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When food can kill

Next steps for food allergy awareness and emergency preparedness
University Business, Oct 2011
Cautionary measures: Allergen-sensitive environments such as My Zone at Rensselaer Polytechnic Institute offer easy access to fresh and frozen meals and grocery items. Photo: Sodexo

In the event of a severe allergic reaction, a delay of even a few minutes in getting an epinephrine injection can make a scary situation deadly. That appears to be what happened to Kennesaw State University (Ga.) student Tyler Cody Davis, who, on August 18, ate at the campus dining hall, later returned there in distress to seek emergency assistance, and not long after was pronounced dead at a local hospital, according to a KSU statement. While the official cause of death is under investigation, published reports and reader comments indicate that Davis had a milk allergy and was known to be cautious of what he ate.

The tragedy “likely could have been avoided,” says Christopher Weiss, VP of advocacy and government relations at FAAN, The Food Allergy & Anaphylaxis Network. Young adults are at the highest risk group of a fatal allergic reaction—“largely because they exhibit risky behavior, such as leaving home without their epinephrine, or eating foods that they are not completely sure about,” he says.

How does that risk translate to administrative action? As many as 15 million Americans, including about 6 million children, have food allergies, according to FAAN, and many campus leaders are conscious of those numbers. Weiss advises ongoing awareness efforts and training among food service staff, which will allow them to accurately convey information to students and help prevent cross-contact in kitchen prep areas.

On the table at some institutions is having epinephrine—often called an EpiPen, a brand-name self-injectable epinephrine—on hand for emergencies in which someone with allergies isn’t carrying an EpiPen, another dose is needed before emergency personnel can arrive, or someone without known allergies experiences anaphalaxis.

“A back-up system of having EpiPens on file at strategic campus locations can be helpful” in an emergency, acknowledges Arlethia Perry-Johnson, KSU’s VP for external relations. KSU is exploring that idea, although a risk of the approach could be that students might become lax about equipping themselves with an EpiPen at all times.

Weiss says other potential obstacles include staff training, EpiPen costs, and expiration date monitoring—since devices generally need to be replaced annually. There also might be legal concerns related to nonmedical staff administering treatment. Yet, students with known allergies can typically self-administer.

The EpiPen idea has been served up at College of the Holy Cross (Mass.), too, says dietician/nutritionist Kathy Egan, RD, LDN, but officials decided not to pursue it now. The college has a “very thorough allergy process” for affected students involving a meeting with the director of health services and a requirement to always carry an EpiPen. In the dining hall, everyone from line staff and servers to the head chef is trained to know their own responsibilities when a customer notifies them of an allergy. With meal plans being an on-campus student requirement, “we felt it was important to have options for everyone,” Egan says. Holy Cross is one of 63 institutions in the FAAN College Network, which helps prospective students learn more about schools’ allergy policies.

Food service operators also play a key role in dining hall policy and practice. Parkhurst Dining Services worked with FAAN and Walt Disney World (known as being “allergy aware” in the food allergy community) on its allergy program. Bill Moore, director of safety and security at Parkhurst’s parent organization, Eat’n Park Hospitality Group, shares that a collaboration with food safety company San Jamar resulted in a purple cutting board and color-coded kitchen utensils set used only for guests with allergy concerns. A training video illustrates the emotional side of having a food allergy.

Sodexo offers My Zone, a separate area within the dining hall to accommodate special dietary needs, and Simple Servings, which avoids seven of the “Big 8” allergens, says spokesperson Monica Zimmer.

Allergy program ideas are shared openly in the industry, says Moore. “It’s not about profitability or a competitive edge. It’s about doing the right thing.”

UPDATE: The Georgia Bureau of Investigation announced that an autopsy determined Tyler Cody Davis had in fact died from an allergic reaction. He was carrying an EpiPen and tried to use it, but the needle bent and he was unable to inject the medicine in time.