Allergic reactions to milk-contaminated ''nondairy'' products

Article Abstract:

People who are allergic to milk products restrict their diets to avoid such products, but severe reactions have occurred in such people even to products labeled ''nondairy'' or ''pareve''. To determine whether such foods can, in fact, contain milk proteins, an analysis was undertaken of several foods eaten by six children immediately before severe allergic reactions began, most requiring hospitalization. The foods included frozen tofu (Lofts Tofulite), a beef hot dog (Oscar Mayer), a frozen dessert, and canned tuna fish (Acme). The patients were known to have milk product allergies and had histories of allergic reactions to allegedly milk-free foods. Results of the analyses for casein (insoluble milk proteins), whey (soluble milk proteins), and other milk proteins showed that virtually all products evaluated contained some amount of these proteins. Extreme variation was noted with respect to the amounts contained; however, the two samples that had actually caused allergic reactions had rather large amounts of milk proteins. For example, the concentration of proteins in Tofulite was the equivalent of 2.5 milliliters of cow's milk per four-ounce serving. When the manufacturers were contacted, it was learned that two products (Tofulite and Rice Dream, a dessert) had been manufactured in dairy-processing plants, while Oscar Mayer had changed its recipe for hot dogs and bologna to include the sodium salt of casein (an additive). This change had not been included in the product label, but must be included after March 1991 unless other delays are granted to the company by the Department of Agriculture. Another product containing mild proteins was Good Start HA infant formula, eventually withdrawn from the market. Three reactions occurred after products labeled both ''non-dairy'' and ''pareve'' were consumed. To prevent such life-threatening reactions in people who are highly allergic to milk products, the meat and dairy industry should be required to accurately label their products. The patients studied ate different brands of the same kind of food on subsequent occasions without reacting. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Labeling, Milk, Food labeling, Milk-free diet

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Safe administration of the measles vaccine to children allergic to eggs

Article Abstract:

A single vaccination with the measles-mumps-rubella (MMR) vaccine appears to be safe in children who have a documented allergy to eggs. These vaccines contain live virus that is grown in chicken embryo cultures. The American Academy of Pediatrics currently recommends that these children receive a skin test for egg allergy and if they are positive they should receive six separate vaccinations over a period of time. Researchers gave a single 0.5 milliliter vaccination to 54 children who had a proven allergy to eggs and a positive skin test to eggs. Three of the children had a positive skin reaction to the vaccine. All of the children were safely vaccinated. The institutions involved in this study have gone on to vaccinate 222 children with egg allergy with a single vaccination. Children with egg allergy should be vaccinated once and observed for 90 minutes in an emergency room.

Dosage and administration, Measles vaccine, Measles vaccines

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Fatal and near-fatal anaphylactic reactions to food in children and adolescents

Article Abstract:

Children and adolescents with asthma and food allergies may have a high risk of death from anaphylactic reactions to food. An anaphylactic reaction is an allergic reaction characterized by respiratory distress and shock that can be fatal. Among 13 children and adolescents with asthma who had an anaphylactic reaction to a food, six died and seven nearly died. Four patients experienced an anaphylactic reaction to peanuts, six to nuts, one to eggs and two to milk. Most of the food items were ingredients in candy or baked goods. Only two children who died were treated with epinephrine within the first hour of eating the food item, but six children who survived were treated within 30 minutes. Five children who died were in a public place at the time of their reaction, but all the children who recovered were in a private home.

Anaphylaxis

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