Cameron Jean-Pierre, an 11-year-old boy from Brooklyn, N.Y., died on New Year’s Day, and his parents are blaming the fumes from fish cooking in his grandmother’s kitchen.
Such allergic reactions are extremely rare, allergy experts say, but they do happen on occasion.
“It’s a very rare case,” said Dr. Moshe Ben-Shoshan, an associate professor in the division of allergy, immunology and dermatology at the Montreal Children’s Hospital. “It highlights the risk, but we need to remember that most accidental reactions occur by ingestion more than by inhalation.”
The boy, who had asthma as well as fish and peanut allergies, and his father were visiting relatives in Brooklyn when Cameron was stricken, apparently after inhaling aromas from a traditional Caribbean fish dish that his grandmother and aunt were cooking.
Steven Jean-Pierre said that he used a nebulizer to administer medication to Cameron, but the breathing treatment was not as effective as it had been in the past.
“Out of nowhere, he just said: ‘Daddy, for some reason it’s not working,'” the father said. “He felt like it wasn’t giving him enough air. And that’s when I called 911.”
Police said the boy was taken to Brookdale Medical Center, where he was pronounced dead. Medical examiners have not yet determined the exact cause of death, and his asthma may have contributed.
Dr. Edmond Chan, a pediatric allergist at BC Children’s Hospital, said that allergic reactions to food from the air can only be triggered if the allergy-causing protein is present.
“It typically occurs through some kind of cooking or processing type of situation,” he said. “In this case, the fish would have been aerosolized through water vapour like steam or frying or something.”
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This isn’t the same as a smell, said Ben-Shoshan.
“When we smell the peanut butter smell, it contains fatty acids. That’s the reason we have that specific odour. But it does not contain the protein. To have a reaction, you have to be exposed to the protein.”
This means that even if you’re allergic to peanuts, walking into a room and smelling peanuts doesn’t mean you will have a reaction, they say. The protein would have to be put into the air through cooking or some other means.
“We don’t want patients to unnecessarily have fear about very common situations,” said Chan, who is also a medical adviser to the patient advocacy group Food Allergy Canada.
All the same, people with fish or shellfish allergies should avoid places where these items are being cooked, Ben-Shoshan said.
Chan advises that the friends and family of people with allergies make sure they understand exactly what their loved ones are allergic to and take steps to ensure that it doesn’t accidentally get into the food they prepare.
Parents of children with allergies should ensure that their child always carries epinephrine and that if the child has asthma, it’s being properly controlled, as this can increase the risk of a dangerous reaction, he said.
But when it comes to public life, Chan said preparedness is the patient’s responsibility.
“In the general public, the reality is it’s impossible to control exposures to very common food items such as peanut or fish,” he said.
“What’s really mandatory is the patient being prepared by asking these public settings whether or not the food they’re about to eat contains the allergens that they’re allergic to, and also the patient being fully-prepared by carrying the epinephrine injector at all times, having their asthma well-controlled.”
—With files from the Associated Press