'The tiniest piece of celery can leave me gasping for breath': Rising number of children allergic to fruit and veg

By Daniel Martin
The Daily Mail
Apr. 24, 2009

Soaring numbers of children are being diagnosed with allergies to fruit and vegetables.

Doctors have seen the numbers rise by as much as five times in some areas of the country, putting children at risk of asthma.

Experts fear the rising tide of intolerance to fruit and veg could be the new peanut allergy, which affects one in 50 children.

Symptoms of the new phenomenon - known as 'oral allergy syndrome' - include swelling in the mouth and throat, which in the worst cases can lead to severe breathing difficulties.

The syndrome is linked to hay fever, a seasonal condition. But because fruit and veg are consumed all year round, the effect is more debilitating.

Dr Pamela Ewan, an allergy consultant at Addenbroke's Hospital in Cambridge, said cases or oral allergies to fruit and veg were rising, particularly among children.

'We have seen a big rise in the number of cases in the past four to five years,' she said. 'It is a bit like the peanut was the epidemic of the 1990s.

'I think fruit and vegetables are becoming the epidemic now. In terms of numbers, fruit and vegetables are the new form of peanut allergy.'

She added: 'We think fruit and vegetables are healthy, which they mostly are, but you can be allergic to them. Early on when we first picked is up, it was passed off as not being serious. It began with fairly mild itching in the mouth.

'But now we are seeing people who are getting really severe throat closure, a significant swelling at the back of the throat which can impede breathing.'

Figures are hard to come by, but in south Wales, the numbers being diagnosed have gone up from one for every 100,000 of the population to five - in just six years.

Muriel Simmons, chief executive of the charity Allergy UK, said: 'What is happening is that people who have hay fever also react to fruit and vegetable items.

'At the moment, birch pollen is very much around, and people with this allergy may have trouble with apples, pears, tomatoes and celery because of the cross reaction with the pollen.

'This doesn't happen to everyone but, with 25 per cent of the population having hay fever, up to that number could have oral allergy syndrome. And that would make it all year round.

'GPs are certainly seeing more of these cases, but too often they don't understand what it is and dismiss it. If they do, the allergy can lead to asthma if it is ignored.'

She said children might be becoming more susceptible because of the 'hygiene hypothesis' - where living environments are too clean for people's good.

'Children play with computers a lot more in their room and don't play outdoors where they can take a tumble and come into contact with bacteria,' she said.

'Another possibility is that there are far more different types of fruit and veg commonly available. A few years ago, kiwi, mango and sweet potato were not so easily available.'

Allergy UK believes 40 per cent of adults now have allergies - up from 15 per cent in the 1990s. The number of children with food allergies has tripled in a decade.

They say more varied diets are to blame - and warn the number of sufferers is sure to rise as more exotic foods enter the diet.

Oral allergy syndrome usually affects people who are already allergic to pollen. It happens because the protein in some of the pollens is structurally similar to proteins in certain foods.

For example, the protein in birch pollen is similar to that found in apples and bananas.

The body's immune system which overreacts to birch pollen can therefore overreact in the same way to apples and bananas.

However, this cross-reactivity does not always occur - meaning those allergic to certain pollens will not always be allergic to associated fruit.

Dr Adam Fox, a consultant paediatric allergist at Guy's and St Thomas' Hospital in London, said: 'We are certainly seeing lots of oral allergy syndrome.

'This affects people who are allergic to pollen - such as birch pollen. There is a cross-reactivity between the protein in that pollen with those in fruit and vegetables, so people start getting a reaction to fruits such as apples and pears.

'Normally we would see this among young adults as they start to develop hay fever but we are starting to see more of it among young children. As there is more allergy, the severity seems to be increasing and the patterns are changing.'

Dr Jonathan North, an immunologist from Birmingham, said fruit allergies would rise in the future.

'The chance of cross-reactions with fruits increases with the larger number of types of fruit to which we are exposed,' he said.

'I wish I could eat what everyone else can'

Schoolboy Jack Harrison is allergic to most types of fruit. A banana can bring him out in a rash.

And even the tiniest piece of celery in a salad can leave him gasping for breath.

'I can eat some types of apples, as well as blackberries and raspberries - but beyond that I can't eat any of the fruits most people eat: oranges, pears, bananas, most type of apples,' said the 15-year-old from Wymondham in Norfolk.

'And celery too I have to avoid. I have quite a bad reaction to that. My throat swells up and I often get a rash. I have to carry my inhaler everywhere.'

Both Jack and his seven-year-old brother Jerome suffer from fruit allergies. Their intolerance is linked to pollen from birch trees.

'There are times when it is so annoying and you wish you could eat what everyone else can,' says Jack. 'If someone has a banana or something I think - yeah that'd be nice.

'It's difficult because it makes it much harder to get my five a day. I have to work hard to get just two or three.

'I've got used to it now. When I go out with my mates I have to be more careful, and when I am abroad I have to look a lot harder.'

Their mother Margaret says the allergies make life more complicated - and more expensive.

'They can't have tomatoes, they can't have oranges. I've had to ban melons, and kiwi are a no no. I have to buy same sort of apples all the time: they can eat Royal Gala, one can eat Granny Smith. One can eat raspberries but it makes it very much more expensive.

'The anxiety is they're not getting enough nutrients. They can't have school dinners, and I have to supply food if they go to someone's birthday party. If they eat out they can have a baked potato - and that's about it. Celery is lethal so you can't just pick what you want out of the salad bar.

'You always have to have it in mind. You can't just walk out of the door and think it's ok - because it isn't. I carry antihistamine cream wherever I go with them.'

The allergies first became apparent when Jack was as young as 18 months, but it was not until he was 10 that the full list of problematic foods became apparent.

'Jack knows what he's doing now, but with Jerome I usually spot the signs before he does - he starts to scratch, or the lips start to swell.

'When they go out they have to ask before they eat anything. I've had to train Jerome to say - I won't have that till mummy comes.

'Some doctors say they will grow out of this. It'd be lovely but we're not holding out much hope.'