muñoz-Furlong agrees, pointing out that evacuating a bus due to a peanut is a rare and extreme example. “In the U.S., we have two million school-age children with food allergies. They go to school, they participate in class parties and field trips, they’re on the bus and they are mingling – just like every other child.”
ALL THE SAME, the backlash has grown. The current rumblings date back to January 2008, when Harper’s magazine published an article in which writer Meredith Broussard did not mince words. “The rash of fatal food allergies is mostly myth,” she wrote, “a cultural hysteria cooked up with a few ingredients: fearful parents in an age of increased anxiety, sensationalist news coverage and a coterie of well-placed advocates whose dubious science has fed the frenzy.”
She slammed FAAN for its fatality statistics that estimate 150 people a year die from food allergies, but neglected to mention that those figures, which emanated from a Mayo Clinic study in Minnesota, were derived using widely accepted methods.
When Christakis came forward to similarly cast doubt on the wisdom of school accommodations, his words carried considerable weight in the media, since he wrote as a Harvard professor and physician, and did so in the august BMJ. Within the scientific community, however, his views quickly became divisive.
In a letter to the BMJ, Dr. Jonathan Hourihane, a well-regarded Irish pediatric allergist, took issue. Hourihane said, for instance, that the professor had distorted the question of false positive allergy tests: “There is no such thing as ‘meaningless’ allergies to nuts, or else we have to accept the terms ‘meaningless’ asthma and ‘meaningless’ cancer,” he wrote.
Christakis turned down Allergic Living’s repeated interview requests, but several weeks later, Hourihane is still fuming about that BMJ article. In an interview from his office in Cork, he says: “The fact that food allergy doesn’t affect one particular individual doesn’t make it trivial to those who are affected.” He adds: “If [Christakis’s] child had a food allergy, I would imagine he would be down there banging on the door of the school saying, ‘You’ve got to protect my child or I’ll sue ….’”
Hourihane says it’s a question of finding the balance between the cost society is prepared to pay, and the protection of the food allergic. For example, while restricting all food allergens completely is clearly unreasonable, keeping egg out of a particular daycare facility might be prudent, since many infants are allergic to this food.
“Christakis is saying that because we now ask people not to send their children to school with peanuts or nuts, we’re making everyone scared of these foods. We’re not. What we’re doing is we’re slightly inconveniencing people in their dietary choices to ensure the health and safety of a small group of people who really do need protection,” he says.
Next: Flaws in the allergy ‘facts’