B ROLL The Dwyer family, with son Dylan Children with peanut allergies	OVERVIEW: Shon Dwyer is constantly fearful that her 7 year-old son Dylan may come in contact with peanuts or any peanut-product. Because of Dylan’s peanut allergy, even a trace of the nuts could send Dylan into anaphaylaxis, a severe life-threatening allergic reaction. Shon talks about how Dylan’s allergy affects his life and the life of his family. Dr. Marc McMorris, an allergy specialist at the University of Michigan Health System, discusses severe allergic reactions, who may be at risk for this life-threatening event, and what allergy dangers may lurk in the warmth of summer.
Shon Dwyer Son has potentially life-threatening allergy	SHON DWYER: [SHAWN DWY-er] [02:01:03] My son Dylan, when he was about 10 months old, I came home from an appointment and just checked on him in his crib to find him with a huge hives, like quarter-sized on his face and really didn’t know what happened. I asked my husband, ‘what did he have for lunch ‘or ‘what was going on?’ And, ‘nothing. Just normal stuff.’ And went back in the room and he was fully covered with hives, so [I] started to treat him with Benadryl and really said exactly what did he have to eat? And he said, ‘you know, I gave him half of the peanut butter and jelly sandwich we had but only the jelly side,’ and so that’s when I knew that he had this peanut allergy at least, [02:01:46]
	[02:01:49] …that was the start of a very long road and we’ve since found that he’s allergic to both peanuts and almonds and very severe. [02:01:57]
	[02:03:40[ This allergy really has affected our life. We’ve had to change how you grocery shop, how you prepare food, where you can go, all of those kinds of things. And the reaction to it by other people has been very difficult and you have to get over the hump with your family, and some people can just think you’re overprotective or a little crazy. But it’s our job; we talk about it, to keep him safe and to also keep him as normal as possible. But it does change your life. [02:04:13]
	[02:05:11] I would never leave the house without the epi-pen. We always have, well, we have an emergency bag and they’re around school and they’re everywhere because the allergies, especially the peanut, is completely unpredictable. You can have no reaction or very little reaction to an exposure and the next time have anaphylaxis so it’s extremely important that you have it with you wherever you go because that’s the number one thing that will save their life. So we don’t leave home without it. [02:05:38]
Marc McMorris, MD Division of Allergy & Immunology University of Michigan Health System	MARC McMORRIS, MD: Allergies and severe allergic reactions [01:02:34] Within the scope of all of allergies, we have about 20 to 30-percent of our population is allergic to something, whether it’s trees or grass or weeds or foods, or some other allergen. Within the context of that, a very small percentage is actually prone to having life-threatening allergic reactions or anaphylactic reactions. [01:02:55]
	[01:03:30] The most common allergens known to cause life-threatening allergic reactions are medications, foods and insect stings in general in this country. [01:03:41]
	[01:16:19] There are allergens that are life-threatening and there are allergens that cause common symptoms for the population. Those allergens, such as insect stings, bees, yellow jackets, wasps, down-south fire ants, where the venom is injected into the body, gets absorbed more rapidly and distributed more rapidly, which allows for a systemic reaction to occur, or potentially life-threatening reaction. The same would hold true for foods that you’re ingesting. They get into the intestinal system, get absorbed and get recognized as foreign products and then the allergy system releases the chemicals and mediators that cause the allergic reaction… []
	[01:17:12] This is much different, generally, than hay fever, for example, which is just impacting, for example, the nose or the eyes and causing local symptoms. [01:17:20]
	Anaphylaxis [01:04:00] Anaphylaxis, or a serious life-threatening allergic reaction, generally comes on very quickly, generally comes on within five minutes to sixty minutes, as opposed to other allergic symptoms such as hay fever or allergic rhinitis. You would find severe symptoms consisting of hives, throat swelling, troubles breathing, nausea. It goes far beyond the usual symptoms one would see with hay fever, for example. [01:04:27]
	[01:09:30] Patients with food allergies or other allergies such as insect stings or medications, with subsequent exposures the reactions can become more severe and can become life-threatening. We don’t know when that will occur. The problem with these is you don’t know if that’s going to be the next exposure or five exposures from now. So you have to be very careful with regard to avoidance and taking appropriate measures to avoid those allergens that you have sensitivity to, particularly if you have a life threatening reaction because these can become very severe and can become life threatening. [01:10:02]
	Who is at risk for life-threatening allergies [01:05:49] Generally, the serious food allergies that we’re seeing these days occur initially in early childhood, although, adults can develop new onset allergies to, for example, nuts or seafood, more commonly. Insect stings tend to be more common as you get older. [01:06:05]
	[01:19:43] I think uh if we look at how do we advise families with regard to their children, uh the same ways I would look at my children, um those families who have a family history of allergies, hay fever, asthma, eczema, certainly from the food perspective, would be wise to avoid the high-risk foods during early childhood and there are set guidelines that we use for that now. With regard to other causes of anaphylaxis or life-threatening reactions, particularly bees and wasps, et cetera, then just take normal precautions. []
	[01:14:58] Patients who have an allergy to a potentially life threatening allergen should be evaluated by their primary care doctor and subsequently by an allergist to determine if they indeed have had symptoms serious enough to require aggressive therapy, including carrying of the epinephrine self-injector. I think anybody that has had a life-threatening reaction should have epinephrine with them at all times. That would include children, as well as parents and families, no matter what locations they’re in. [01:15:33]
	Treating life-threatening allergies [01:10:33] Anaphylaxis by definition is a severe, life-threatening reaction. And patients may develop life-threatening and even fatal responses to an allergen if they’re not treated appropriately and aggressively. The key to therapy is very early recognition and very early therapy with appropriate medications. [01:10:55]
	[01:11:02] We would want to treat anyone that has a severe potentially life threatening allergy two ways. One is preventatively. Obviously, avoid those things that you’re allergic to. []
	[01:11:44] …epinephrine or adrenaline is a medication used which basically reverses the effects of anaphylaxis. It raises your blood pressure, it controls the system that releases all the chemicals that are responsible for anaphylaxis or the serious reaction. It is delivered by injection. Families can have auto-injectors in their home… []