New federal guidelines for schools regarding student allergies

4 Nov

Moi wrote about allergies in Food allergies can be deadly for some children:
If one is not allergic to substances, then you probably don’t pay much attention to food allergies. The parents and children in one Florida classroom are paying a lot of attention to the subject of food allergies because of the severe allergic reaction one child has to peanuts. In the article, Peanut Allergy Stirs Controversy At Florida Schools Reuters reports:

Some public school parents in Edgewater, Florida, want a first-grade girl with life-threatening peanut allergies removed from the classroom and home-schooled, rather than deal with special rules to protect her health, a school official said.
“That was one of the suggestions that kept coming forward from parents, to have her home-schooled. But we’re required by federal law to provide accommodations. That’s just not even an option for us,” said Nancy Wait, spokeswoman for the Volusia County School District.
Wait said the 6-year-old’s peanut allergy is so severe it is considered a disability under the Americans with Disabilities Act.
To protect the girl, students in her class at Edgewater Elementary School are required to wash their hands before entering the classroom in the morning and after lunch, and rinse out their mouths, Wait said, and a peanut-sniffing dog checked out the school during last week’s spring break….
Chris Burr, a father of two older students at the school whose wife has protested at the campus, said a lot of small accommodations have added up to frustration for many parents.
“If I had a daughter who had a problem, I would not ask everyone else to change….

More children seem to have peanut allergies.
See, More school battles about peanut allergies

Mike Stobbe of AP reported in the article, Feds post food allergy guidelines for schools:

ATLANTA (AP) — The federal government is issuing its first guidelines to schools on how to protect children with food allergies.
The voluntary guidelines call on schools to take such steps as restricting nuts, shellfish or other foods that can cause allergic reactions, and make sure emergency allergy medicine — like EpiPens — are available.
About 15 states — and numerous individual schools or school districts — already have policies of their own. “The need is here” for a more comprehensive, standardized way for schools to deal with this issue, said Dr. Wayne Giles, who oversaw development of the advice for the Centers for Disease Control and Prevention.
Food allergies are a growing concern. A recent CDC survey estimated that about 1 in 20 U.S. children have food allergies — a 50 percent increase from the late 1990s. Experts aren’t sure why cases are rising.
Many food allergies are mild and something children grow out of. But severe cases may cause anaphylactic shock or even death from eating, say, a peanut.
The guidelines released Wednesday were required by a 2011 federal law.

Here is information from the Centers for Disease Control about the guidelines:

Food Allergies in Schools
Food allergies are a growing food safety and public health concern that affect an estimated 4%–6% of children in the United States.1, 2 Allergic reactions can be life threatening and have far-reaching effects on children and their families, as well as on the schools or early care and education (ECE) programs they attend. Staff who work in schools and ECE programs should develop plans for preventing an allergic reaction and responding to a food allergy emergency.
Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs [PDF – 10MB]
Food Allergy Guidelines FAQs [PDF – 163KB]
What is a Food Allergy?
A food allergy occurs when the body has a specific and reproducible immune response to certain foods.3 The body’s immune response can be severe and life threatening, such as anaphylaxis. Although the immune system normally protects people from germs, in people with food allergies, the immune system mistakenly responds to food as if it were harmful.
Eight foods or food groups account for 90% of serious allergic reactions in the United States: milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts, and tree nuts.3
Symptoms of Food Allergy in Children
Symptoms Communicated by Children with Food Allergies4
• It feels like something is poking my tongue.
• My tongue (or mouth) is tingling (or burning).
• My tongue (or mouth) itches.
• My tongue feels like there is hair on it.
• My mouth feels funny.
• There’s a frog in my throat; there’s something stuck in my throat.
• My tongue feels full (or heavy).
• My lips feel tight.
• It feels like there are bugs in there (to describe itchy ears).
• It (my throat) feels thick.
• It feels like a bump is on the back of my tongue (throat).
The symptoms and severity of allergic reactions to food can be different between individuals, and can also be different for one person over time. Anaphylaxis is a sudden and severe allergic reaction that may cause death.5 Not all allergic reactions will develop into anaphylaxis.
Food Allergies in Schools
• Children with food allergies are two to four times more likely to have asthma or other allergic conditions than those without food allergies.1
• The prevalence of food allergies among children increased 18% during 1997–2007, and allergic reactions to foods have become the most common cause of anaphylaxis in community health settings.1,6
• In 2006, about 88% of schools had one or more students with a food allergy.7

Treatment and Prevention of Food Allergies in Children
There is no cure for food allergies. Strict avoidance of the food allergen is the only way to prevent a reaction. However, since it is not always easy or possible to avoid certain foods, staff in schools and ECE programs should develop plans to deal with allergic reactions, including anaphylaxis. Early and quick recognition and treatment of allergic reactions that may lead to anaphylaxis can prevent serious health problems or death.
Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs
In consultation with the U.S. Department of Education and a number of other federal agencies, CDC developed the Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Centers [PDF – 10MB] in fulfillment of the 2011 FDA Food Safety Modernization Act to improve food safety in the United States. Download Food Allergy Guidelines FAQs [PDF – 163KB].
The Voluntary Guidelines for Managing Food Allergies provide practical information and planning steps for parents, district administrators, school administrators and staff, and ECE program administrators and staff to develop or strengthen plans for food allergy management and prevention. The Voluntary Guidelines for Managing Food Allergies include recommendations for each of the five priority areas that should be addressed in each school’s or ECE program’s Food Allergy Management Prevention Plan:
1. Ensure the daily management of food allergies in individual children.
2. Prepare for food allergy emergencies.
3. Provide professional development on food allergies for staff members.
4. Educate children and family members about food allergies.
5. Create and maintain a healthy and safe educational environment.
1. Branum AM, Lukacs SL. Food allergy among U.S. children: trends in prevalence and hospitalizations. NCHS Data Brief. 2008;10:1-8.
2. Liu AH, Jaramillo R, Sicherer SH, et al. National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2010;126(4):798-806.e13.
3. Boyce JA, Assa’ad A, Burks AW, et al; NIAID-Sponsored Expert Panel. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126(suppl 6):S1-S58.
4. The Food Allergy & Anaphylaxis Network. Food Allergy News. 2003;13(2).
5. Sampson HA, Munoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium. Ann Emerg Med. 2006;47(4):373-380.
6. Decker WW, Campbell RL, Manivannan V, et al. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol. 2008;122(6):1161-1165.
7. O’Toole TP, Anderson S, Miller C, Guthrie J. Nutrition services and foods and beverages available at school: results from the School Health Policies and Programs Study 2006. J Sch Health. 2007;77:500-521.
Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs [PDF – 10MB]
Food Allergy Guidelines FAQs [PDF – 163KB]

It requires a great deal of tact and give and take on the part of parents and the school to produce a workable situation for students, the child with the allergy, and parents.
A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination
If children have allergies, parents must work with their schools to prepare a allergy health plan.


Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code

USDA’s Accommodating Children With Special Dietary Needs

Child and Teen Checkup Fact Sheet

Video: What to Expect From A Child’s Physical Exam

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