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Epinephrine initiative aided students, staff after food allergy-related anaphylaxis
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ATLANTA — Students and staff members in the Chicago Public Schools system benefited from a district-issued emergency epinephrine initiative after experiencing anaphylactic reaction from food allergy, according to research presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting.
In urban centers such as Chicago, food allergy prevalence among students is 10%, which exceeds the pediatric national average of 8%, Ruchi S. Gupta, MD, MPH, associate professor of pediatrics, Northwestern Feinberg School of Medicine, Northwestern University, said. Nearly 25% of first-time allergic reactions occur in school.
Ruchi S. Gupta
“Because children are going to school so young, oftentimes they haven’t tried a lot of the foods, so they’re trying it for the first time in school, and they have their first reactions,” Gupta said.
“Stock epinephrine laws” and regulations are now in effect in most states, Gupta said.
Chicago Public Schools (CPS), the nation’s third-largest school system, with 86% low-income students and 91% minority students, was at the forefront of passing epinephrine legislation. This was spurred by a peanut-allergy related pediatric death, in which epinephrine was not available, Gupta said. The most recent legislation passed in Illinois in July allows undesignated epinephrine administration in schools by trained personnel, Gupta said.
In the 2012-2013 school year, the first year stock epinephrine was available in CPS, 35 students and three staff members received emergency epinephrine auto-injector, according to CPS records. A school nurse administered 76.3% of the epinephrine, followed by other staff members (18.4%) and self-administered (5.3%).
Food was the most common trigger for allergic reaction, with peanut (18.4%) and fin fish (13.2%) being most prevalent; 34.2% of reactions were unidentified.
“Thirty-eight [epinephrine injections] were used in the first year [of the CPS program], half in kids who had no known allergy,” Gupta said. “There are a lot of kids having these first-time reactions in schools, so something needs to be done to make that sure schools are prepared and these kids are safe.
“School districts all over the country are working on this right now. … As laws are put into place, we have to make sure that everybody is trained and ready to use [emergency epinephrine].”
"Asking families about their plan in school is critical, Gupta told Healio Allergy/Immunology. " Making sure physicians help in preparing schools to handle anaphylaxis emergencies by training on stock epinephrine and prescribing it is essential." — By Bruce Thiel
For more information:
Gupta RS. Abstract 44. Presented at: American College of Allergy, Asthma and Immunology Annual Scientific Meeting; Nov. 6-10, 2014; Atlanta.
Disclosure: Gupta works with Mylan supporting their epipen4schools program and is on the medical advisory board of FARE.