Nutty killer: Peanut policy perplexes parents

In Mary Esselman's world, a kid eating a peanut butter sandwich on a playground might as well have a "loaded gun" in his hand. Hers is a world where she must be ever-vigilant about what her two-year-old son, Luke, eats– or even just puts in his mouth. It's a world of constantly checking ingredients, never leaving home without Benadryl and EpiPens– and having other people think she's a little nuts.

Until what happened in Canada November 19. Fifteen-year-old Christina Desforges of Quebec kissed her new boyfriend, went into a coma, and died. The boy had eaten a peanut butter sandwich nine hours earlier, and now Esselman and other parents of children with food allergies no longer seem quite so paranoid.

But the vigilance never ceases, and when Esselman heard that the peanut-friendly burger joint Five Guys was going to open a restaurant in the former SNL building on the Downtown Mall and at Hollymead Town Center, she worried that Luke's mall hangouts were about to be imperiled. At Five Guys, patrons eat peanuts and throw the shells on the floor.

"It was like seeing a big gun store going up," she says.

Her friend Erin Hanusa sent a letter to local newspapers beseeching Five Guys to drop the dropping of peanut shells. "...[F]or some people, even being in the same room with a peanut can cause anaphylactic shock and death," she wrote.

Hanusa predicts the shells and peanut dust will get into the shoes and clothing of children dining at Five Guys and then be spread to other downtown kid spots like the Discovery Museum, Weeville, and the library.

"Any kid who goes into Five Guys... will carry that dangerous substance into all the places kids like to go, making them unsafe for peanut-allergic children," she writes.

Experts says it's unlikely an allergic child at the Discovery Museum would go into anaphylactic shock from kid-carried peanut dust and shells.

"Casual contact isn't a serious problem, to the best of our knowledge," says Dr. Gary Rakes at UVA's allergy and clinical immunology division.

He won't rule out such a thing happening– "There are no absolutes in all this when peanuts are involved"– but explains that allergic reactions are caused by mucosal contact. "We're talking contact with the eye, nose, mouth," he says. "Even contact with the rectum and vaginally could cause a reaction."

Over at the Allergist Ltd., Dr. Albert Huber agrees that killer peanut dust emanating from a downtown Five Guys is "stretching things a little," but he does suggest that the restaurant take a practical approach to make sure there's adequate warning for unsuspecting people who walk into the shell-strewn establishment.

"I don't think we can outlaw peanuts in downtown Charlottesville," says Huber. "Peanuts are killing an estimated 200 people a year and bring even more people a lot of grief– but automobiles kill more people, and we don't outlaw them."

In fact, a sign in the Barracks Road Five Guys– and the menu– do advise patrons that peanuts abound. "Our fryers use peanut oil, so I guess there's more than one issue," says Five Guys co-owner Bill McKechnie.

Throwing peanut shells on the floor is "sort of a little trademark thing," says McKechnie. He wasn't aware of concerns about transmitted peanut dust and shells, nor has he had any complaints or concerns about the practice that's particularly favored by Texas-themed chains.

However, that doesn't mean Five Guys is insensitive to patron concerns, he says: "We would never want to place anyone's health in jeopardy."

And he mentions that his children go to school with a child with allergies. "No one in the class can bring peanuts," he says.

Anne Munoz-Furlong is the founder and CEO of the Food Allergy and Anaphylaxis Network. She hasn't heard reports of post-Five Guys allergic reactions because "as soon as people see the peanut shells on the floor, they turn around and leave," she suggests.

Nor has she heard of reactions from baseball parks or circuses, although she advises parents to avoid the latter because they're confined under the tent with peanuts "everywhere."

Some airlines have banned peanuts. She cites a study that looked at allergic reactions when 200 people in a plane open bags of peanuts at the same time. The peanut proteins became aerosolized, says Munoz-Furlong, and allergic passengers had mild symptoms like stuffy noses and watery eyes– but no anaphylaxis.

But, she warns, "When a reaction begins, you have no idea how bad it will be."

No one knows for sure why food allergies seem so much more prevalent, or why the number of peanut allergies in those under five doubled between 1997 and 2002. One theory is that the sanitized, antibiotic-riddled 21st-century environment fails to exercise the immune system. "We're not seeing allergic reactions in developing countries that we are in industrial ones," says Munoz-Furlong.

While some schools have become peanut/tree nut-free zones– Esselman says there's a child with a nut allergy in every class at the Montessori of Charlottesville school Luke attends– so far there are no health codes that prohibit tossing peanut shells on the floor in restaurants, according to Roy Crewz at the Thomas Jefferson Health District.

Esselman will continue to practice avoidance, the only option for those with food allergies because there is no treatment. She does take Luke to eat at nearby Christian's Pizza, making sure that the slice of cheese pizza didn't come in contact with one that has pine nuts on it (Luke is also allergic to tree nuts). "Certainly we would avoid Asian restaurants and buffets," she says.

Esselman, a writer who contributed to a December 19 "Kiss of Death" article in People, interviewed Robert F. Kennedy Jr., who has a son with severe multiple food allergies and who inspects restaurant kitchens before dining there. "But that's Robert Kennedy Jr.," Esselman points out.

She acknowledges that Luke can't live in a bubble, and insists she's not trying to impose his health restrictions on everyone else– although she cringes when parents bring PBJ sandwiches to the playground.

"You want to protect your kid, but you don't want to trample the rights of other people," she says. "It's my job to be vigilant."

Still, she says, "I'd love it if [Five Guys] did away with the peanut shells and oil."

Mary Esselman discovered her son, Luke, was one of the 5 million children with food allergies when his eyes swelled shut after drinking from the same glass of milk as his father– who was eating a peanut butter and jelly sandwich.


The "Kiss of Death" headline isn't confined to tabloids. It's seen here in
People .