The CDC reports that 4 to 8% of children and 2% of adults have some kind of food allergy. Approximately 3.3 million of those individuals have peanut or treenut allergy, the most common cause of life-threatening allergic reactions. As there is no cure for food allergies, and nearly 80% of fatal or near fatal allergic reactions occur as a result of peanut allergies annually, it has become extremely important for parents to understand how to reduce risk in this area – and how to communicate these issues to their families and friends.

Peanut allergy is different from peanut intolerance, though some of the more minor symptoms are similar. Someone with a peanut intolerance can usually eat small amounts of peanuts with only mild symptoms (i.e. heartburn and indigestion), and their immune system is not involved. A peanut allergy, on the other hand, is a reaction to peanuts that triggers an immune system response because the body perceives the peanuts to be harmful.

When the immune system identifies the peanut protein as something dangerous, the body begins to produce immunoglobulin E (IGE) antibodies to neutralize the peanut allergen. The next time that same individual is exposed to peanuts, the antibodies in their body will alert the immune system to release chemicals like histamine into their bloodstream. Exposure to even trace amounts of peanuts can spark an immediate reaction ranging from swelling and itching to wheezing and anaphylaxis – a situation where the airways constrict, making breathing difficult. Severity of a reaction can vary, and can occur within minutes, or within an hour.

Exposure to peanuts can occur through direct contact – eating peanuts, or kissing/touching someone who has eaten peanuts, cross-contact – unintended exposure from a product’s processing or handling, and inhalation – breathing in dust, cooking sprays or aerosols that contain peanuts. Commonly used products that may contain peanuts include peanut butter, peanut flour, mixed nuts, baked goods, salad dressing and cereals. Traces of peanuts can even hide in candy, artificial tree nuts and nut butters. Sunflower seeds are often processed on equipment that also produces peanuts.

A child’s first allergic reaction, if they are going to have one, usually occurs between ages one and two. About 20% of children will outgrow peanut allergy, but if they still have the allergy by age three, they are less likely to outgrow it. A family history of allergies puts an individual at increased risk for developing peanut allergy.

Though it is unclear as to why the prevalence of peanut allergies, and allergies in general, seem to have doubled in American children over the last five years, some studies suggest that improved hygiene (and the resulting alteration of the immune system) may be to blame. If an allergy is suspected, a doctor can perform a skin test and/or blood test to measure an individual’s immune system response to peanuts. Those at high risk for having a severe reaction should carry injectable epinephrine with them at all times.

Dr. Robert Wood, Director of Pediatric Allergy and Immunology at Johns Hopkins University School of Medicine, says that the best strategy for managing food allergies is to avoid any food that triggers a reaction, and to treat reactions promptly when they occur. Individuals with known peanut allergies should be extremely careful in restaurants and other situations where the food could contain hidden ingredients. Along those same lines, children with allergies should refrain from trading snacks or sharing food with friends. Schools should be notified of a child’s allergy upon enrollment, and their condition should be reemphasized throughout the term.

In fact, so serious is this situation that several schools throughout the country are in the midst of placing tighter restrictions on the consumption of peanuts and treenuts on school grounds. Earlier this year, the Rhode Island legislature established its own “peanut law” to help make schools safer for students with allergies state-wide. And some schools, like Temple Isaiah Preschool in Los Angeles, California, have asked that parents eliminate nuts from their children’s lunches completely. More schools, we hope, are sure to follow.