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Paging Dr. Gupta: Peanut Allergy in a Nutshell

Aired July 10, 2003 - 11:26   ET


LEON HARRIS, CNN ANCHOR: All right now. Turning to health news, 1.5 million Americans live in deathly fear of accidentally eating a single peanut. For them that single peanut could be a fatal mistake.
Well, now we hear there is a new treatment that can provide a significant margin of safety for people like that. And our medical correspondent Dr. Sanjay Gupta is here to talk about that for us this morning.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Yes, lots of studies coming out peanuts now. And peanut allergies can be a very significant problem. Seven studies actually in a very prominent journal coming out just this week.

Let me just give you some of the highlights here and then we're going to take some of your e-mail questions. A lot of those have been coming in.

First of all, as you mentioned already, Leon, 1.5 million Americans suffer from these allergies, can be extremely profound in children. Also children who have severe asthma, severe asthma 50 percent of time it's going to actually be due to allergies, to food.

Also less than two peanuts at times can cause severe reactions. Just two peanuts. And maybe you've seen less and less peanuts on airplanes and things like that. That's part of that as well.

There is some new information coming out, as you mentioned, Leon. A new diagnostic test to actually look at some of peanut allergies. Twenty percent of children will outgrow their peanut allergies. How do you test for it? How do you know if your child has outgrown it? Well there are some new tests out there. We're going to talk about that.

And peanuts may worsen asthma. Again, asthma and allergies so closely interlinked.

Finally, just really quick before we bring in a really good guest to help us work through some of this, there's been some evidence that liquid charcoal can actually block peanut absorption. And there is some vaccine now. I'm going to talk about this charcoal thing...

HARRIS: Liquid charcoal?

GUPTA: Yes, we'll talk about that. There's a vaccine that's in the works. And peanut butter, if you had to pick between the two, peanut butter or just regular peanuts, peanut butter less allergenic than peanuts. And that's a good thing to know.

Listen, we have been taking your e-mail questions all morning. A lot of them coming in. And to help us work through this, joining us from New York is an allergist, a very prominent one, Dr. Clifford Bassett who's also at the New York University. He's one of the fellows of the American Academy of Allergy, Asthma and Immunology. Thank you very much for joining us.

DR. CLIFFORD BASSETT, ALLERGIST: It's nice to be here.

GUPTA: All right. Tell you what. Let's get it our first e-mail questions. There are so many of those that are coming in. Our first one actually has to do with someone who was growing up attending primary school, had "severe allergy cases, such as peanut allergies". They "seemed to be few and far between. Why do these severe allergies seem to be more prevalent today as opposed to 20 to 25 years ago?"

It does seem, Doctor, that a lot of people are talking more and more about allergies. Are there actually more allergies today, or are we just finding them more?

BASSETT: That's a very good question. We think that there has been a greater amount of reporting of allergies both by hospital, emergency departments and also in doctors' offices.

In addition, exposure to peanut products and various topical solutions such as moisturizers or creams, perhaps for infants, may sensitize the individual and increase the risk factors of peanut allergies themselves.

HARRIS: Interesting. Very interesting. We got another one, e- mail here for you, Sanjay. I'm going to jump in here to (UNINTELLIGIBLE) Dr. Bassett. Leon, here.

This one coming in from Rebecca in Phoenix, Arizona. Now, Sanjay, you talked about this a second ago. She's asking, "Can children outgrow peanut allergies?" How is that?

GUPTA: That's an interesting question. I think that the conventional wisdom, Dr. Bassett will jump in here as well, conventional wisdom is that once you have them, you're going to have them for a lifetime. But actually there's a new test out now to actually try and test to see if in fact the kids may have a better chance of outgrowing those peanut allergies. Can you talk about that, Dr. Bassett?

BASSETT: Right. As you mentioned, we think about one out of five kids that have peanut allergies maybe 20 percent of the time may actually outgrow their peanut allergies specifically by the age of 5.

There's a blood test that's available in the allergist's office that can screen individuals for peanut allergies. And it's very important to get proper screening because this is a problem that can be prevented. We're talking about helping the individuals, the 1.5 million American people that have peanut allergies, identify some of the approaches to reduce their exposure, and hopefully in the future we'll have a cure for this problem.

GUPTA: That's a good point. I mean the focus on preventing exposure's always been the key.

But something I think I found interesting is reading through all these studies was that if your child has severe asthma, in addition getting checked for asthma, it is important to get checked for food allergies as well. Fifty percent again, 50 percent of severe asthmatics in children may have a corresponding food allergy that may make that worse.

More questions coming in now. Talking about peanut allergies and pregnant woman, specifically about brestfeeding. "I've heard that if you eat peanuts while you're pregnant or breast feeding, it increases the chance that your baby will be allergic to peanuts even if you're not."

Is there any truth to that, Dr. Bassett?

BASSETT: Well there's certain risk factors that people should be aware of that are put out by the American Academy of Pediatrics and other groups. And it says if you have a family history of allergy or you have a family history of allergic condition, such as eczema or food allergy, you may be at a higher risk of developing food allergies specifically to peanuts.

So we recommend during the third trimester of pregnancy, during breastfeeding and perhaps avoiding peanut and other peanut products up until the age 3, would probably be prudent advice. But there are no firm recommendations on these findings.

GUPTA: And that's so hard to do, Leon. Peanuts are pretty much everywhere nowadays. All kind of foods, sometimes restaurants. What do you tell patients, Dr. Bassett, who do have significant peanut allergies? Can you even go out to eat? There's so many places where these peanuts are located now.

BASSETT: Well the good news is there are a lot educational programs for restaurants and other facilities where food is served.

And it's very important that the education occur early on. Prevention is the key to this problem. It's totally preventable. Very important to be aware of your surroundings. Cross contamination both at home and at work and in restaurants. Utensils being used, cooking spaces being contaminated with peanut products.

So it's very important to be aware of your surroundings and ask a lot of questions. When you go out and you're in a restaurant let the server know that you have a peanut or other food allergy problem and they will take it seriously and do their best to help you.

HARRIS: You know I have been impressed to see restaurants more and more get on board with that and label things on their menus. You've noticed that quite a bit.

All right. One more question here. This one is addressed to you, Dr. Gupta. This is coming in from Randall (UNINTELLIGIBLE) in Memphis, Tennessee. "When should a young child start trying peanuts or peanut-based products?"

GUPTA: I think that a fascinating question and probably the answer's changed now as a result of some of the research Dr. Bassett's been talking about. There is a test now to be able to determine how profound a child's allergic response is to peanuts. Depending on the results of that test it may be more prudent to actually start challenging the child with peanuts earlier on in life. Dr. Bassett, what do you think about that?

BASSETT: Again, a screening test is a screening test. It's important to evaluate the probability of having a food allergic problem. Again, risk factors are very important. Discuss with your pediatrician, with your family doctor your allergist what your risk factors are. And let's make a good decision for the individual in the family in terms of exposure to foods such as peanuts.

GUPTA: All right. Dr. Bassett, thank you very much for joining us. Lots of answers to lots of good questions.

You don't have peanut allergies...

HARRIS: I've got the shellfish allergies.

GUPTA: Shellfish, which didn't serve you so well in Africa.

HARRIS: No, as a matter of fact every place I went to there was nothing buy shellfish

GUPTA: Crabs.

HARRIS: Lobster, you name it. So that's why I ate lots and lots of African rice. Much more than I wanted to. I can tell you that.

But this is very interesting stuff and I would love to see if they're able to learn something from this and translate that to other allergies like the one I have to shellfish.

GUPTA: I think that that's probably going to happen now and there's going to be some new medications coming out there to make those allergic responses less severe. People die from these and I think forget that you can actually die from a peanut allergy. So obviously very important, especially to those people.

HARRIS: You got it right. Dr. Sanjay Gupta, thanks, as always.


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