In July 2013, Natalie Giorgi headed out for a summer family camping trip. She was allergic to peanuts, and everyone in her family was vigilant in keeping her safe.
While at the camp, Natalie bought a Rice Krispie treat from a food stand run by the camp. Within 20 minutes she started vomiting. Her father, a physician, administered two doses of epinephrine using an injector. The camp located another injector and her father gave her that one too. They called 911 and she was taken to the hospital. That night, she was pronounced dead.
How did this happen? The Rice Krispie treat had peanut butter in it. Though her family treated her reaction as best they could, Natalie died from her allergic reaction.
How do allergies and intolerances work?
Allergies are a false alarm of a body’s immune system. Immune systems identify things that are harmful, like bacteria or toxins. But the immune system can accidentally label harmless things like pollen or certain foods, as dangerous. When the immune system finds these things, it will react by releasing chemicals like histamine, which cause varying symptoms. A common allergy is hay fever, and most people experience mild symptoms. But reactions can vary by person and allergy.
Food intolerances or sensitivities, like Celiac disease or lactose intolerance, are somewhat common. Instead of involving the immune system, this is when the body’s digestive system has trouble digesting certain foods. Symptoms can include nausea, stomach pain, vomiting, or diarrhea, along with many other variable symptoms. Though these are not typically life-threatening, they still are very real and cause discomfort for people who experience them.
Why are food allergies dangerous?
Food allergies can be unpredictable. People react differently to their food allergies. Some may get a rash or a sore throat, while others can experience vomiting or cramping. Even if in the past someone has mild allergic reactions, it can still turn deadly.
The worst kind of allergic reaction is called anaphylaxis, or going into anaphylactic shock. Anaphylaxis affects the entire body and includes a drop in blood pressure, hives, itching, wheezing, tightness in the throat, and tingling. Because it affects a person’s ability to breathe, it can lead to death.
Epinephrine is a chemical that can help reduce the effects of an allergic reaction by improving breathing, stimulating the heart, and raising blood pressure. Often people who have food allergies carry an epinephrine injector with them, just in case. But in severe cases like Natalie’s, epinephrine injectors might not be enough to stop an allergic reaction.
The 8 major food allergens
There are 8 major food allergens that the FDA recognizes as causing most allergic reactions. These are:
- Tree nuts
Sesame and sesame seeds are also a common allergy, and the FDA is considering adding it to the major list of allergens.
Keep in mind that although these are the most common allergies, people can be allergic to all kinds of food.
What can food handlers do to prevent allergic reactions?
Communication is key! Listen to your customer’s concerns about allergies and communicate with all staff involved in preparing their order. If you don’t know if a dish has an allergen, find out before serving it to the customer. Check labels or be proactive and make a list of what dishes have which major allergens.
Even if a dish does not have an allergen as an ingredient, it can still be contaminated. Cross-contact is when an allergen is transferred from one food to another. For example, if a cook touches a piece of bread and then prepares a salad without washing their hands in between, that salad now has wheat allergens on it.
A good practice is to prepare allergen-free food first to avoid cross-contact. Handwashing is very effective at preventing cross-contact as well.
Once a food has been contaminated with an allergen, you can’t remove it, even if you take the allergenic food off. You must start over in preparing the order to keep your customer safe.
Make a plan for dealing with allergies
Food allergies are becoming more common. If you haven’t had customers with food allergies yet, you will. Think ahead and make a documented plan to help food workers know how to handle allergy-free orders. You might even want to provide food allergy awareness training to your employees. No one wants to have a customer be hospitalized because of an allergic reaction that could have been avoided.
Natalie Giorgi’s story has now become a legacy and a call to do better. In 2019, the California Legislature passed a new law called the Natalie Giorgi Sunshine Act. The law requires food handler training to include information about handling food allergies safely beginning in January 2021. Through her story, Natalie will save countless lives.
— Kylie Molen
Download/print cartoon: Food Allergen Mobsters