To the unsuspecting bystander, they appear innocent. Wrapped in cheerful, brightly colored paper or dyed in luminescent hues, a packet of trail mix or M&M's may seem the perfect midmorning snack. For some, however, within these tasty treats could be lurking nightmares -- nightmares in which every second counts.

For individuals suffering from peanut allergies, these nightmares are a daily reality.

Hives. Swelling. Vomiting. Cramps. Wheezing. All of these are symptoms of the potentially fatal peanut allergy, which afflicts roughly 1 percent of America's population, according to the American Academy of Allergy, Asthma and Immunology. Peanuts are one of the eight major allergens, along with milk, soy, eggs, fish, shellfish, tree nuts and wheat. They comprise 90 percent of all food-related allergic reactions.

Peanuts pose a larger problem than their fellow allergens, however, for many reasons: the first is the high risk of anaphylactic shock.

Anaphylactic shock (or anaphylaxis) is a life-threatening medical condition characterized by the rapid dilation of blood vessels, followed by a sudden drop in blood pressure. Airways swell, causing breathing difficulties, and the person may experience other symptoms, including vomiting, hives, fainting, diarrhea and palpitations. Without treatment, the patient may have cardiac or respiratory arrest (heart and breathing stop, respectively), or the patient may go into shock. If the patient does not receive medical attention, anaphylaxis will result in death.

Allergic reactions to peanuts are notorious for being activated by microscopic amounts of peanuts. Consider, for example, the following hypothetical situation: Celia eats a peanut-butter-and-jelly sandwich for lunch. Afterward, she goes to French class, where she takes notes and participates in the lesson. The next period, Lily, who has a peanut allergy, also attends French class, sitting at the desk Celia just left. A few minutes into the class, Lily begins retching and her face swells. She is experiencing an allergic reaction.

When Celia ate the peanut butter, microscopic particles of peanut were stuck on her hands. The particles gradually came off as she engaged in other activities; when she touched the desk in French class, some of the particles were left on the desk. When Lily entered the room and touched the desk, she came in contact with the peanut particles. This prompted her allergic reaction.

Individuals with peanut allergies may begin to experience symptoms after exposure to less than 1/8 00th of a peanut. This can be transferred from person to person, like a handshake, hug or kiss, or from object to person, like a desk, doorknob or stair rail. Of course, symptoms and tolerance levels vary from person to person. Some individuals are so sensitive that they cannot walk past an open bin of peanuts in a supermarket without having a reaction.

When an allergic reaction occurs, it is important that emergency procedures are taken immediately to reduce the possibility of more serious complications. Individuals at risk for anaphylaxis carry anti-inflammatory medication called epinephrine. This injection provides temporary relief from anaphylaxis and allergy symptoms. The epinephrine's effects will usually wear off after 10 to 15 minutes, so many individuals will need to take another anti-inflammatory medication, such as Benadryl, or another dose of epinephrine. Emergency medical care must be sought as quickly as possible, especially as the patient may experience a relapse of the reaction after a few hours.

Rachel Mackenzie, 14, has been suffering from peanut allergies for "as long as I can remember." The Lewiston-Porter freshman carries an EpiPen (epinephrine) and also wears a Medic Alert bracelet, a form of identification that informs others of her allergy.

Rachel says if she has an allergic reaction, she must use her EpiPen "within 10 minutes, or I die."

Rachel remembers a rather scary peanut reaction she had in kindergarten. She believes someone "may have given me peanuts to eat," and she had to "go in an ambulance." At the time, Rachel was 5.

"When I eat it, [it feels like] my throat closes up," says Rachel. "I can't eat it -- [and] I can't touch it."

Rachel is not as concerned about her allergy as she used to be.

"When I was little, I had to sit at a special [nut-free] table, but now I can deal with it. I used to want to eat them but now I don't care," she said.

Justin Leathers, 16, suffers from a mild peanut allergy.

"It irritates my throat," says the Niagara Catholic junior. "If I'm [somewhere] and they have cookies, I ask if there are peanuts so I don't eat them."

Even though he has only a mild sensitivity to peanuts, Justin cannot eat any nuts or products containing nuts, like certain M&M's. Peanuts and peanut butter are hidden in many products, such as soap, Chinese food and candy. Many food products contain the disclaimer "may come in contact with peanuts" or "manufactured in a facility which processes peanuts."

"I [have to] try to avoid it," says Justin.

There is no cure for peanut allergies.

Current federal legislation mandates that products containing or possibly coming into contact with peanuts incorporate a warning label on the packaging.

New York has published voluntary guidelines for schools in a manual called "Making the Difference: Caring for Students with Life-Threatening Allergies." These include, but are not limited to, prohibiting the sharing of food, disinfecting surfaces contaminated with food, encouraging handwashing before and after eating, training teachers to recognize and treat anaphylactic reactions and educating students on the dangers of life-threatening allergies.


Beatrice Preti is a senior at Niagara Catholic High School.