By Lisa Rapaport

(Reuters Health) – Although most summer camps welcome kids with food allergies, they often don’t require individualized emergency plans from these campers, a U.S. study suggests.

Researchers surveyed 559 leaders at 258 summer camps about food allergy policies, training, medication availability, anaphylaxis events, and confidence in staff to recognize and treat anaphylaxis – a potentially life-threatening allergic reaction that can be triggered by things like bee stings or peanuts.

Overall, 95% of survey participants said kids with food allergies attended their camps. But only 48% required campers with allergies to have individualized emergency action plans developed by a clinician as a condition of attendance.

“Preparedness is key – every child with a history of food allergy should have an emergency action plan,” said lead study author Dr. Natalie Schellpfeffer of the University of Michigan, in Ann Arbor.

“These plans should be formulated within the child’s medical home, which is comprised of the child’s primary care doctor, allergist and parents,” Schellpfeffer said by email.

Campers can develop anaphylaxis symptoms rapidly once they’re exposed to an allergen, making it critical that counselors or other adults recognize these symptoms and know how to respond. Kids can have these reactions from foods, medications and insect stings.

“Common symptoms of an allergic reaction can include rash, trouble breathing, frequent cough, vomiting, diarrhea, facial swelling, dizziness, lightheadedness,” Schellpfeffer said. “The first line treatment for anaphylaxis is injection with an epinephrine autoinjector,” such as the EpiPen.

In the study, 24% of participants said they had treated anaphylaxis with epinephrine within the previous two years at their camp. These respondents were more than twice as likely to have training sessions for staff on recognizing and responding to anaphylaxis.

One third of camp leaders, however, were not confident that their staff could manage anaphylaxis, and 16% said they weren’t satisfied with their training materials.

These results suggest that summer camps need more complete food allergy polices and more thorough training for staff, the study authors conclude in the Journal of Allergy and Clinical Immunology: In Practice.

“As awareness of food allergy trickles over from schools to camps, it is clear that the camp environment offers a unique set of risks,” said Dr. Steve Handoyo of the University of Chicago.

“It is critical that parents are aware of these risks, such as staff potentially being teenagers themselves, with less awareness of individual conditions due to rapid turnover of campers,” Handoyo, who wasn’t involved in the study, said by email. “Food preparation will also differ from schools and homes, there may be less available staff trained to treat, and remote location may hinder ready access to hospitals.”

Parents should talk to camps in advance to discuss their child’s allergy and precautions needed, advised Dr. Ruchi Gupta, director of the Center for Food Allergy & Asthma Research at Northwestern University Feinberg School of Medicine in Chicago.

“They can review their action plan and medications with the camp staff and make sure everyone is trained on how to recognize a reaction and how to treat it,” Gupta advised.

SOURCE: Journal of Allergy and Clinical Immunology: In Practice, online November 23, 2019.