1. Food Allergies Keeping Children Safe at School Megan Schaper, SNS August 15, 2007

2. What is an Allergy? A food allergy is an abnormal response to a food triggered by your body's immune system. Allergic reactions to food can sometimes cause serious illness and death.

3. What ISN’T an Allergy? Adverse reactions to food that do not involve the immune system are not allergies. These may be: • Food poisoning • The inability for digest certain foods (Lactose Intolerance, PKU, Celiac Disease)

4. Quick Facts 11 million Americans have food allergies. Food allergy occurs in 4 to 8 percent of children under the age of 4 and 2 to 4 percent of adults. The prevalence of food allergy is increasing.

5. Quick Facts Food allergy causes roughly 30,000 episodes of anaphylaxis and 100 to 200 deaths per year in the United States. Anaphylaxis: a severe, sometimes life-threatening, allergic reaction that occurs within minutes of exposure to an offending substance

6. Quick Facts Peanuts and tree nuts, such as walnuts, almonds and cashews, cause most cases of severe food allergic reactions.

7. Quick Facts Currently, the only ways to manage food allergies are to: • avoid the foods that cause reactions • treat the symptoms caused by allergic reactions.

8. The Big 8 The most common food allergens are: • Fish • Shellfish • Milk • Eggs • Soy • Wheat • Peanuts • Tree Nuts

9. Food Allergy Triggers People with food allergies can experience a reaction as a result of: • Ingesting the allergen • Touching the allergen • Inhaling the allergen A reaction can be induced by as little as 1/5,000 of a teaspoon of the allergy causing food.

10. Symptoms of a Reaction Symptoms typically appear within minutes to two hours after a person has been exposed to the food. Every child is different and will react differently.

11. Tingling sensation in the mouth Swelling of the tongue and throat Difficulty breathing Hives Vomiting Abdominal cramps Diarrhea Drop in blood pressure Loss of consciousness Death Symptoms of a Reaction

12. Managing Allergies in the School Cafeteria • Identify the Student & Allergens • Know What to Avoid and Substitute • Read Labels • Avoid Cross Contamination • Know What to Do in the Event of a Food Allergic Reaction

13. Identify the Student • Parents provide a physician’s statement outlining the foods to be avoided and appropriate substitutes. • An allergy plan, provided by the parents and including a picture of the child, is posted in the kitchen and reviewed with all staff. • An allergy alert is added to the child’s POS account.

14. Know What to Avoid & Substitute • The parent reviews the menu and ingredient listings with the food service director to determine what foods to avoid. • If food substitutions are required, the parent provides a monthly menu with modifications noted.

15. Reading Labels • Federal law requires labels to clearly identify the source of all ingredients that are — or are derived from — the eight most common food allergens. • Manufactures may change ingredients often and without warning – re-check the label each time a product is served.

16. Avoid Cross Contamination • Change gloves and wash hands each time a new food item is to be prepared. • Thoroughly clean production areas between the preparation of each menu item. • Designate an area/cart for making peanut butter sandwiches. Don’t use the area for any other food production.

17. Avoid Cross Contamination • Do not reuse cleaning clothes after they have been used to wipe up potential allergens until they have been washed in a washing machine. • Wash utensils thoroughly after they come in contact with potential allergens. • Dispose of any food items that have been cross contaminated.

18. The Three Rs for Handling a Reaction • Recognize the symptoms • React quickly - Contact the school nurse so that the student’s allergy action plan can be implemented. • In an emergency, dial 9-911. • Review what caused the reaction and how well the emergency plan worked Initially mild symptoms may not be an indication of the severity of the overall reaction.

19. Student Safety Is In Our Hands It is the law. But more importantly… It’s the right thing to do.