According to the American Academy of Allergy, Asthma & Immunology, one in every 13 children -- or approximately two children per classroom -- has a food allergy.
Anaphylaxis is a potentially life-threatening reaction that may occur by accidental ingestion of a food allergen. Immediate administration of epinephrine is the only treatment that has shown to be effective in preventing deaths from anaphylaxis.
Epinephrine currently comes in two different auto-injector devices, Epi-pen and Auvi-Q, and is very safe in children, with the most common side effect being a transient increase in heart rate. Similar to automated external defibrillators (AEDs), which are available in schools for life-threatening heart disease, these prescription devices are designed for self-administration by nonmedical personnel and require minimal training to use.
While the majority of children diagnosed with food allergies are aware of their allergy, 25 percent of epinephrine administrations occurring in school involve children whose risk for allergy was unknown at the time of a reaction.
Previous Florida legislation allowed a student to have a prescription auto-injector available at school, but it did not allow schools to keep a stock supply of epinephrine for emergency use. Unfortunately, this meant that any child who experienced a first-time anaphylactic reaction at school did not have access to this life-saving treatment.
It also placed known food allergic children at risk if they did not have an epinephrine auto-injector readily available. In fact, this was an unfortunate reality for a 7-year-old Virginia student, Ammaria Johnson, who died of a food-induced anaphylactic reaction at school in 2012. She did not have an injectable epinephrine auto-injector at school and the school did not have a nonstudent-specific stock of epinephrine. Her death may have been prevented if epinephrine was readily available and if school personnel were allowed to administer the medication without fear of liability.
The Florida Allergy, Asthma & Immunology Society, which represents approximately 150 allergists throughout the state of Florida, proposed an amendment to the current legislation pertaining to anaphylaxis in schools. Senate Bill 284, School Emergencies, enables public and private schools to adopt an anaphylaxis protocol to be developed by a licensed physician.
School personnel would be trained on how to recognize anaphylaxis, treat an anaphylactic emergency and be trained how to use epinephrine auto-injectors. It also permits schools to maintain a nonstudent-specific stock of epinephrine auto-injectors for emergency use. This amendment was supported by the Florida Medical Association, numerous Florida medical societies, patient advocacy groups and concerned parents of children with food allergies.
Additionally, two manufacturers of epinephrine auto-injectors, Mylan and Sanofi-Aventis, have also agreed to distribute devices to every public and private school in the state. The Florida Allergy, Asthma & Immunology Society and its members agreed to assist in the development of protocols and to train school personnel.
The primary sponsors of the important collaborate amendment were Rep. Mike LaRosa and Sen. Joe Negron. It was signed by Gov. Rick Scott on May 30 and took effect July 1.
This amendment represents a major victory for Florida students. It gives our school personnel the training and tools to freely treat anaphylaxis in all school children. Hopefully, Florida school districts, encouraged by physicians and parents, will comply and assist with this opportunity to protect all students from life-threatening food allergies.
Patrick J. DeMarco, M.D., FAAAI, FACAAI, is the immediate past president of the Florida Allergy, Asthma & Immunology Society.
