by Tori Hamby

A pending federal law could give states an incentive to provide a life-saving drug to public school students with severe allergies.

The School Access to Emergency Epinephrine Act, co-sponsored by a bi-partisan group of 35 senators including N.C. Sen. Kay Hagan, would encourage schools nationwide to improve access to epinephrine – the drug used to treat life threatening allergic reactions – and epinephrine auto-injectors, such as the EpiPen.

Hagan announced last week that she will sponsor the bill, introduced by Illinois Senators Dick Durbin and Mark Kirk in November of last year.

“…Exposure to the wrong food at lunch can quickly become fatal,” Hagan said in her sponsorship announcement. “This legislation will help ensure that schools are prepared to assist in the … administration of epinephrine, which can mean the difference between life and death…”

Senator Richard Burr signed on as a bill co-sponsor in November.

The bill, which also has 90 co-sponsors in the House, would reward states that pass laws requiring schools to keep a state-provided stock of epinephrine on hand for emergencies. In exchange for compliance, those states would be given preference for receiving asthma-related grants from U.S. Department of Health and Human Services.

To receive grant preference, states must:

• Allow trained staff to administer epinephrine using an auto-injector to a student believed to be having a severe allergic reaction.

• Require schools to keep a supply epinephrine. A doctor would provide each school with a prescription.

• Protect school staff who administer the drug to students.

North Carolina does not currently have a “stock epinephrine law.” Andy Fair, spokesman for Mecklenburg County’s health department, said that while the department keeps track of the numbers of asthmatic students in Charlotte-Mecklenburg Schools, it does not track allergies. State law allows parents who fill out a medical form to keep an epinephrine auto-injector for their child at the school.

“A lot of schools already have (epinephrine auto-injectors) assigned to individual students,” Fair said. “Some schools I’ve spoken to have as many as 20.”

Virginia passed “Amarria’s Law” in April, which requires its schools to stock epinephrine and develop a plan for using the drug. Seven-year-old Amarria Johnson died at her school in January due after a reaction from a peanut allergy.

Virginia at the time, like most states, only allowed students to carry their own prescribed epinephrine auto-injectors to school. Amarria’s mother knew about the child’s peanut allergy, but Amarria – who ate a peanut butter cookie given to her by another student – didn’t have her epinephrine auto-injector that day.

The state’s two-year budget calls for $200,000 to be put toward the public school epinephrine auto-injector initiative.

Roger Friedman, an allergist at Nationwide Children’s Hospital in Columbus, Ohio, said an incident like Amarria’s is rare.

“It’s reasonable overall for schools to have an EpiPen,” Friedman said, “but there aren’t hundreds of people dropping dead from consuming food...”

He said although the law is not a bad idea, students with allergies should still carry their own epinephrine auto-injectors to school. States should also provide training to teachers and staff, he said.

“Every child who has an EpiPen has a prescribed plan of action specifically for them,” he said.

The Food Allergy & Anaphylaxis Network, a food allergy resource organization based in Virginia, has strongly advocated for the bill’s passage. Spokeswoman Nancy Gregory said that about a quarter of allergic reactions requiring an epinephrine injector at schools occurred in students who were unaware of their allergies.

Because their allergies had gone undiagnosed, she said, the child didn’t have a prescribed epinephrine auto-injector and had to wait for emergency medical personnel to arrive at the scene. The School Access to Emergency Epinephrine Act, she said, could change that by reducing the wait time.

“Symptoms can progress very quickly and each reaction is unpredictable, so seconds save lives,” Gregory said.

By the Numbers

• 15 million – how many Americans are estimated to have food allergies

• 90 – the percentage of food allergies caused by milk, eggs, peanuts, tree nuts, wheat, soy, fish and shellfish

• 300,000 – the number of annual ambulatory-care visits caused by food allergies in children younger than 18

Source: The Food Allergy & Anaphylaxis Network