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Food Allergies during the Holiday Season and the Stocking of Epinephrine in Schools

posted on Tue, Dec 10 2013 3:02 pm by Lauren Peterson

Every holiday season brings an abundant variety of seasonal foods and treats — and for many parents, a real concern: if my kids have food allergies, how can I keep them safe? Food allergies are the leading cause of anaphylaxis, a systemic allergic reaction that can cause asphyxiation, extremely low blood pressure and, if untreated, even death. Given that the holiday season is upon us, parents of children with food allergies must remain hyper-vigilant, but this gets challenging when the children are in school.

Most children with food allergies participate in school activities during the holiday season where candy and other sweet treats are offered. For example, many elementary school classrooms throw holiday-themed parties for their students. Even the late winter and spring months bring risks for kids with food allergies, when treats come with valentines and Easter egg hunts, especially for younger children. Ultimately, schools must be aware of how to keep kids with allergies safe during the school year.

In recent years, there has been a push from both state and federal legislators to require, or at least encourage, schools to stock auto-injectable epinephrine to be used on any child experiencing allergic reactions without the need for a prescription. Epinephrine is a medication that can reverse the severe symptoms caused by food allergies or insect venom. A Network blog post from December 2012 highlights these legislative efforts and since then, even more states have passed legislation to require schools to stock epinephrine for emergency use. This is likely in response to tragic events that occurred in U.S. schools in recent years. In Virginia, a seven-year-old girl died after eating a peanut given to her by a classmate. Two years earlier in Illinois, a 13-year-old girl died after eating food brought into the classroom that contained peanut oil.  These tragedies have sparked considerable debate about the use of auto-injectable epinephrine (the most common form being the EpiPen©) in schools. To date, 30 states allow the stocking of epinephrine for use without a prescription by a trained individual. Of those 30 states, only four — Maryland, Nebraska, Nevada and Virginia — require that schools stock the drug. On the state level, the trend seems to be moving towards stocking epinephrine in schools for emergency situations. Many of these state laws also address liability issues for the administration of epinephrine, often releasing from liability any school personnel who provide treatment in good faith.

On the federal level, The School Access to Emergency Epinephrine Act was first introduced in the Senate on November 17, 2011 to encourage states to require elementary schools and secondary schools to maintain, and permit school personnel to administer epinephrine at schools. This bill would amend the Public Health Service Act to increase the preference given in awarding certain asthma-related grants to states allowing trained school personnel to administer epinephrine. Despite extensive bipartisan support in Congress and support from advocacy organizations nationwide, the Act did not pass in 2011. On May 22, 2013, the bill was introduced in the House as H.R. 2094. On July 30, 2013, the bill was approved by the House of Representatives, and in September introduced as Act S. 1503 in the Senate. The bill passed the Senate on October 31, 2013 and was signed by President Obama on November 13, 2013.

It’s apparent that both state and federal governments recognize the importance of preventing injury and death from serious allergic reactions. The passage of the federal law will encourage more states to allow their schools to maintain an emergency stockpile of epinephrine — something that may put parents and educators a little bit more at ease in holiday seasons to come.

This blog was prepared by Lauren Peterson, Public Health Law Clinic student at the University of Maryland Carey School of Law, with supervision by Kathleen Hoke, J.D., director of the Network for Public Health Law – Eastern Region at the University of Maryland Carey School of Law.

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state. The views expressed in this post do not represent those of the Robert Wood Johnson Foundation.

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