When Were Food Allergies First Discovered

The History Of Allergies

Though allergic reactions have been documented in ancient Greek and Roman history, the modern era of the study of allergies really began in the 1800s when hay fever was described by Dr. John Bostock in 1819. This continues to be one of the most common allergic reactions, affecting approximately 15 million people in the United States.

In 1869 the first skin test for allergies was described when a scientist placed pollen into a small cut in the skin and watched for a reaction.

The concept of immunotherapy, which is building up the immune system through the administration of injections to help people cope with their allergies, was introduced in 1914.

Antihistamines, medications that would help the body respond better to allergic reactions became more widely used in the late 1930s. They helped by lessening the bodys reaction to allergens.

In 1948 corticosteroids were first used to treat asthma and allergic reactions. They worked on reducing the inflammation that would be caused by the allergens.

The discovery of mast cells in 1953 helped to identify what caused allergies to set off the immune response of the body. In 1963 IgE antibodies were discovered and this further helped to identify what set into motion the chain reaction within the body leading to the release of histamine and allergic reactions.

If you would like to be tested for allergies or discuss the best course of treatment, please call Jamaica Hospital at 718-206-6742

Early Detection And Treatment

Educate patients regarding recognition of the early signs and symptoms of a food-induced allergic reaction, and provide them with a written management plan for successfully dealing with these reactions.

Write a specific list of clinical signs and symptoms to look for if a reaction may be occurring, and include a clear management plan. An excellent example of such a plan is available on the Food Allergy Research and Education Web site.

Demonstrate to the patient and family how to actually administer medications, especially injectable epinephrine, in the event of an allergic reaction. To accomplish this, use demonstration trainer devices in the clinic setting. Reinforce that if injectable epinephrine is administered, the patient must be immediately evaluated in a medical setting.

For patient education information, see the Allergies Center, as well as Food Allergy and Severe Allergic Reaction .

References

How To Get Tested

A food allergy will usually cause some sort of reaction every time the trigger food is eaten. Symptoms can vary from person to person, and you may not always experience the same symptoms during every reaction. Allergic reactions to food can affect the skin, respiratory tract, gastrointestinal tract and cardiovascular system. It is impossible to predict how severe the next reaction might be, and all patients with food allergies should be carefully counseled about the risk of anaphylaxis, a potentially fatal reaction that is treated with epinephrine .

While food allergies may develop at any age, most appear in early childhood. If you suspect a food allergy, see an allergist, who will take your family and medical history, decide which tests to perform and use this information to determine if a food allergy exists.

To make a diagnosis, allergists ask detailed questions about your medical history and your symptoms. Be prepared to answer questions about:

• What and how much you ate
• How long it took for symptoms to develop
• What symptoms you experienced and how long they lasted.

After taking your history, your allergist may order skin tests and/or blood tests, which indicate whether food-specific immunoglobulin E antibodies are present in your body:

Your allergist will use the results of these tests in making a diagnosis. A positive result does not necessarily indicate that there is an allergy, though a negative result is useful in ruling one out.

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How Are Medications Used In Peanut Allergy Treatment

If you have a peanut allergy, your healthcare provider may prescribe medications to reduce the symptoms of an allergic reaction. You may take:

• Epinephrine : This is a lifesaving emergency medication that immediately begins reversing anaphylaxis symptoms.
• Antihistamines: These are medicines that reduce congestion or itching.
• Corticosteroids: These medications reduce swelling if you have an allergic reaction.

A Brief History Of Allergies

Allergies were discovered over 150 years ago, however despite historical developments mankind is still searching for a cure.

How an Allergic Reaction Works

In 1859, Charles Harrison Blackley sneezed. A doctor in Manchester, England, Blackley suffered from what were called summer colds, with seasonal sneezing, watery eyes, and a runny nose. The idea of hay fever had been around for some time, but Blackley was passionate about discovering its cause: heat was one popular theory of the time, ozone another. However, Blackley realized that it was neither ozone nor heat making him sneeze but pollen, and he went on to prove itlargely by experimenting on himself.

Allergies are not new. Its possible that our immune systems have always overreacted to certain innocuous substances, going into overdrive and producing allergic symptoms such as swelling, rashes, red eyes, runny noses, and shortness of breath. Such reactions have been described in historical documents with asthma symptoms recorded in ancient China, Rome, Egypt, and Greece, from where the word asthma comes, meaning panting. But while allergies are not new, our modern understanding of them is.

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A History Of Allergies Part Three: The 16th Century To The 20th Century

We conclude our series covering the book Ancestors of Allergy, edited by F. Estelle R. Simons, MD, FRCPC, with an allergy history timeline of major advancements from the sixteenth through the twentieth century:

• 1565 Italian-born Frenchman Leonardo Botallo, a well-known anatomist, became the first European to describe the symptoms of seasonal allergy. He described a collection of symptoms headache, sneezing, and an itchy nose among them that developed in the presence of roses. He calls this allergy rose catarrh. This observation of nasal symptoms as a reaction to roses was reiterated by scientists throughout the sixteenth century, and the linking of roses to a variety of symptoms caused the designation rose catarrh to persist. However, roses were blamed because of their conspicuousness. The actual allergy-inducers were wind-pollinated trees, grasses and weeds now known to be associated with seasonal allergies.
• Around 1600 Belgian physician Jan Baptista van Helmont describes summer asthma, another step toward recognizing seasonal allergies as such.
• Around 1700 Nehemiah Grew, an English microscopist who focused on plants, began naming various pollen shapes after peppercorns, Holland cheeses, and fish.
• End of 1700s Seasonal allergic rhinitis was now often observed and recognized. The term hay fever replaced rose cold. Physicians believed seasonal allergies were an aristocratic disease because it was most commonly diagnosed among the upper class.

Food Allergies In Children

No parent wants to see their child suffer. Since fatal and near-fatal food allergy reactions can occur at school or other places outside the home, parents of a child with food allergies need to make sure that their childs school has a written emergency action plan. The plan should provide instructions on preventing, recognizing and managing food allergies and should be available in the school and during activities such as sporting events and field trips. If your child has been prescribed an auto-injector, be sure that you and those responsible for supervising your child understand how to use it.

In November 2013, President Barack Obama signed into law the School Access to Emergency Epinephrine Act , which encourages states to adopt laws requiring schools to have epinephrine auto-injectors on hand. As of late 2014, dozens of states had passed laws that either require schools to have a supply of epinephrine auto-injectors for general use or allow school districts the option of providing a supply of epinephrine. Many of these laws are new, and it is uncertain how well they are being implemented. As a result, ACAAI still recommends that providers caring for food-allergic children in states with such laws maintain at least two units of epinephrine per allergic child attending the school.

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Characteristics Of Food Allergens

Food allergens are typically water-soluble glycoproteins resistant to heating and proteolysis with molecular weights of 10-70 kd. These characteristics facilitate the absorption of these allergens across mucosal surfaces. Numerous food allergens are purified and well-characterized, such as peanut Ara h1, Ara h2, and Ara h3 chicken egg white Gal d1, Gal d2, and Gal d3 soybean-Gly m1 fish-Gad c1 and shrimp-Pen a1.

Closely related foods frequently contain allergens that cross-react immunologically but less frequently cross-react clinically. Delayed allergic reactions to meat proteins have been attributed to reactions to carbohydrate moieties.

What Tests Help Diagnose A Peanut Allergy

Your healthcare provider may use a blood test to diagnose a peanut allergy. A blood test called an immunocap radioallergosorbent checks the number of antibodies in your blood. A higher number of certain types of antibodies can indicate an allergy.

Your healthcare provider may also use a skin test to identify or rule out multiple types of allergies. During a skin test, your provider:

• Makes a few tiny needle pricks in your back or arm.
• Applies small doses of different types of allergens where you have needle pricks.
• Montiors your skin reaction and interprets them after 15 minutes.

Skin patches that become red and itchy indicate an allergic response. Your provider can use this information to diagnose allergies.

You may also have an oral food challenge. During an oral food challenge, you eat tiny, increasing amounts of a peanut-based product in your healthcare providers office. Your healthcare provider has emergency medication and equipment on hand in case you have an allergic reaction.

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Are Food Allergies On The Rise

To answer this question simply: yes.

The Center for Disease control estimates about a 50% increase in the rate of food allergies diagnosed in children under age 18.

Why are food allergies increasing? Unfortunately, there is no definite answer to this question. There are several popular theories for the increase in food allergies.

Reporting Adverse Reactions And Labeling Concerns

If you think that you or a family member has had an allergic reaction or injury that might be associated with a problem of having eaten a particular food product, discuss this with your healthcare provider. If a product has unclear labeling or you believe contains an allergen that isnât labeled, the FDA would like to know. Keep any food packages because they may contain important information. You may want to contact the manufacturer about the problem. Also, report the problem to the FDA in either of these ways:

Consumers and manufacturers can submit reports detailing product reactions or labeling concerns to an FDA Consumer Complaint Coordinator for the state where the food was purchased. You can also call FDA at 1-888-SAFEFOOD.

Consumers can submit a report using FDAâs MedWatch Online reporting form for consumers.

Reports submitted to the FDA should include as much information as possible:

• Who is reporting the incident and who was affected? Please provide names, addresses, and phone numbers.
• The name and address of the place where the product was purchased
• A clear description of the reaction, including:
• Date the reaction occurred.
• How long after you ate or drank the product that the reaction occurred.
• Medications used to treat symptoms.
• Whether the reaction required further medical care, and if so, what kind. Please provide contact information for the doctor or hospital.

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First Halloween When We Discovered Food Allergies

So Halloween… The time for dressing up in costumes, going tricking or treating, and hanging out with friends. When we started on this journey, we didn’t think about what could be hidden in the ingredients. We just knew we were staying away from gluten, not corn. I talked to the kids’ classroom teachers about what foods they would be serving at their Halloween classroom party so I could make food for the kids that matched. We let our kids go trick or treating and thought all would be okay. The candy we thought would be okay , was not. Thank you hidden corn. UGH. The kids not only felt horrible, but they also ended up giving their candy bags to their friends at school the next day. Boy, they ended up with friends they never knew they even had.

Some of the items the kids found in their trick or treat buckets were legos, fuzzy socks, gum, ice cream, markers, homemade caramel, a deck of cards, books, fruit roll-ups, soda, a card that stated they had no chores for a day, and a couple of special chocolate bars that are only sold in one store. I had started buying things early because the cost of all 24+ items would add up fast if I was to buy it all at once.

We also had a very easy time collecting the buckets. We made it a game for our older kids who could collect the most buckets. Sweetening it with a prize didn’t hurt either.

Our itinerary for the night is listed below.

Food Labels And Allergens

People with food allergies should read labels and avoid the foods they are allergic to. The law requires that food labels identify the food source of all major food allergens used to make the food. This requirement is met if the common or usual name of an ingredient already identifies that allergen’s food source name . The law also requires that the type of tree nut , and the species of fish and Crustacean shellfish to be declared. The allergen’s food source must be declared at least once on the food label in one of two ways.

The name of the food source of a major food allergen must appear:

In parentheses following the name of the ingredient.Examples: âlecithin ,â âflour ,â and âwhey â

â OR â

Immediately after or next to the list of ingredients in a âcontainsâ statement.Example: âContains wheat, milk, and soy.â

FALCPA’s labeling requirements extend to retail and food-service establishments that package, label, and offer products for human consumption. However, FALCPA’s labeling requirements do not apply to foods that are placed in a wrapper or container following a customerâs order at the point of purchase.

FDA guidance and regulations for the food industry states that advisory statements should not be used as a substitute for adhering to current good manufacturing practices and must be truthful and not misleading.

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Rose Colds & Sea Anemones: Early Allergy Science

We begin in 1819 when the physician John Bostock presented the first clinical description of hay feveror summer catarrhto the medical community. By the mid-1800s, doctors had begun diagnosing patients with summer or rose colds . In 1905, immunologists discovered they could produce an anaphylactic response in animals and began experimenting with allergic reactions in the laboratory. These anaphylactic responses to sea anemones were not considered allergic reactions or allergies. That link would be discovered later.

Hay fever and seasonal allergies were relatively easy for clinicians to diagnose with skin tests and desensitization techniques. Desensitizationor allergen immunotherapyin its early form involved allergens converted into a serum or vaccine and injected into a patient. Leonard Noon and John Freeman discovered allergen immunotherapy in 1911, and this technique is still used for treating seasonal allergies today.

Until the early 20th century, food allergy remained somewhat of a nebulous concept. It was widely recognized but hadnt yet been proven. In 1912, Oscar Menderson Schloss breathed legitimacy into food allergy diagnosis and proved its existence. An American pediatrician, Schloss developed a skin scratch test with which he correctly diagnosed egg sensitivity. While this was seen as a breakthrough in allergy detection, skin scratch tests did not produce consistent results, as many patients with obvious clinical allergies didnt react to these tests.

In The Middle Ages Nothing New

Much later, in the Middle Ages, progress would come, as often at this time, in the Persian and Arab world. It is they who understood that allergic syndromes are often linked to the season.

The Iranian Rhazes, who lived in the late 9th century and early 10th century AD, describes the symptoms of his philosophy teacher, who suffered from allergic rhinitis: stuffy nose, sneezing, pruritus, etc. Just like in the Papyrus Ebers, Rhazes stresses that symptoms often worsen in the spring. He therefore recommends avoiding strong odors, but also certain plants such as roses or basil.

300 years later, it is Moise Maimonides, doctor and philosopher in the Muslim Spain of the 12th century, who in his treatise on asthma, describes a disease that is declared only according to the time of year, while taking into account the weather conditions and the small habits of everyday life. It is possible to think that Maimonides was actually describing allergic asthma.

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Fact Fad Or Fiction A Brief History Of Early Allergy Science

This guest post was written by Theresa MacPhailassistant professor in the Science, Technology, and Society Program at Stevens Institute of Technology.

Many physicians think that idiosyncrasies to foods are imaginary. Albert Rowe, MD

Two years ago, my 63-year-old aunt developed hives. Large red wheals covered her entire body, and the slightest pressure to her skinincluding wearing clothescaused her pain. Over the course of her life, she had coped with eczema and the occasional rash, but this was new. This was different.

Her doctor sent her to a dermatologist, whodumbfoundedsent her back to her doctor. After many medical appointments, blood tests, and rounds of steroids, an allergy specialist asked her to undertake an elimination diet, cutting out several foods. My aunts hives immediately cleared, and it was only after she introduced wheat back into her diet that the hives resurfaced. Her diagnosis: a wheat allergy.

My aunts experience is an all-too-common tale of food allergy classification: routine misdiagnosis, common misconception, and a general lack of understanding within the broader medical community. What is it about food allergies that make this story so familiar? Why are food allergies and intolerances so difficult to diagnose and treat? It turns out that our troubles with allergy diagnosis have a long and complicated history.