Peanuts, peanut butter, and peanut oils are processed into literally thousands of products, candies, cookies, and main dish recipes, making it extremely difficult for anyone to avoid the symptom-provoking proteins.

But some people have severe, life-threatening reactions when exposed to even trace amounts of peanuts. A knife used to spread peanut butter and subsequently dipped into a jar of jelly can have lethal consequences for an unsuspecting peanut-allergic child or adult when, days later, they use the jelly to top a piece of toast at breakfast.

Sitting next to a person eating peanuts, kissing (or being kissed by) someone who just ate peanuts, or touching a surface contaminated with invisible residue of peanut protein pose terrifying threats to the peanut-allergic person.

Adults and children with severe, anaphylactic reactions to peanuts should never be far from an oral antihistamine and auto-injected shot of epinephrine, such as EpiPen® or EpiPen Jr.®. EpiPen®, distributed and marketed by Dey, L.P., comes with a training unit.

Periodically review your physician’s instructions for managing a peanut allergy emergency and practice using the training unit. Don’t wait for a medical crisis to test your memory!

Symptoms of severe reactions may include:

• Increased saliva
• Itching inside the mouth
• Swollen tongue or lips
• Itching inside or outside the throat area
• Difficulty breathing
• Profuse sweating
• Hives (raised red patches of skin) all over the body
• Shallow pulse or shallow breathing
• Anxiety (you’d be stressed out, too)
• Changes in skin color – flushing, loss of color, blue or purplish tint to the lips or fingernails

These signs and symptoms indicate a medical emergency. If your physician has provided written instructions to follow, now’s the time to enact them. If you don’t know what to do, call 911 and don’t worry about who’s going to pay the bill. Anaphylactic reactions do not need prior authorization to ensure your health plan pays for the emergency treatment at a hospital. Even if you do not have health insurance, you can always work out a payment plan with the billing office once you’ve recovered from the incident!

Even the more subtle signs and symptoms of peanut allergies can suddenly become life- threatening and should therefore be taken seriously. Sometimes, it’s the rash or tiny raised bumps around the mouth, increased nasal discharge, or coughing that hints peanut allergy may be present. RAST (blood) testing for peanut allergy performed and assessed by a board-certified allergist along with your verbal description of what happens after eating, inhaling, or touching peanut proteins can also confirm the diagnosis.

Friends and family members of a peanut-allergic person must also be very watchful of their own peanut habits to avoid becoming the source of peanut contamination. For example, eating a package of peanuts on a plane and then kissing a peanut-allergic child who eagerly awaits your arrival at the gate may cause a reaction no one would attribute to peanut allergy until it’s too late.

If there is a family history of allergies, nursing mothers may be advised to avoid eating peanuts until after weaning the baby from the breast. Because peanut allergy can be deadly and one in 200 children have peanut allergies by age four, delaying introduction of peanut butters may also be advised.

It’s a delicate dance of prevention and planning. You do everything you can to avoid problems while remembering that you live in a world of peanut lovers and products.

While airlines serve fewer peanut snack packs, it’s unlikely we’ll see a worldwide ban on peanuts. It’s your job to arm yourself with the tools necessary to protect your or your child’s health and teach your family to do the same.

Reprinted from Allergy & Asthma Health magazine, Spring 2001.