PEANUT ALLERGY

Peanut allergy is most common in infants, but may appear for the first time in adults. Peanut allergy causes more problems than other food allergies because it is common (1 in 200 infants), exposure is hard to avoid and even trace amounts can trigger symptoms. Less than 10 % of cases resolve, although severity may occasionally lessen with age.

Allergic reactions to peanut can be serious
The majority of allergic reactions to peanut are mild. Contact hives, worse eczema and vomiting are the most common complaints. Some sensitive individuals develop difficulty breathing due to asthma or throat swelling, or a drop in blood pressure. This is known as anaphylaxis, and allergy to peanuts is one of the most common triggers.

Other allergies may also be present
Food allergy is more common in people who have other allergies like hayfever, asthma or eczema. As many children have allergies to other foods such as milk, egg or other nuts, your doctor may test for these allergies as well.

Reliable diagnosis of peanut allergy is important
Your doctor will normally ask a series of questions that may help to narrow down the list of likely causes of allergy such as foods or medicines consumed that day, or exposure to stinging insects. This approach will also help to exclude conditions that can sometimes be confused with food allergy. Skin or blood (RAST) allergy testing helps confirm or exclude potential triggers.

Peanuts are hard to avoid
Peanuts are widely used in processed Western and in Oriental cooking. This poses significant problems for people with severe peanut allergy. Laws require that any product, which might feasibly contain peanut traces, must be labeled to that effect, so the labels of all foods should be checked before purchase. Some manufacturers will also label their products as possibly containing traces of nuts. In such situations, multiple products may be made on the same production line and cross-contamination with traces of nuts cannot be guaranteed. The risk of cross contamination is greatest for those with severe food allergies. Occasionally nut products or oils have been used as unlabelled ingredients in cosmetics such as massage oils. For example, the term Arachnis oil on the label is the scientific name for peanut.

The following list provides some examples of foods that can contain peanut. While peanut may not always be present, foods in this list should be examined carefully to ensure that no traces of peanuts are present.

Highly purified peanut oil contains little allergen
Refined peanut oils (not cold-pressed) have been shown to be safe in small studies. Unfortunately, it is difficult to guarantee that the oil is sufficiently refined to remove all traces of allergen. This particularly applies to restaurants which use peanut oils for cooking, as peanut proteins may leach into the oil during cooking, and the oil may be re-used a number of times. In general therefore, avoidance of peanut oil is frequently advised.

Avoidance is the only proven treatment for peanut allergy
It is therefore fortunate that omitting peanuts from the diet has no adverse nutritional consequences. Children should bring their own nut free food with them to school. They should also be encouraged not to swap food. In common eating and food preparation areas, where there are children with severe peanut allergy, particularly in day care centers and pre-schools, all nut-containing foods should be avoided.