Knight Ridder Newspapers

DETROIT – Andy Hsiao was less than 1 year old and apparently tired of waiting for his mother to finish her shopping. When Andy started to cry, Jimmy Hsiao gave his son a few crumbs of a peanut butter cookie.

Suddenly Andy started to make a noise so horrible that years later, his mother still can’t describe it. A passing security officer heard Andy had eaten a bit of a peanut butter cookie, and immediately said, “Call 911.”

That’s how his parents learned Andy, now 8, is allergic to peanuts. The All-American peanut butter and jelly sandwich could, in Andy’s case, be a real killer.

“We didn’t know about allergies; we didn’t know about peanut allergies; we didn’t know what was going on,” said Andy’s mother, Kaori O’Hara.

Peanut and nut allergies tend to be much more lethal than other allergies, causing about 200 deaths each year nationwide. Kids like Andy could have a serious reaction after inhaling just a little dust from a bag of peanuts at the next lunch table, or rubbing against a shirt that a classmate brushed their hand against while eating a nutty breakfast bar.

These allergies are the subject of a growing debate. Is it better to create nut-free schools for kids with a potentially fatal allergy, or is public education and awareness a better weapon? In Andy’s case, they chose the nut-free school.

“It’s frightening,” O’Hara said. “I don’t even know what would be the best for Andy or the safest for Andy and I don’t think the school knows, but we’re preventing all the risks we can think of.”

About 25 percent of first-time reactions happen in school. Angell Elementary in Ann Arbor, where Andy attends school, tries to be nut-free. The staff starts with the obvious. That means no nut products in lunches, said Lee Ann Dickinson-Kelley, Ann Arbor, Mich., Public Schools’ administrator for elementary education.

“We don’t say nut-free, because we could not possibly guarantee nut-free,” Dickinson-Kelley said. “There’s always a chance that at the manufacturing level, there’s some cross-contamination.”

Then they move on to the less obvious. Andy wears a fanny pack containing a syringe so his teacher can instantly administer medication in case he has an allergic reaction. When he’s not with his teacher – at lunch, during recess or on a field trip – Andy has an aide with him. School cleaning procedures are specialized. Even buses get scrubbed.

“We’re talking about the health and safety of a child that is not just discomfort, but possibly life-threatening,” Dickinson-Kelley said. “We really feel a responsibility to participate and really take on these procedures.”

Andy hasn’t had an extreme reaction since, but he has broken out in hives a few times since these precautions began. Since he’s also allergic to fish and shellfish, his parents say they aren’t sure what caused the milder reactions.

O’Hara is grateful for all the extra care.

“It makes me feel more comfortable,” O’Hara said.

Not all the severe allergies schools worry about are due to nuts.

Forest Elementary in Farmington Hills, Mich., is a peanut free school. Nine of its 350 students have allergies serious enough to need an injection if they are exposed. But the child getting the most attention has unknown allergies, said principal Lewis Lloyd.

“One student right now is going through a series of allergic reactions and we’re not quite sure why,” Lloyd said. “She always has to have an adult when she’s out on the playground, and she has to be in line of sight of that person.” If the child starts to have a reaction, an adult will immediately administer the injection.

Lloyd said that once allergies were explained, the students quickly understood why they wouldn’t see any more PB&Js at school. It took some of the parents a little longer. A few parents thought it was unfair to their children, Lewis said.

Not everyone agrees with nut-free schools. Allergy education is better than bans, said Anne Munoz-Furlong. She founded the Food Allergy & Anaphylaxis Network, based in Fairfax, Va., when her daughter, Mariel, now 20, was diagnosed in childhood with egg allergies.

“We’ve had kids wind up in the emergency room because they’ve had milk splashed on them,” Munoz-Furlong said. “Any food can cause a fatal reaction.”

While allergies are relatively common, especially among children, peanut allergies are not. Only about 6 percent of the population will be allergic to nuts or products made with nuts or peanuts. Peanut allergies tend to affect the airways, causing swelling that cuts off breathing. Other symptoms can include abdominal pain, hives or vomiting, said Dr. Michelle Rivera, an emergency room staff physician at Children’s Hospital of Michigan in Detroit.

Andy’s allergies changed the way his family lives. O’Hara carries a cell phone and a pager, in case she can’t receive a cell phone signal. She reads the labels on every food that comes into their home. She rechecks labels each time, even if she’s bought the same brand before, to make sure the manufacturer didn’t change the recipe.

Eating out means quizzing the restaurant staff to be sure that sauces weren’t thickened with peanut butter. She and her husband talk to Andy about food before he goes to a friend’s house. They accompany him to birthday parties, bringing treats in case Andy can’t eat what’s served.