Peanut Allergy: EPI-Education, Preparation and Identification to Make Halloween Safe

James Thompson, MD Health Pro
  • As October 31st draws near, many parents of children with peanut allergies wonder if the terror of the night will come in the form of their child having a severe allergic reaction. Peanut allergy in children has increased over the years. Hospital admissions for food allergic reactions have more than tripled since year 2000. There are 150 to 200 deaths in the U.S. from food allergy annually. The majority of the fatalities are related to peanut and tree nut allergy.



    Three factors that increase the risk of having a fatal allergic reaction to food are:


    1) A delay in getting an injection of epinephrine

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    2) Having a history of anaphylaxis to food

    3) Having a history of asthma



    Keys to avoid letting Halloween fun result in a trip to your local emergency department are education, preparation and identification (EPI). Interestingly, this mnemonic "EPI" is the shortened name of the potentially life-saving injectable drug that is essential to have if signs of anaphylaxis arise (epinephrine).



    Become familiar with the many ways your child may be exposed to peanut allergen. Loose, unwrapped candy should always be avoided. Homemade goodies should also be denied because of uncertainty of whether peanuts may be an ingredient. Taffy apples look and often taste delicious but peanuts are often in the vicinity since it is a popular coating. One tiny crumb of peanut in the caramel may cause severe throat swelling in the unsuspecting child superhero. I have included a link to more information about peanuts as a hidden food allergen below.



    Learn about the signs and symptoms of anaphylaxis and how epinephrine is used to treat it. You shouldn't have to waste time reading "how to" instructions if your child displays symptoms of anaphylaxis and requires your help. Your health care provider should demonstrate the steps to take in giving an epinephrine injection to your child with a placebo device (fake unit that does not contain a needle or any drug).



    Coach your child on how to politely turn down suspected peanut containing candy. Go trick-or-treating with your child if he/she is very young. Otherwise establish a verbal or written contract with your older child regarding candies to avoid while trick-or-treating or at a Halloween party. Inform other parents or supervising adults (or older children) about your child's safety guidelines and how to reach you if there are questions. I highly recommend you read Gina Clowes article from October last year entitled "15 Tips for Food-Allergy Safe Halloween Fun" linked below.



    You and your child (if old enough) should be able to identify whether a candy or treat is peanut safe. If this cannot be done (no label, unwrapped etc.) consider it to be unsafe. It is important to identify and confirm whether there are other food allergies. Tree nuts are not in the same family grouping as peanuts but many children have allergy to both peanuts and tree nuts. Allergy testing helps to identify specific food allergy triggers. See a board certified allergist if there is any doubt about the food your child is allergic to.


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    An identity bracelet or necklace with inscribed medical information should be worn by anyone with a history of food allergy. This information may assist a friend, stranger or emergency personnel in giving urgent aid.


    Your home may be a peanut safe haven for your child but if trick-or-treating or Halloween parties are on the agenda preparations need to be made. The more you are aware, prepared and involved with this annual costume and candy oriented celebration, the greater your peace of mind, knowing that your child will be safe.


    Gina Clowes "15 Tips for Food-Allergy..."  


    This link is about peanuts as a hidden ingredient.

Published On: October 29, 2010