Monday, February 8, 2010

To Kiss or Not to Kiss…with Food Allergies

by Kelley Lindberg

I’m feeling a little under the weather today, so I’m repeating a Valentine’s-themed post from last year. Happy Valentine’s Day, everyone!

Valentine’s Day is almost here. Yes, it’s that time of year again… the time for love, romance, special dates – and kissing.


Just what we food-allergy sufferers need. Something else to worry about.

For young people, kissing is complicated enough. Think what kisses can lead to – brain malfunctions, ruined reputations, marriage proposals, bad dates, broken friendships, unreasonable expectations, dizziness, pregnancy, forgetfulness, poor fashion choices, high credit card bills, lousy steak dinners… and that’s all in a good weekend.

Now, throw in the fact that food allergens can stay in a person’s mouth for hours after they eat, and suddenly you’ve added “scary trips to the ER” to the list.

My son is only ten. He’s still in the “Oh gross, they’re kissing!” stage. Every time he sees someone kissing on TV, he slaps his forehead as if to say, “What are they THINKING?” I’m encouraging this attitude. As far as I’m concerned, he can think kissing is gross until he’s 35. Or 40. Really.

But sadly, I figure I’ve only got another few years (okay, I admit it, I’m optimistic) before the hormones suddenly turn from “eww” to “oooh.” And then I’ll be staying up late, worrying about all the usual things parents of teens worry about, plus that other one: “Did the girl he’s kissing eat peanuts today?”

Food allergies bring a whole new aspect – a really ugly one – to the already dangerous minefield of kissing.

In 2003, the Journal of Investigational Allergology and Clinical Immunology published a paper called "The Hazard of Kissing When You Are Food Allergic" from Swedish doctors who studied how many allergic people had a reaction after kissing someone who’d eaten the offending food. Their study showed 12% of survey participants had an allergic reaction after kissing. (When they eliminated respondents who “didn’t know” if a reaction was caused by a kiss, the numbers rose to 16%.) That’s not comforting.

As an interesting side note, the doctors surveyed both Russian and Swedish participants. Of those, 12% of the Swedish survey participants reported a reaction, and only 5% of the Russian participants did. I can think of all sorts of jokes here about who you would rather kiss – a member of the Swedish Bikini Team or the Russian Swimming Team, but that would be rude and stereotypical. So I’ll let you come up with your own jokes.

The Mayo Clinic Proceedings website outlines a 2003 case report (apparently 2003 was an extraordinarily bad year for kissing) of a seafood-allergic woman kissing her boyfriend after he’d just eaten shrimp, and then suffering from an anaphylactic reaction and having to go to the hospital ("The Kiss of Death: A Severe Allergic Reaction to a Shellfish Induced by a Good-Night Kiss").

This case report was only one of many that have been showing up with alarming frequency in the literature, so some doctors in New York decided to study how long peanut residue could stay active in the saliva of people who’ve eaten peanut butter, and whether or not brushing teeth or other “interventions” would help get rid of the allergens. They published their results in 2006 ("Peanut Allergen Exposure Through Saliva: Assessment and Interventions to Reduce Exposure"). They studied 38 people. Immediately after eating 2 tablespoons of peanut butter, the subjects’ amount of allergens in their mouth varied “considerably,” but many had levels of peanut proteins high enough to cause reactions. They tested again one hour after eating; at that point, 87% had undetectable levels. Unfortunately, that means 13% still had detectable levels of peanut in their mouth.

When they used interventions to cleanse the mouth immediately after eating peanut butter, such as rinsing or brushing their teeth, the allergens were reduced, but still remained in approximately 40% of the samples. Their conclusion: “Patients with peanut allergy require counseling regarding the risks of kissing or sharing utensils, even if their partners have brushed their teeth or chewed gum. Advice to reduce risks, although not as ideal as total avoidance, includes waiting a few hours plus eating a peanut-free meal.”

Another comment in the study added: “Teenagers with peanut and other food allergies need to be reminded that to stay safe, restraint and patience are necessary even in the most intimate situations.”

Yeah, good luck with that. Parents have been trying to remind teenagers to use restraint and patience to stay safe since they were running around poking spears in angry wooly mammoths.

So what’s a teen to do? Well, here’s what the experts recommend:

1. Tell your date what you’re allergic to, and explain how serious it is.
2. Ask your date to refrain from eating those foods on the day of your date.
3. Ask your date to brush their teeth and wash hands if they have eaten something you’re allergic to, and wait AT LEAST one hour before kissing.
4. Keep your EpiPens with you at all times.
5. Wear a medical ID bracelet, so if you end up unconscious, the EMTs will know what to do with you. A bracelet also is a good way to "break the news" to people -- when they ask what the bracelet is for, it's easy to explain food allergies without sounding like you're fishing for a kiss.

As for us parents, here’s what we can do:

1. Worry.
2. Pray.
3. Trust that we’ve taught them well.
4. Love them.
5. Breathe a sigh of relief when they come home safe with that silly look on their face. Despite the silly look.
6. Keep on the lookout for other teens who also have food allergies, and try fruitlessly to arrange accidental meetings between your child and those other teens.

Personally, I’m going to be creating a “dating application” for my son. All of his prospective dates will have to complete the application, submit to a lie detector test, and provide a $100 deposit for ambulance transportation fees before the date commences.

I can hear my son slapping his forehead now.

Happy Valentine’s Day.

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