It's lunchtime at the Westside Child Care Center. About half a dozen two and three year old wash their hands then find their names on their shin-high chairs. They help themselves to taco salad and corn with the help of their teachers.
None of the children in this class has an allergy to nuts, but if they did their meals would be specially prepared to be "peanut-free". The Westside center could be considered an anomaly, because right now it's fortunate enough not to have any cases of nut allergies. But the school's director, Charlotte Stille, says that does not mean they are not prepared.
"The first thing that we do is ask at the intake when a parent first enrolls is does your child have any allergies of any kind? If it happens to be a peanut allergy then we ask the parent to come in and demonstrate the use of the Epipen to the teachers that that child is going to be working with. And they sign off on a form that they've trained the staff and that we know what the precautions are."
Today it's not unusual for a child to take home a note to their parent warning them of a student who has a nut allergy in their class. And some schools are designating "peanut-free" tables in cafeterias in an effort to avoid what could be a fatal allergic reaction.
Ohio State University pediatric allergist, Doctor Roger Friedman, did not call the rise in peanut allergies an epidemic, but did say it has significantly increased over the past 20 years.
"When I started practice nearly 22 years ago, every school had one or two children that had some peanut allergies. Now it's almost every class that has one."
Friedman says there are a number of theories about why there are more peanut allergies today than two decades ago. But he says the most prevalent one is the hygiene hypothesis.
"Because we've become much healthier, and because we have less infections, and because we have less indotoxin, an indotoxin in particular is from indoor animals, especially farm animals but also cats and dogs. Because we're less exposed to this that our immune system, instead of having to become a strong infection fighter it stays as an allergic immune system."
Friedman says if as a child you have lots of infections your immune system will make you less prone to allergies. He believes more allergies, such as a peanut allergy, is an unfortunate consequence to being healthier.
Luckily, Friedman says scientists have a much better understanding of the nature of the antigen that causes allergic reactions.
"That's very important because we're hoping in the future, that maybe a few more years away to have a vaccine using this knowledge, this DNA, to try and desensitize people who have peanut allergies."
A new drug, Xolair, is currently being tested on children with peanut allergies. A few years ago a preliminary study tested adults who would have a severe reaction to one peanut and gave them Xolair. After receiving the medication, on average, it took eight peanuts to have a similar reaction.
"That doesn't let you eat peanuts, but that prevents tragedies from happening. That prevents, again, the story in the news about the young girl who died from just a very tiny exposure to peanuts. Hopefully the Xolair-type therapy will prevent that."
Friedman says Xolair decreases the allergic antibodies, or IGE, in the patient. He says by decreasing IGE the severity of food allergies can be less severe.
Until researchers find more effective medications Friedman says people with nut allergies will have to be careful what they eat and keep their emergency epinephrine shot within reach.