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The Tragedy of Mislabeling Allergens in Foods

Even in light of tragedy, epinephrine is first line of treatment for anaphylaxis.
food label behind red transparency with white text, You read the label. Is it correct? Is it safe?

orla in articleThere is plenty to be frustrated by the story of Órla Baxendale reported by Allergic Living, the New York Post, and People Magazine. The recent heartbreaking loss of this young New York City dancer who was at the beginning of a promising career, is extremely upsetting. It once again brings to light the utmost importance of appropriate and careful food allergy labeling. As the story highlights, the complexities of the modern supply chain put Ms. Baxendale in mortal danger. She was fully aware of her allergies and did everything right in keeping herself safe. A breakdown in communication of ingredient changes and labeling along the supply chain of manufactured food in addition to food manufacturers actively working against the spirit of the FASTER Act and other food labelling laws ultimately put Baxendale and everyone else managing life threatening allergies at risk.

While ongoing advocacy work ensuring accurate food ingredient labelling continues with outreach to legislatures and food manufacturers, it is important to remember that contrary to NY Post and People Magazine reporting, epinephrine is the first line of treatment for anaphylaxis in all cases. This is confirmed by the National Institute of Allergy and Infection Diseases, the American Academy of Allergy, Asthma & Immunology, and the World Allergy Organization Journal. While epinephrine is the only treatment for anaphylaxis, a very small percentage may not respond as per Frontiers in Immunology, Clinical Commentary Review, and Wiley. Research shows that teenagers and young adults, like Ms. Baxendale, are at higher risk for a lethal reaction. Reasons for this can be delayed administration, too much allergen ingested, associated illness, exercise, alcohol, and even menstrual cycle can affect severity of an allergic reaction. Unfortunately, sometimes the reason may not be known.

Here is the bottom-line guidance in all cases of anaphylaxis:

  • Read all labels before eating manufactured food. While that didn't save Ms. Baxendale, doing so will likely save you or someone close to you.
  • Carry 2 doses of epinephrine, non-expired, properly stored.
  • Ensure your friends and colleagues are trained and equipped to help you if you have a reaction.
  • Recognize early symptoms of an allergic/anaphylactic reaction and administer epinephrine without delay. Even if you're not sure.
  • Call 911 immediately and lay down with legs up.

Sometimes fatal anaphylaxis may still happen, and there's no cure for peanut allergy. Food immunotherapy may ease the severity of a reaction or at least increase the threshold of reactivity and reduce the risk of fatality of accidental exposure.

Allergy Advocates New York will continue to support efforts for appropriate food allergy labeling and teaching communities across New York State about the importance of early administration of epinephrine.