If food allergy deaths in food-allergic individuals are rare, do we change our ways?

This is a follow up post to 1 reason I despise science headlines.  It is in response to the recent press-coverage of Incidence of fatal food anaphylaxis in people with food allergy: a systematic review and meta-analysis  published in the journal Clinical and Experimental Allergy.

After a week of thought, I am content that a group of researchers attempted such a risk assessment given the existing literature, i.e. what is the risk to a population of food allergic individuals dying from an allergic reaction to food.  There is a real need for good, hard statistics to put things into perspective.  What I am unsure of is whether this study warranted the press coverage that it has received.  As discussed in my first post, there is a huge range of error surrounding their identified risk of death - 1.81 deaths per million food allergic individuals per year (with a statistical error that gives a 95% chance that the true value falls between 0.94 and 3.45 deaths per million assuming no bias).  However, there are real issues of possible bias, which includes but is not limited to possible medical coding errors surrounding death due to anaphylaxis and pinning down the true prevalence of food allergy.  This at least is a first attempt at systematic review/meta-analysis and certainly warrants more powerful studies to hone in on the true value with better accuracy and precision.  The bottom line is that even with obvious known flaws in their acquired value, it is very unlikely that the risk of food allergic individuals across the food allergic population dying from their food allergy will trump the risk we all face from accidental death.  The number of U.S. deaths due to accidental death is reported as 391 per million per year, according to the CDC.  The study authors certainly have noble intentions of this study reducing the anxiety faced by food allergic individuals or their caregivers.  Senior author, Dr. Robert J. Boyle, a pediatric allergy specialist at Imperial College London is quoted in a New York Times blog, “It’s a matter of not letting food allergy rule your or your child’s life.  The risk is surprisingly low. You still have to take precautions, but I think it’s important to see it in context.”
What I've been grappling with personally is - does this study reduce my anxiety level?  

1 reason I despise science headlines

For a week now, I've been pondering an article I came across in ScienceDaily - Dying from Food Allergy Less Likely Than Being Murdered.  As all good headlines should do, they grab the reader's attention and make you want to read more... MORE!  As a parent of a severely food allergic child, this headline certainly grabbed my attention and elicited a most visceral response - how dare they minimize our daily struggle and fear to prevent a life-threatening reaction (anaphylaxis) by comparing it to something completely unrelated (like murder?!)!  After an eye roll so large that I thought my eyeballs would permanently cramp at the top of their sockets, I opted to let the emotion settle a bit and break this down further.  Clearly, I'm biased, but I needed time to analyze this while recognizing my own biases to see if there is indeed merit to the article and the original peer-reviewed article it is based upon.

Bone marrow transplants to cure food allergies?

Let me get this out of the way from the get-go, bone marrow transplants (BMTs) to cure food allergies are not really a question up for debate - this is NOT a good treatment option for your typical food allergic individual. There I've said it - the disappointing part. More on WHY I say this further in the post where I will discuss exactly what a BMT is. Let's just say the potential life-threatening risks of a BMT (among a few other factors, such as cost) far outweigh the potential benefits of a food allergy cure - even for those of us dealing with the risk of life-threatening anaphylaxis.

So where did this business of BMTs curing food allergies even come from? This week, clinicians presented a case-study at the annual #ACAAI (American College of Asthma Allergy and Immunology) scientific meeting, that a 10-year-old boy with both leukemia and a life-threatening peanut allergy was likely cured of his peanut allergy following a BMT to treat his leukemia (Link to press coverage of the case study) [1]. First off, I cannot even imagine dealing with a life-threatening food allergy and then discovering cancer on top it. Needless to say, this family has endured a lot. The really good news is that as far as I can read in the scientific abstract from the meeting, the boy is cancer-free and peanut-allergy free! Below I am giving you the details that are given in the abstract, which inquiring minds may want to know (Meeting abstracts are published in the 2013 November Supplement to the Annals of Allergy, Asthma and Immunology).

 

Food Allergy Bloggers Conference Wrap-up: Genius Loves Company

It has been over 4 days since I returned from warm, sunny Las Vegas and the first ever Food Allergy Bloggers Conference, belovedly going by #FABlogCon on Twitter.  Last Friday, I assumed that I would publish a wrap-up post on the blog by Wednesday.  Boy was I wrong!  I've been grappling for days now, how to put this event into the words that even begins to give it the justice it deserves.

Exciting times - guest post and food allergy bloggers conference!

So much exciting news to share:

Yesterday, a piece that I authored was published on the ever so resourceful, insightful, and evidence-based website, Asthma Allergies Children with editor in chief, Henry Ehrlich.  I am honored and humbled to be included among the distinguished individuals in the allergy community contributing to this website.  Go check it out!  It just may make you think twice about the long arduous process of science and what "negative" results in science mean.  I also want to thank Dr. Xiu-Min Li, a highly talented, passionate, and extremely caring food allergy scientist/clinician for taking the time to make this piece possible!

In other news: What happens in Vegas, won't stay in Vegas!



I will be attending the first ever Food Allergy Blogger Conference in Las Vegas (Nov. 2 - Nov. 4)!  This was a labor of love by two food allergy bloggers themselves, Jenny at Multiple Food Allergy Help and Homa at Oh Mah Deeness.  The list of speakers and attendees is extraordinary, and I wish that everyone out there could be in attendance.  Since this isn't the case, why not use modern technology to "be there."  I will be using Twitter (along with many other bloggers!) to live tweet conference details.  Selena at Amazing and Atopic wrote a fabulous, visual post explaining how you can get updates from all the bloggers tweeting the conference.  In addition, it contains all of those tweets embedded in a post that is live updating on her blog.  If you aren't a fan of twitter, you can check out her blog throughout the conference and see the live tweets!

If you are not familiar with Twitter but would consider getting an account, it involves all those #(insert favorite word/phrase here) pervading our culture (thank you Justin Timberlake and Jimmy Fallon).  In this case, #FABlogCon will be used!  You can search for #FABlogCon or click on it at any time, and you will see all tweets from anyone using this "hashtag" even if you do not follow them on Twitter!  I signed up for Twitter last winter (against every fiber of my being) because of live tweets from the #AAAAI conference - @FdAllergySleuth.  It really was cool to see all the live tweets of cutting edge scientific findings coming from conference attendees.  I was finally convinced that , yes, Twitter does have a purpose after all! 

Oh and last, but not least - a huge shout out to my family and amazing husband/partner in crime for making this possible.  Traveling or leaving family behind while dealing with life-threatening food allergies (and two small children!) can be stressful to say the least. 

See you all soon - whether you are in Vegas or on Twitter!