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The decision made by several airlines to stop serving peanuts on their flights due to the risk of allergic reaction have raised a few eyebrows, but the risk of peanuts triggering allergic reactions on planes should not be underestimated, according to NUS Medicine alumna Dr Lydia Wong, who is also an associate consultant from the Division of Allergy, Immunology and Rheumatology at the National University Hospital.

“Allergies are not just triggered by consuming an allergen, but they can also be caused through skin contact or inhalation of particles. Studies have found that the threshold for inducing a severe allergic reaction is very low, even if minute amounts (of the allergen) are inhaled,” Dr Wong explained.

Particularly, protein particles that drift into the air when other passengers eat peanuts can be recirculated within the confined spaces of planes as their air filters are unable to filter them out completely, potentially triggering allergic reactions.

Peanut allergy cases have constantly risen internationally, with their prevalence among children in the United States rising from 0.4 per cent in 1997 to 1.4 per cent in 2010, according to a study by Mount Sinai Hospital in New York City. While there is no consensus on why peanuts can cause severe allergic reactions or why they are increasingly prevalent, some experts suggest that it may be due to the proteins of peanuts that could prime the body to label them as foreign bodies as they are not found in any other foods. Early and heavy exposure of children to peanuts can also lead to a misidentification by the immune system that it is dangerous.

Notably, peanut protein particles can lead to anaphylaxis very quickly, a potentially life-threatening allergic reaction that impairs breathing and can send the body into shock.

“Early symptoms like rashes can spread to other body systems in a matter of minutes or seconds and the subject’s condition deteriorates rapidly,” said Dr Wong. As severe symptoms such as wheezing and a decrease in blood pressure set in, a person can die from constriction of the airway or a cardiovascular system failure if medical attention is not immediately administered. Other possible symptoms of peanut allergy include itchy skin or hives, a runny or congested nose, an itching or tingling sensation in or around the mouth or throat and nausea.

While those with peanut allergies should carry medications like an EpiPen while travelling on planes, they ultimately serve only as a temporary remedy. Rather, the public can help them by learning about the potentially severe consequences of a reaction and show greater understanding, said Dr Wong.

“Some people get upset because they think this is a minor risk, and think parents are being fussy when they wipe down surfaces or require special meals for their children, but minor inconveniences are worth accommodating to keep more people safe,” she added.

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