By John Burton
State Assemblywoman Caroline Casagrande believes strongly that a sponsored bill will have a significant effect for children
“It could save lives,” she said, the lives of children while they are in school and out of the care of their parents or guardians.
Casagrande is one of the sponsors of Bill 304, which was approved by the entire Assembly back on May 22, and its twin, Bill S-801 recently made it out of the Senate’s education committee. This bill would require schools, both public and private, to stock epinephrine auto injector pens – commonly referred to as Epi-pens – for children who go into anaphylactic shock from a food allergy and allow nurses and other trained professionals to administer the anecdote without necessarily having prior permission.
“This bill actually closes some gaps that we have in allergic reaction for kids,” in the way schools can address the situation, Casagrande (R-11) recently explained. “Which is important now because allergies, especially food allergies, have become so pervasive in the United States.”
Under current law, school nurses are permitted to administer the injection to children if the kids’ parents or guardians have previously provided permission and the pens. This bill will provide blanket immunity for officials along with having the pens available in the schools.
“This bill is important because it recognizes that a child may experience a food allergy reaction for the first time in school,” Casagrande said, noting that parents may not even be aware of the condition until their child comes in contact with the allergen and has that reaction.
The alternative, Casagrande warned, would be for school officials to call 9-1-1 and when someone experiences this sort of reaction, time is of the essence and could literally mean the difference between life and death. “Anaphylactic shock is a pretty quick process,” she noted.
And increasingly prevalent. Casagrande cited the U.S. Center for Disease Control and Prevention statistics indicating that among children under 18 there are more than 300,000 emergency facility visits for food allergy reactions each year.
“Expediency is often the key to survival,” noted Dr. Feryal Hajee, a Lincroft allergist and immunologist who “strongly” supports the bill. “We’re seeing patients dying from food allergies and from anaphylactic shock not because of anything other than delays in receiving the epinephrine.”
When asked about this legislation, Hajee said, “This will save lives.”
Children and adults most often develop allergies from the protein found in milk, eggs and peanuts, as well as other foods and bee stings. What happens to these patients, Hajee explained, is their immune system reacts to the allergens and will produce antibodies that attach to cells in the skin, lungs and in the stomach and gastrointestinal tract. And when the body takes in these allergens, they “will cause a cascade of reactions,” that releases histamines and can cause swelling, hives and difficulty in breathing, Hajee said. Anaphylaxis – an acute allergic reaction – occurs when that reaction hits two or more organ systems in the body. “And that is often life threatening,” when it causes swelling of blood vessels, leading to a drop in blood pressure and cardiac arrest and asphyxiation.
In response, “The safest thing to do is to give epinephrine,” Hajee said.
Currently about 8 percent of U.S. children have food allergies and annually as many as 1 to 3 percent of those children will die from reactions, mostly from peanut allergies. About 20 percent of children suffering from them will outgrow the allergies, mostly from eggs and milk more than peanuts and shellfish, Hajee said.
As to what is causing the rise in food allergies, theories include what Hajee said researchers have labeled the “Hygiene Hypothesis,” our aversion to exposure to germs has meant we haven’t developed natural immunities; other theories blame vaccines and the increase of pollutants in our environment. All of those at this point are just conjecture, Hajee stressed.
The bill has yet to make it to the full Senate for a vote, but Casagrande said she is hopeful. “I think many are very supportive,” in the Senate, “because the law reflects the changing times…This law would not have been needed in the 1970s and ‘80s.”
Should it pass the Legislature’s upper chamber it would require Gov. Chris Christie’s signature. On that front, “We haven’t heard a ‘no,’” Casagrande offered, believing if it has strong support in the Senate that could encourage the governor’s approval.
