食物過敏癥“挑食”的孩子傷不起

by Ellen Le

More children are showing food allergies， including peanuts， but medical investigators dont have a clear explanation for the increase.

Earlier this month a 13-year-old California girl with a peanut allergy died in her fathers arms after unknowingly consuming a small amount of peanut butter in a snack she was eating. The girl quickly spit out the small bit of peanut butter， but efforts to save her life， including multiple injections that should have brought her allergic reaction to a halt， were futile.

The teens death brings to light the dangers faced by those with severe food allergies.

The number of all allergies， including peanuts， is rising， said Dr. Sami Bahna， chief of allergy at Louisiana State University.

The World Health Organization says food allergies appear to be on the rise in all industrialized nations and considers it an important health issue. According to a report in May from the federal Centers for Disease Control and Prevention， the number of U.S. children who have food allergies rose by 50 percent from 1997 to 2011.In particular， peanut allergies among children appear to have tripled between 1997 and 2008， according to a study published in 2010.

There is still no cure for food allergies， although the federal governments investment in food allergy research has risen from $4 million in 2004 to $31 million today， said John Lehr， CEO of Food Allergy Research & Education， a Washington， D.C.， nonprofit.

“But more work is needed，” he said.“Scientists do not yet know why there has been an increase in food allergy 1）prevalence.”

Food allergies involve the immune system and can be life-threatening.

Bahna emphasized that true food allergies are much less common than positive skin tests show. For example， peanut allergies affect 1 percent of the population， and of those， only a tenth are severely 2）anaphylactic， capable of causing a sudden， severe and possibly lifethreatening reaction. Ninety percent of peanut reactions are limited to 3）gastrointestinal and 4）dermatological or 5）wheezing symptoms.

Often， allergies are 6）overdiagnosed， which can lead to undue “psycho-social impacts” on the child， Bahna said. Both Lehr and Bahna stressed having a proper diagnosis and detailed management plan from an 7）allergist.

For those who do suffer from life-threatening food allergies， life continues， 8）albeit 9）precariously.

Kylie Kozar， 13， of Los Angeles was diagnosed with a life-threatening peanut allergy when she survived 10）full-blown 11）anaphylaxis at 18 months old after taking a bite of a Tigers Milk protein bar.Her mother， Yael Kozar， was unaware of the severity of peanut allergies at the time.

Kylies blood test showed her level of peanut allergy was “immeasurable，” her mother said. Yael Kozar made the difficult decision to put her television career on hold for her child. “I couldnt trust the world，” she said.

When Kylie was 7， she suffered another 12）traumatizing near-death experience. Her family was eating dinner at one of the five restaurants they trusted. Kylie took a bite of a sauce that the waiter said did not contain peanuts.

“She was on my side of the table in less than a minute， clutching at her throat，” Kozar said. The waiter ran back and found out the sauce did have peanuts. “I knew at that moment I had to inject，” said Kozar， who administered an 13）EpiPen to her daughter. Kylies throat opened up immediately， but the reactions didnt end.

Kylie ultimately suffered four reactions and was in and out of hospitals for three days from one bite. Afterward， she continued to feel like her throat was closing. Doctors investigated and found 14）esophageal 15）scarring， which 16）mimicked anaphylaxis.

Kylie was treated for post-traumatic stress disorder after the incident and still has recurring anxiety. “She thinks its going to happen again，” her mother said.

Until a cure is found， the only way to avoid a reaction is to avoid the 17）allergen. Before she eats anything， Kylie makes sure she knows the ingredients. She also enlists the help of her friends， who tell her when they see someone with a peanut butter and jelly sandwich. Telling friends “you have an allergy and where your meds are is really helpful，” Kylie said.

But how about enlisting the help of your entire school？

Elk Grove schools announced last week that the district would stop serving peanut products in its elementary schools in response to the death last month of 13-year-old Natalie Giorgi.

Bahna believes total peanut bans are impossible to implement， and he worries that they create a false sense of trust in the safety of foods prepared by others. “The schools have been unable to be drug-free or gun-free，” he said.“Schoolchildren with food allergies should eat food prepared by parents at home.”

Last week， the U.S. House of Representatives passed a groundbreaking measure that would expand access to 18）epinephrine auto-injectors in schools， which the president needs to sign， Kozar said.

But Giorgis case is a reminder that emergency treatment can still fail. Giorgis father， a Sacramento doctor， administered three EpiPens before his daughter stopped breathing.“That EpiPens may not always work，” Kozar said， “is truly a new level of torture to the mind.”

After the 19）harrowing experience from that bite of sauce， Kozar presented her daughter with two choices. The first involved being “the bubble child”： home-schooling， no sports and no play dates.

Kylie opted for the second. “ ‘I want to live in the real world and help others. She said that at age 7，” Kozar said. Kylie and her mother have since become national advocates for food allergy awareness.

Melissa Engel， 18， of Illinois has survived a childhood with multiple lifethreatening food allergies， including peanuts. She said that awareness is “definitely already getting better since I was younger—the labeling is getting better.”

But this fall she faces a new challenge： college. In a month， Engel heads to Emory University in Atlanta. She eventually wants to be a 20）pediatrician.

“Next year， Im going to have to be trusting other people to be making my food. But you cant live your life in total fear. Im very careful，” Engel said. “If I have a bad feeling about something， I just dont eat it，”she said.

“Once youre an adult， I think thats easiest because you can make your own food and be in control. Thats whats hardest—is that you cant always be in control having allergies，” Engel said.

越來越多的兒童表現(xiàn)出食物過敏癥狀，包括對花生過敏，然而醫(yī)學研究人員并未能對數(shù)字攀升的原因作出明確解釋。

本月初，一名患有花生過敏癥的13歲加州少女在父親的懷里死去，原因是女孩無意中吃下了含有少量花生醬的零食。女孩立刻吐出吃下的少量花生醬，但是試圖挽救其生命的所有努力均未能令她起死回生，包括本應(yīng)能止住其過敏反應(yīng)的多次注射也未能起效。

這名少女的離世讓人們對嚴重食物過敏癥患者所面臨的風險重視起來。

路易斯安那州州立大學過敏科主管薩米·巴納博士說，過敏癥患者的人數(shù)，包括花生過敏癥患者，正在不斷上升。

世界衛(wèi)生組織稱，食物過敏癥在所有工業(yè)化國家中都呈現(xiàn)上升趨勢，是一個值得重視的健康問題。美國聯(lián)邦疾病預(yù)防與控制中心五月份的一份報告顯示，從1997年至2011年，美國患有食物過敏癥的兒童人數(shù)上升了50%。特別值得一提的是，一份2010年發(fā)布的研究指出，患有花生過敏癥的兒童人數(shù)在1997年到2008年之間翻了兩番。食物過敏癥至今仍無根治方法，雖然聯(lián)邦政府在食物過敏癥的研究經(jīng)費投入，已經(jīng)從2004年的400萬美元增加至如今的3100萬美元，約翰·勒爾如是說。他是華盛頓特區(qū)一家食物過敏研究與教育非盈利機構(gòu)的首席執(zhí)行官。

“但我們還需投入更多的研究工作，”他說?！翱茖W家們?nèi)匀徊磺宄楹问澄镞^敏癥患者會日漸增多?！?/p>

食物過敏癥關(guān)乎免疫系統(tǒng)，可能威脅生命。

巴納強調(diào)，真正的食物過敏癥比皮試顯示為陽性的過敏癥更加少見。比方說，花生過敏癥影響著1%的人口，而在這些人口中，只有十分之一的人呈嚴重過敏癥狀，這些癥狀可引致突發(fā)的嚴重反應(yīng)并可能威脅生命安全。90%的花生過敏癥狀僅限于腸胃不適以及皮膚過敏、哮喘等癥狀。

通常，過敏癥會被過度診斷，從而給兒童帶來過度的“心理社會影響”，巴納說。勒爾和巴納均強調(diào)，應(yīng)從過敏癥?？漆t(yī)師那里獲得合適的診斷及詳細的控制方案。

對于那些患有威脅生命的食物過敏癥的人來說，生活仍在繼續(xù)，雖然步步驚心。

13歲的凱莉·科澤來自洛杉磯。18個月大時，她在吃了一口虎奶牌能量棒之后全面過敏，好不容易逃過鬼門關(guān)。那時她就被診斷出患有一種威脅生命的花生過敏癥。她的母親耶爾·科澤在那時對花生過敏癥的嚴重性渾然不知。

凱莉的血液測試顯示，她的花生過敏癥水平“不可估量”，她母親如是說。耶爾·科澤作出了艱難的抉擇，為了孩子，將自己的電視事業(yè)暫時擱置?！拔覠o法信任這個世界，”她說。

7歲時，凱莉經(jīng)歷了另一場重創(chuàng)，瀕臨死亡邊緣。她和家人在五家他們信賴的餐廳的其中一家用餐。凱莉吃了一口服務(wù)員聲稱不含花生的醬汁。

“她坐在桌子靠近我的那一邊不到一分鐘，緊握著喉嚨，”科澤說。服務(wù)員跑回去，發(fā)現(xiàn)醬汁果真含有花生?！澳莻€時候，我知道我需要給她注射，”科澤說，她給女兒注射了腎上腺素。凱莉的喉嚨立即打開了，但是過敏反應(yīng)并未完全消失。

因為這一口，凱莉最終經(jīng)受了四次過敏反應(yīng)，三天內(nèi)幾進醫(yī)院。之后，她繼續(xù)感覺到喉嚨窒閉。醫(yī)生調(diào)查發(fā)現(xiàn)她有食道瘢痕，與過敏性反應(yīng)相類似。

那次事件之后，凱莉接受了創(chuàng)傷后壓力紊亂癥治療，至今仍不時出現(xiàn)焦慮?！八傄詾檫@樣的事情會再次發(fā)生，”她母親說。

在找出治療方法之前，避免過敏反應(yīng)的唯一途徑是避免接觸過敏原。在進食之前，凱莉需要確保自己清楚知道食物的成分。她也向朋友們尋求幫助，每當朋友們看見有人吃花生醬果凍三明治時就會告訴她。告訴朋友們“自己患有過敏癥，隨身的抗過敏藥物放在哪兒真的很有用”，凱莉說。

但是向全校師生尋求幫助又如何呢？

麋鹿林市的學校在上周發(fā)布通告，稱鑒于上個月13歲的娜塔莉·吉奧吉的離世，該區(qū)將停止在區(qū)內(nèi)小學供應(yīng)花生食品。

巴納認為，全面叫?；ㄉ?yīng)是不可能實施的，而且他也擔心這類花生禁令會營造出一種錯覺，讓人盲目以為從此他人準備的食物就絕對安全?！皩W校不可能做到無毒、無槍，”他說。“患有食物過敏癥的學童應(yīng)該吃由家長在家準備好的食物。”

上周，美國眾議院通過了一項開創(chuàng)性的措施，措施將拓寬腎上腺自動注射器在學校中的使用限制，這項措施正待美國總統(tǒng)簽署頒布，科澤說。

然而，吉奧吉的事件提醒了我們，急救處理也可能無功。吉奧吉的父親，是一位來自薩克拉門托的醫(yī)生，在女兒停止呼吸之前，他為她注射了三次腎上腺素。“腎上腺素注射未必總能起效，”科澤說，“這真是一種心靈上更深層次的折磨?！?img src="https://cimg.fx361.com/images/2018/07/08/qkimagesfkyyfkyy201312fkyy20131215-5-l.jpg"/>

經(jīng)歷了那一口醬汁的痛苦折磨之后，科澤給出了女兒兩個選擇。一是當一個碰不得的“泡沫孩子”：在家學習，不參與運動，沒有玩伴。

凱莉選擇了第二個。“‘我想生活在現(xiàn)實世界里，幫助別人。7歲時的她就這么說，”科澤說。凱莉和她的母親從此成了喚醒對食物過敏癥重視的全國倡導(dǎo)者。

來自伊利諾伊州的18歲的梅麗莎·恩格爾，熬過了一個充滿了多種威脅生命的食物過敏癥（包括花生過敏癥）的童年。她說“從我小時候到現(xiàn)在，對過敏癥的重視意識確實提高了不少——食物標簽也改善了很多。”

但是，這個秋天，她面臨著一個新的挑戰(zhàn)：上大學。一個月之后，恩格爾就將前往亞特蘭大的埃默里大學讀書。她希望將來成為一名兒科醫(yī)師。

“明年，我就得信賴別人為我準備食物了。不過，你不能總在恐懼中過日子。我非常謹慎，”恩格爾說?！叭绻矣X得哪些食物感覺不對，我就不會吃，”她說。

“一旦你成年了，我想那就最方便了，因為你可以自己做飯吃。一切可以在掌握之中。最難之處在于——你患有過敏癥，你不可能總是運籌帷幄?！倍鞲駹栒f。

Top美國十大致敏食品

小 鏈 接

1. Dairy

2. Eggs

3. Fish

4. Peanuts

5. Tree nuts （walnuts， almonds， cashews， pecans， etc）

6. Sesame

7. Shellfish and other seafood

8. Soy

9. Wheat

10. Gluten （barley， rye， and some other grains）