EpiPens emerge as life-saving kid accessory

[Guest guest]

EpiPens emerge as life-saving kid accessory

Growing number of allergies has led to 36 percent jump in

prescriptions

By Kavita Varma-White

msnbc.com contributor

updated 2:56 p.m. ET, Thurs., Nov. 20, 2008

Janeen Zumerling of Auburn Township, Ohio, knows better than to let

her 4-year-old son, , go anywhere without a pocket-sized medical

device that can save his life.

Like growing numbers of parents of severely allergic kids — and the

children themselves — Zumerling keeps a nearby supply of EpiPens,

single-use shots of epinephrine that can quickly counter 's

potentially fatal reaction to foods from gluten and eggs to milk,

peanuts and tree nuts.

" I have two in the kitchen cupboard, two in the hall closet by the

door that goes outside, two at school and two in the backpack, " says

38-year-old Zumerling, who's had to use the device once, when

was 20 months old. " There's always [an EpiPen] nearby. "

She's not alone. About 3 million American children are suffering from

food allergies, a number that's increased 18 percent since 1997,

according to a recent study by the Centers for Disease Control.

As allergies to peanuts, milk, eggs and gluten have become

commonplace, a cult-like following has emerged around the EpiPen,

which auto injects a pre-measured dose of epinephrine to someone

experiencing anaphylaxis, a severe whole-body allergic reaction.

An equally strong market has emerged for stylish EpiPen carriers,

including some adorned with robots and strawberries for young kids

and discreet holsters for self-conscious teens.

Doctors prescribed 1.4 million EpiPens in 2003, but by 2007 that

number had reached 1.9 million — a 36 percent rise, according to

research provided by IMS Health, a healthcare information and

consulting company.

" A pediatrician 10 years ago might have written five or 10 EpiPen

prescriptions, and now writes 40 or 50, " said Dr. Wood,

Director of the Allergy and Immunology division at s Hopkins

Children's Center in Baltimore, Md. " If you go to an elementary

school nurse, 10 years ago she might have had one or two EpiPens on

hand. Now she has 50 to 60. "

Dr. Virant, an allergy/asthma specialist at Seattle's Northwest

Asthma and Allergy Center, said that after skin and blood tests have

established a severe allergy, " From a physician's standpoint, you can

never be faulted for giving someone an EpiPen. "

100 to 200 die each year of food allergies

When Zumerling was 20 months old, he had an allergic reaction

to egg and started showing signs of anaphylactic shock: hives,

unstoppable runny nose and projectile vomiting. Other symptoms can

develop in seconds or minutes and can include dangerously low blood

pressure, swelling in the face and throat so severe it can block the

airway, fluid in the lungs and abnormal heart rhythms.

Janeen Zumerling, for the first and only time so far, jabbed the

black tip of the EpiPen into her son's thigh and held it for the

required 10 to 15 seconds. To her relief, the reaction subsided.

The epinephrine in an EpiPen works to reverse the effects and gives

the child a 10 to 15 minute window to get further emergency medical

assistance.

Each year in the U.S., anaphylaxis caused by food allergies results

in estimated 100 to 200 deaths, sometimes within minutes of exposure,

according to Love, a spokesperson for the Food Allergy &

Anaphylaxis Network.

EpiPen is the brand name of the original auto-injector that was

introduced by pharmaceutical company Dey, L.P. in 1980. For years, it

was the only product of its kind in the United States. (Currently one

other company also makes a similar product, but EpiPen still

maintains 97 percent of the market share.)

The Epi Puppy

The rising number of EpiPens has created a growing market for fashion-

inspired EpiPen carriers and portable pouches.

Some carriers are geared to young kids and come adorned with robots

and strawberries. Other styles have belt straps or leg straps for

teens who may be self conscious about visibly carrying their pens.

Others for older kids or adults come in various designs and fabrics

that are marketed as functional, convenient or just plain hip.

There are some in neon colors (easy to spot). Others come in weather-

resistant material, since EpiPens must be protected from extreme

temperatures.

A handbag designer from Markham, Ontario, in Canada, Helen Yamashita,

started her own line of KoziEpi pouches two years ago. Best sellers

are the pink EpiPen Princess for girls and a camouflage design for

boys.

The pouches of old were " masculine, black and uncomfortable to wear

because of rough material, " said Yamashita.

Debra Stafford of Alberta, Canada, got into the EpiPen carrier

business out of necessity. When her 4-year old daughter Hayley, who

is allergic to peanuts, was starting kindergarten, Stafford could

only find adult-size fanny packs in which to carry the EpiPen.

Desperate on the day before school started, she found a pencil case

in the form of a stuffed brown puppy. She attached a cord to it and

sized it for her daughter's tiny waist.

The Epi Puppy was born. Stafford developed a prototype with a New

Jersey company that creates plush toys. The chocolate Lab fits two

EpiPens and has an adjustable, kid-sized belt.

Hayley Stafford, now 10, says it doesn't bother her to always carry

an EpiPen. She has never been embarrassed by it, she says, because

it's just something she has learned to live with. Besides, her

friends liked her Epi Puppy so much, they wanted their own.

" My friends wanted one to wear to carry stuff in, " said Hayley, who

recently bought a new EpiPen carrier that's purple with stars on

it. " My friends say they like the puppy better, but the new one goes

with more of my clothes, " she said.

'A leap of faith'

The cute and lighthearted carriers may entice kids, but they belie

the seriousness of the device within. Carrying the EpiPen, say

parents of severely allergic children, is like a soldier in war

carrying a gun. It is the first line of defense to a condition that

could take a child's life in an instant.

While fear of using the EpiPen is common, " once [parents] see how

quickly the epinephrine starts to work, they aren't afraid to use it

again, " says Anne Munoz-Furlong, founder of the Food Allergy and

Anaphylaxis Network, based in Fairfax, Va.

Vogel's children Katrina, 8, and son Brett, 7, were both

diagnosed with allergies by age 2. Since then, the Fort Lauderdale,

Fla., family has kept their house a peanut-free zone. But on New

Year's Day in 2006, the kids asked if they could have a cookie left-

over from the previous night's party with close family friends.

Katrina took one bite, tasted the peanut butter, and immediately spit

it out. " But Brett, who had never had peanut butter and didn't know

what it tasted like, swallowed his bite, " Vogel said. In the next 10

minutes as her son exhibited tell-tale signs— hives, a scratchy

throat, and a throbbing tongue — she mustered her courage and

injected the EpiPen. It's the only time she's ever had to do it.

" I got in the zone, " she said. " I was scared but I knew I just had to

do it. "

One benefit from the Vogel family's experience: it spooked both kids

into an extreme vigilance about their allergies. " When they go on

play dates, my kids ask about everything. If they don't know the

ingredients, they won't eat, " Vogel said. " It really is a leap of

faith. But you get used to it. This is our life. I have to trust

them. "

It also sometimes means trusting another adult with your child's

life. Dropping a severely allergic child off for a sleepover also

means dropping off an EpiPen, often to an adult who has never seen

one before.

le , mother of 4-year-old Bella, who is allergic to

peanuts, teaches sitters, friends and family members how to use the

EpiPen by injecting the accompanying trainer pen into an orange.

said it's not hard to use the EpiPen. There are teaching

videos on the Internet. And each pen comes with explicit directions

on its packaging.

Life insurance

What is hard, says, is getting people to understand that an

allergic reaction is an emergency situation. She said at first it was

a challenge to train Bella's grandparents on how to use the EpiPen

because peanut allergies weren't prevalent when they were raising

kids.

" Once they realized the severity of it, they were supportive of

learning how to use it, " she said.

Since the EpiPen expires every 12 months, it can be a costly endeavor

for families. Even with insurance, one EpiPen often runs between $60

and $100.

Some families have never had to use the EpiPen. So when they think

about cutting expenses, they think of the money they spend on unused

EpiPens. But Munoz-Furlong warns that families with allergic children

can't get complacent.

" They consider not renewing their prescriptions, " Munoz-Furlong

said. " But you just don't want to take chances. Consider the EpiPen

is your life insurance. "

More on Childhood allergies | EpiPens

Kavita Varma-White is a freelance writer based in Bellevue, Wa.

© 2008 msnbc.com

URL: http://www.msnbc.msn.com/id/27725975/