Allergies galore!

Camping Magazine, July-August, 2002 by Cassandra Piper, Helen Rebull

Managing Allergies Is More Than a Call to 911

In the summer of 2001, Congressional Camp found itself hip deep in allergies. Of the 490 campers on our campus, 222 had identified allergies. This fact left us limp and sweaty with concern ... and it wasn't because of the humid Virginia summers.

We knew that food allergies never take a break, never rest, never leave well enough alone, and never forgive a tiny transgression -- "just this one time." The worry about an exquisitely allergic child is continuous -- for the parents and for our director and staff.

A million questions swarmed like mosquitoes around our heads. How would we manage? Could we trust the counselors we hired to maintain the necessary precautions? How could we possibly avoid milk and peanut butter? After all, peanut butter crackers and ice cream are the staples of summer. Would allergic kids let us know if they felt bad or accidentally contacted something? Could we keep the medications organized and available, yet safe?

We realized that educating our staff was a big priority. The camp nurse was consulted and laid out some things for us to think about.

1. True allergies are not food whimsies of a child.

2. Food allergies are not necessarily based on religion nor self-imposed as voluntary food restriction.

3. Food allergies come in a variety of degrees of seriousness.

4. Food allergies can kill.

We consulted a leading authority in the field of food allergy, the Food Allergy & Anaphylaxis Network. Camp directors can find enthusiastic encouragement from the Food Allergy & Anaphylaxis Network. No one understands how important vigilant attention to detail is like this group -- an organization that knows of many children who have perished from accidental exposure to a common food.

The Network shared a story of a fourteen-year-old camper who went on an all-day canoe trip. When the group stopped for lunch, the counselors pulled out the previously set aside jelly sandwich for the food allergic canoeist. They then proceeded to make peanut butter sandwiches for the rest of the party. They realized that the girl's jelly sandwich was not cut, so they carefully wiped the knife and cut the sandwich. Everyone began to eat. In a very few minutes the counselors knew they were in serious trouble.

The trace amount of peanut butter on the knife was sufficient to precipitate an allergic response in the girl. The counselors realized too late that no one had thought ahead to bring the girl's emergency medication -- No one had thought to bring a cell phone to be able to call for help. No one could do anything to stop this young girl's body from collapse. Within minutes she was dead.

Taking Steps

After reading some literature, viewing the nurse's videos, and talking over our mutual experiences, we felt it was best to start by talking with the parents and campers. Our camp director and nurse invited each parent to come for a visit and to give us the details of his or her child's allergies.

Learning from Parents and Campers

It is from the parent that a clearer picture of the extent of the allergic sensitivity can be determined. For instance, could a peanut allergic child be in the same room with others eating peanut butter or would the camper need to be isolated? The parent is the person best able to explain what has happened during previous contacts. Did the child have to go to the emergency room or was an oral antihistamine sufficient to stop the allergy in its tracks?

We created an Emergency Allergy Form so that the parent could formally authorize the camp officials and the nurse to give medications and proceed with emergency care in an orderly way. We use our own form, but an excellent form is available on the Food Allergy & Anaphylaxis Network Web site.

We were also able to talk with the camper and determine if the child had sufficient maturity to be able to cooperate. Could this child be trusted not to eat food offered from a best friend's lunch? If the child began to feel bad or realized that he/she accidentally ate something that was forbidden, would they feel it was important to report it to an adult? This is a fine-line judgment call, and we recognized that in every case nothing substitutes for proper supervision.

Educating Staff

To increase and maintain an adequate level of staff awareness on the serious nature of severe food allergies, camp directors and camp nurses need to remind, reeducate, reinforce, and restructure, as necessary, the issues surrounding food preparation procedures, serving techniques, impromptu snacks, and "care" package inspection.

Our next step was to share as much about food allergies as we could with our staff. We had to teach them how to read a food label and to look for hidden ingredients lurking in unexpected places. For instance, who knew that hot dogs contain a binder made of milk? We learned that some Fig Newton cookies have ground peanuts inside. We taught everyone that they had to read every label every time. Recipes change and new warnings on labels are posted all the time.