Advocates for those with food allergies are urging more cities to follow the lead of Hamilton, Ont., which could become the first city in the world to require all food service outlets to have life-saving medication on hand for people with severe food allergies.
Food allergies can lead to severe reactions called anaphylaxis, which causes a dangerous drop in blood pressure and swelling of the throat and tongue. It untreated, the condition can quickly lead to death.
To stop the reaction, allergy sufferers need the quick administration of epinephrine -- also known as adrenaline -through an epinephrine injector, often called EpiPens, to helps relax bronchial muscles and buy them time as they wait for emergency medical care.
Hamilton Councillor Lloyd Ferguson would like to make sure that epinephrine injectors are available wherever food is sold in his city, in hopes of avoiding sudden and tragic deaths like one this past spring of a Stoney Creek girl.
Twelve-year-old Maia Santarelli-Gallo had what her doctor said was a mild allergy to eggs and milk that had only ever caused her a runny nose. But last March, while eating an ice cream cone at a Hamilton-area mall with her father and older sister, Maia experienced a sudden, severe allergic reaction that began to cut off her breathing.
Her sister, Zoe, found someone with an epinephrine injector, but by the time it was administered, it was too late. Emergency crews took Maia to hospital but she was pronounced dead.
Zoe, who has also been diagnosed with mild allergies to peanuts, tree nuts and egg whites, now carries an EpiPen with her in case she too develops a severe reaction.
"I worry about it because I don't know. What happened to Maia could happen to me," she says.
After Hamilton Councillor Lloyd Ferguson heard about Maia's death, he decided to draft a ground-breaking motion to get epinephrine injectors in every restaurant and mall in the city.
Ferguson says it's high time that food providers have access to medicines that could help their customers who develop allergic reactions. He says if automated external defibrillator (AEDs) are now being installed in arenas and other community centres, it only makes sense to have epinephrine injectors in areas where food allergy reactions are most likely to occur.
"It took us about 40 years to get defibrillators into public facilities and they have been a great success. This is the next step," he says.
About 2.5 million Canadians report having at least one food allergy, and most are lifelong, with no cure or treatment. Some research suggests that food allergies are the new reality and that their prevalence is growing.
Some patients have no idea how severe their allergies are until they develop a severe reaction. Others assume their allergies are mild enough that they don't need to carry an EpiPen or other epinephrine injector with them.
Allergy specialist Dr.Mark Greenwald would like to go further and see public awareness campaigns that would train the public on how to use epinephrine injectors, just as there have been campaigns encouraging people to learn CPR. Greenwald has now developed an online course called EpiPenTraining.com, to offer training on how to recognize allergic reactions, and how to use the injectors.
He says such training is vital because during anaphylaxis, seconds count.
"By the time 911 sends off fire truck and ambulance, you should have already administered first aid," he says. "You cannot rely on EMS to do the job."
Debbie Bruce of the Canadian Anaphylaxis Initiative was part of a program this past spring to get epinephrine injectors on all fire trucks in Mississauga. She says that like Maia, up to one-third of people who have allergic reactions outside the home did not realize they had a severe allergy and didn't carry an epinephrine injector.
She is now petitioning MPs to come up with a national allergy plan.
"I think it is a new reality," she says. "Reactions happen and we need to be prepared."
Maia's mother, Leah Santarelli, backs all efforts to make the public more aware of anaphylaxis and hopes the Hamilton city council passes Ferguson's motion.
"There's no guarantee that an EpiPen will save your life 100 per cent of the time, just like a defibrillator won't save you 100 per cent of the time, but it is there as a safety measure," she says.
The motion is currently being reviewed by the city's health team; if approved, it should go before Hamilton city council in October.
