Booster Shots

Oddities, musings and news from the health world

Category: allergies

New Benadryl recall adds to consumers' headaches

June 17, 2010 | 11:09 am

The Food and Drug Administration and the maker of a wide range of over-the-counter medicines have announced a new addition to a wide-ranging recall of popular medicines that started in December. The latest recall urges consumers who may have purchased certain 100-count packages of Benadryl Allergy UltraTab tablets and 50-count packages of Extra-Strength Tylenol Rapid Release Gels to stop using these products and contact the manufacturer (either by logging on here or by calling 1-888-222-6036), about refund or replacement.

McNeil Consumer Products says these medications should have been included in the recalls issued in January, which were prompted by reports of a musty, moldy odor emanating from several of the company's products. 

Since the first and second rounds of recalls were announced in December and January -- affecting such products as Tylenol, Motrin, Benadryl and Rolaids -- McNeil Consumer Products says it has discovered the source of the unsettling odor: the breakdown of a product used on the wooden crates and pallets on which the products are transported and stored. "The risk of serious adverse medical events is remote," the company said in its notice of the latest addition to its recall list.

Do you want to be the first on your block to know when the FDA issues a product warning or recall? You can sign up for regular alerts, you know. (But better be ready to get a lot of e-mail!)

--Melissa Healy


With food allergies, much is said but little is known, conclude researchers

May 11, 2010 |  4:55 pm

Milk Food allergies are a problem, especially if you want answers. Just ask often-confused consumers -- or the researchers who recently tried to put a finer point on the topic.

In their noble attempt to establish the prevalence, diagnosis, management and prevention of food allergies, researchers at Stanford University, Rand Corp. and the Veterans Affairs Palo Alto Healthcare System searched databases, analyzed reviews, assessed controlled trials and compared sample sizes. Their conclusion largely seems to be: What a mess.

Or in their words: "There is voluminous literature related to food allergy, but high-quality studies are few. Prime needs for advancement of the field are uniformity in the criteria for what constitutes a food allergy and a set of evidence-based guidelines on which to make this diagnosis."

Their review of food allergy research was published in the May 12 issue of the Journal of the American Medical Assn. 

For starters, the researchers found, there is no agreed-upon definition of food allergies. The National Institute of Allergy and Infectious Diseases, which funded their work, endorses this definition: "an adverse immune response that occurs reproducibly on exposure to a given food and is distinct from other adverse responses to food, such as food intolerance, pharmacologic reactions, and toxin-mediated reactions."

Works for me -- but not apparently for everyone. Such a definition wasn't used in all the research on the matter.

If researchers can't even agree on the definition, you can see how finding common ground on prevalence and diagnosis may be a problem. And as for management ...

Good luck.

The researchers did establish that food allergies affect more than 1% or 2% of the population (but less than 10%). They couldn't confirm, as many believe, that such allergies are actually increasing; nor could they prove that elimination diets will work, even for non-life-threatening reactions. Immunotherapy? It seems promising, but again, no one can say (yet, at least) that it will offer long-term, or safe, relief.

Suffice to say, people allergic to a specific food -- or who think they're allergic to a specific food -- shouldn't expect hard and fast guidance any time soon.

Here's Stanford University's press release on the review, plus a post from the school's Scope blog.

In the latter, the writer recalls a former schoolmate's allergy to milk at a time when food allergies seemed rare. (That's hardly the case now.) My family, on the other hand, was more familiar with the confusion in the food allergy field. An otherwise charming relative blamed it for the loud and seemingly endless throat-clearing after every indulgence of hot-fudge sundae cake -- indulgences that, in retrospect, were surprisingly frequent. Only as an adult was she tested for allergies. Only as an adult did she come to realize she'd bedeviled us all for no reason whatsoever -- no reason having to do with food allergies in any case. Some allergies are outgrown, yes; this apparently was not the case here.

(As for you, Mr. Allergic to Milk but Not Almost-Shocking Amounts of Ice Cream ... let's just say, I'm skeptical. Charmed in an amused way but skeptical. ...)  

But I digress. Here's an L.A. Times story of a few months back explaining in more traditional form why allergies are overdiagnosed, confused and what-not: Think you have food allergies? Think again

As that story states:

With a glut of nonspecialist doctors now offering allergy testing to patients, results that can be difficult to interpret, symptoms that can be wide-ranging and people's insatiable need to find explanations for whatever ails them, foods are frequently blamed for crimes they did not commit.

Though allergies or intolerances (and recognition of them) do appear to be on the rise, there are far more people who erroneously think they have problems with specific foods.

Here are two related stories: Accuracy of allergy tests varies and Cause of rise in real food allergies is unclear.

And here's more on the promising but still unproved immunotherapy: Therapy to suppress peanut allergies is reported: "By taking small but increasing doses of the food, five children can now freely eat items containing peanuts, an allergist says in presenting the results of two clinical trials."

As for people who do, in fact, have food allergies -- which can be life-threatening and thus are not to be taken lightly -- the Food Allergy & Anaphylaxis Network offers advice on how to protect against foods blamed for 90% of such allergies: milk, egg, peanut, tree nuts, fish, shellfish, soy and wheat.

It offers a wealth of other resources as well, as does MedlinePlus' overview of food allergies. Check out the latter's distinction between food allergy and food intolerance. It's one of the issues that make hard and fast answers in this field so difficult. The National Institute of Allergy and Infectious Diseases, meanwhile, offers a rundown of allergy research.

Then sign up to receive emails from the Food and Drug Administration about recalls and safety alerts. Often, products are pulled from store shelves because they contain undeclared allergens. For most people, consuming them wouldn't be a problem. For some people, it could prove deadly.

With researchers still trying to get to the bottom of food allergy prevalence and management, consumers shouldn't become food-allergy hypochondriacs, but they should try to protect themselves as best they can.

-- Tami Dennis

Photo: Allergic to milk? Sensitive to it? Or just don't like the stuff? Sometimes, it's hard to say. (This is soy milk, FYI -- offering double the confusion.)

Credit: Anne Cusack / Los Angeles Times


Free asthma screenings coming to a town near you

May 2, 2010 |  8:00 am

Asthma Los Angeles-area allergists will conduct free asthma screenings as part of the Nationwide Asthma Screening Program beginning Tuesday in Marina del Rey. The program is a yearly event sponsored by the American College of Allergy, Asthma and Immunology. It's a great opportunity for people who have limited health resources to be checked for this pernicious illness. More than 23 million Americans have asthma. Many people have the disease and yet have never been diagnosed and treated.

"With the right diagnosis and treatment, including medication, anyone with asthma can be active, Dr. John Winder, chair of the Nationwide Asthma Screening Program, said in a news release. "No one should accept anything less. If you've experienced these symptoms or just want to make sure you have good control of your asthma, attend a free screening and find relief."

The screening will include a 20-question questionnaire, a lung function test and a consultation with an allergist.

Upcoming screenings include:

  • Tuesday, 9:30 a.m. to 5 p.m., at Marina del Rey Medical Offices, 4650 Lincoln Blvd., Marina del Rey
  • May 7, 9 a.m. to 5 p.m., Bravo Pharmacy at Superior Grocers, 7316 S. Compton Ave.
  • May 25, 12 p.m. to 1:30 p.m., Calle Mayor Middle School, 4800 Calle Mayor, Torrance


Click for a list of asthma screening locations and dates and for more information on asthma.

-- Shari Roan

Photo: A woman listens to instructions before taking her lung function test at a free asthma screening. Credit: American College of Allergy, Asthma and Immunology


Parents of children with severe food allergies should carry two EpiPens, not just one

April 8, 2010 |  3:31 pm

Parents of children with severe food allergies should always carry two EpiPens or similar devices because one shot of epinephrine is often not sufficient to overcome an allergic reaction,  researchers reported Monday. At least one in every eight children suffering anaphylactic shock from a reaction to food required a second dose of the drug to fully recover, researchers from Children's Hospital Boston reported in the journal Pediatrics.

Surprisingly, the researchers found, even children who went to the hospital for their symptoms were often not Epipen treated properly and were not given prescriptions for the devices on their discharge.

Food allergies affect at least 6% of children and, by most estimates, seem to be rising. Symptoms of a severe reaction include skin rash, itching, swelling, trouble swallowing and breathing, nausea and vomiting. An injection of epinephrine is often enough to reverse the condition, but sometimes two shots may be necessary, Dr. Susan A. Rudders of Children's Hospital Boston said.

Rudders and her colleagues studied about 1,200 children with an average age of 6 who were treated at two Boston hospitals for food-related allergic reactions between 2001 and 2006. A little over half of the children suffered severe reactions and 44% of this group received epinephrine. Of that smaller group, 12% received two doses of epinephrine.

To the researchers' surprise, half of the children with severe reactions did not get epinephrine even after going to the hospital. Instead, they received antihistamines, steroids, intravenous fluids and inhaled medicines -- none of which have been proved to be effective first-line treatments. Furthermore, fewer than half of the children left the hospital with a prescription for injectable epinephrine and only 22% were advised to see an allergist.

The most common offending foods included peanuts, tree nuts, milk, shellfish, fish and eggs. Some of the allergic reactions were also triggered by fruits and vegetables, however, even though they are generally considered to have a low propensity for causing allergic reactions.

-- Thomas H. Maugh II

Photo: Sixteen-year-old Allison Rush always carries an EpiPen because of her allergy to peanuts. Credit: David Zalubowski / For the Times


Rodent of the Week: Could patients with severe asthma benefit from bone marrow transplants?

March 19, 2010 |  7:00 am

Rodent Cases of severe, therapy-resistant asthma are on the rise worldwide, and new strategies are needed to treat the estimated 100,000 people who die of asthma every year. Researchers from the National Institutes of Health and their colleagues are exploring a radical solution – bone marrow transplants.

Scientists know the transplants have the potential to reset the immune system and calm an overactive inflammatory response. They’re already used to treat patients who develop acute graft-versus-host disease following an organ transplant. Asthma also involves excessive inflammation, prompting the airways to constrict and the lungs to secrete mucus. Why not reboot the immune systems with a bone marrow transplant?

To test their theory, the researchers gave the transplants to asthmatic mice that were allergic to ragweed. Then, when the mice were exposed to ragweed, their allergic and asthmatic symptoms (measured by chemical levels in their blood) decreased significantly. The scientists concluded that the bone marrow transplants helped the mice by restoring a healthy balance of immune system cells known as Th1 and Th2.

The results were published online this week in Proceedings of the National Academy of Sciences.

Dr. Eva Mezey, who heads the adult stem cell research section at the National Institute of Dental and Craniofacial Research in Bethesda, Md., told HealthDay that “it’s very likely that the intervention would work in humans.”

But she emphasized that more research is needed before bone marrow transplants could be tested in people with severe asthma. For instance, although the mice got their bone marrow through an intravenous injection, human patients might do better with an aerosol because it could deliver the cells directly to the lungs, she said.

— Karen Kaplan

Photo credit: Advanced Cell Technology Inc.


New meaning to the hazards of air travel

February 16, 2010 |  9:00 am

Doggy Air travel seems to get harder all the time. The latest threat to the traveling public comes in the form of four legs and fur.

According to an editorial published today in the Canadian Medical Assn. Journal, it's time for humans with pet allergies to take back the skies. So many people today are flying with small pets in the airline cabins that people with pet allergies are being put at risk, state the authors of the paper, who represent the journal and the University of Ottawa. About one in 10 people have an allergy to animals.

Service animals are rightfully permitted on planes, the authors said, and are not the issue. But pets can travel in cargo, they argue. Some countries have ruled that people who are allergic to nuts should be spared from exposure to those courtesy peanuts aboard many flights, but there are few rules governing pets in the cabin. According to the paper, one Canadian-based airline has pets on about 25% of its flights.

"The preferences of pet owners should not supersede the well-being of their fellow passengers," the authors wrote. "Pets can be accommodated comfortably and safely in airplane cargo holds, which is where they belong. Airlines must choose to put the needs of their human passengers first, or be forced to do so."

-- Shari Roan

Photo credit: Ray Kachatorian / For The Times


Rodent of the Week: Germ exposure in pregnancy may benefit kids, study indicates

December 11, 2009 |  1:00 pm

Rodent_of_the_week The hygiene hypothesis is the idea that exposure to germs early in life builds a stronger immune system and lowers a child's risk of developing allergies and asthma. Another piece of evidence for that concept, published this week, shows that even exposure to germs during pregnancy may reduce allergy risk in the offspring.

German researchers exposed pregnant mice to airborne barnyard microbes. (Studies in humans show children who are raised on farms develop fewer allergies than kids raised in non-farming communities.) The exposure triggered a mild inflammatory response in the pregnant mice, which was measured by an increased expression of microbe-sensing receptors called TLRs and the production of immune system substances called cytokines. The exposed mice gave birth to offspring who were resistant to allergies caused by the microbes. The study was published in the Journal of Experimental Medicine.

"...Studies have demonstrated that many factors affecting the initiation and course of respiratory allergies appear to act within a narrow window of opportunity, either prenatally and/or early in life. It is still unresolved, however, how protective signals are transferred from the mothers to the developing fetus," the authors wrote in the paper.

The paper adds "a new twist" to the hygiene hypothesis, said experts from the Center for Child Health Research at the University of Western Australia, in a commentary published with the study. The allergy response in human tissues differs from mice, they cautioned, but more attention should be paid to maternal environmental exposures during pregnancy that might influence the health of the offspring.

-- Shari Roan

Photo credit: Advanced Cell Technology Inc.


Study points to increasing food allergies among children

November 16, 2009 | 11:04 am

Peanut Almost 4% of American children have food allergies, according to a sweeping analysis of the problem published today in the journal Pediatrics.

The study is the first to make a broad estimate of the prevalence of food allergies among U.S. children and supports previous, smaller studies suggesting that food allergy rates are rising rapidly for reasons that are unclear.

Researchers from the Centers for Disease Control and Prevention found that self-reported food allergies increased 18% from 1997 to 2007.

The estimates were drawn from surveys of the children's parents and from medical records. Using data from medical records taken in 2005-06, researchers found 9% of all children tested positive for immunoglobulin E antibodies to peanuts. IgE tests are not considered reliable indicators of an allergy, but they do suggest an increased risk or past history of an allergy. The antibody tests were positive for egg allergies in 7% of children, for milk allergies in 12% and for shrimp allergies in 5%.

Finally, the analysis showed that healthcare visits for food allergies in children nearly tripled between the two time periods studied: 1992 through 1997 and 2003 through 2006. In the later period, U.S. children had an average of 317,000 visits to healthcare settings per year for food allergies.

The study also suggests potential racial differences among children with food allergies. While Latino children had the lowest prevalence of food allergies in 2007 compared with other racial groups, they had the greatest increase in reported food allergies over the time period studied.

"We used four different surveys, and to see an increase in food allergies in all of those surveys is very telling," said the lead author of the study, Amy M. Branum of the National Center for Health Statistics. "This is not just limited to one demographic or age group."

-- Shari Roan

Photo credit: Al Schaben / Los Angeles Times


Allergic reaction to vaccines should be investigated

October 9, 2009 | 12:01 pm

Allergy Some people have an allergic reaction after having an immunization, an experience that often -- and quite naturally -- leads to an avoidance of any future immunizations. But new guidelines published this week state that any allergic reaction to a shot should be investigated to understand the cause, rather than just giving up on vaccinations.

About 235 million doses of vaccines are given each year in the United States, and about 235 cases of anaphylaxis, a serious medical reaction, occur. Milder reactions to vaccines, such as redness and soreness at the injection site and fever are common and should not deter people from getting future immunizations, said Dr. John M. Kelso, the chief author of the report.

However, when a serious reaction occurs, the patient should be evaluated by an allergist to determine the culprit allergen. This can be done through allergy testing. Vaccine components that could cause reactions include gelatin or egg protein, yeast, latex from the syringe plungers, neomycin and thimerosal.

Once the problem allergen is identified, individuals and their doctors can make decisions about receiving future vaccines in order to ensure safety.

"Persons with a history of allergy to egg or a past reaction to an influenza vaccine may still be able to receive the H1N1 vaccine or the seasonal flu vaccine safely," Dr. James T. Li, an author of the report, said in a news release. "I believe that anyone with this concern should check with their doctor and consult with an allergist."

The guidelines are online at www.allergyparameters.org.

-- Shari Roan

Mel Melcon  /  Los Angeles Times


Learning to tolerate a peanut allergy

February 21, 2009 | 12:00 pm

PeanutbagPeanut allergies affect thousands of people and can even produce life-threatening anaphylactic shock in severe cases. With few ways to protect people with a peanut allergy -- other than avoidance -- British researchers have tested a daring new approach to the allergy. They exposed people to peanuts.

The study, published this week in the journal Allergy, was conducted in only four children with peanut allergies. The researchers slowly exposed the children to peanuts over a six-month period, starting with as little as 5 milligrams of peanut protein, which is about one-fortieth of a peanut. Eventually, the children were all able to tolerate up to 10 peanuts (although one child had anaphylaxis during the study and required an adrenaline injection). Though the amount of peanuts tolerated was small, the authors noted, it might protect children who accidentally ingest peanuts hidden in food.

Previous allergy studies have shown people can be desensitized to allergens like pollen and bee stings. But desensitization has never been shown to work with a food-related allergy. The researchers, from Addenbrooke Hospital in Cambridge, told the BBC that the patients should be able to retain their tolerance by eating a small daily dose of peanut protein. The study is continuing in a larger number of people.

-- Shari Roan

Photo credit: Ken Hammond / Associated Press



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