Why You Don't Need to Panic If You're Flying With a Peanut Allergy
It's a parent's worst nightmare: Being stuck for hours in a metal tube where the very air everyone's breathing can cause your child to fall sick, choke and die from an allergic reaction.
That's the frightening scenario many peanut-allergy sufferers and their families think they face before they board a flight.
But experts say it's a fear that's unfounded. In reality, the science shows that people with peanut allergies can safely fly with minimal precautions — no need to ask the airline to create peanut-free zones, hand out explainer notes and free snacks to your entire cabin or worry yourself to death about a fatal cloud of peanut dust.
"One of the more common misperceptions we deal with is this concern that peanut dust will somehow aerosolize," Dr. Matthew Greenhawt, associate professor of pediatrics and the director of the Food Challenge and Research Unit of Children's Hospital Colorado in Aurora, Colorado, said in a phone interview. "Look, if you have a peanut allergy, you absolutely can fly and do it safely. I see too many families that often don't go on a vacation because they're scared to fly. It's robbing them of the opportunity to live their lives."
Do your homework
Be sure you know what you're dealing with and are clear on what you need to do before you travel. Don't rely on a self-diagnosis or symptoms you've looked up online, and make sure it's really a peanut allergy you're dealing with by speaking with a medical doctor who specializes in allergies and immunology. A misdiagnosis might not only cause you a lot of needless anxiety over peanuts, but it could also be diverting you from an even more serious medical issue.
If you have a peanut allergy and feel the need, call the airlines and make them aware of your condition at least 24 hours before the flight. Most US airlines will typically make some accommodations for you, but know that the airlines can and will vary in how out of their way they'll go for you, even though severe allergies are now considered a federally protected disability. (Don't expect anyone to ban all peanuts from the plane, for example.) There's even the chance the pilot will refuse to board you because she feels it creates a safety issue — and that's allowed by law. But you probably won't really need to do any of this for reasons we'll point out below.
Carry on your medications and wipes
Take all the medications you think you'll need, and make sure they're in a carry-on bag you keep under the seat in front of you, in the seatback pocket or on your person during the flight. Don't check them, and don't put them in an overhead bin — you want them within arm's reach at all times. If you have a severe reaction to peanuts, like anaphylaxis, your med pack will probably include an epinephrine auto-injector. (Don't count on the aircraft having an auto-injector in its first-aid kit, or the flight crew being trained in how to administer to someone in the throes of a severe allergic reaction.)
That said, the No. 1 weapon in your arsenal when traveling with peanut allergies will actually be sanitary wipes. The severe reactions to food allergies, including peanuts, don't happen unless you actually ingest the food — sure, skin or airborne contact with peanut proteins may cause itchy eyes, runny noses and sneezing, but it won't be life-threatening. Merely smelling peanuts won't cause a reaction either; the peanut proteins that are the allergens simply don't travel like that.
"Peanut dust doesn't blow off peanuts," Dr. Hugh Windom, an allergist, immunologist and clinical professor at the University of South Florida, said. "You really have to eat a food to have a food-allergy reaction. There's never been a serious reaction, never been a death from non-consumed exposure to food."
(People with allergies to pet dander, on the other hand, are much more likely to feel the burn if another passenger's brought a pooch on board, all the experts we spoke to agreed.)
What can be a more serious problem, though, is if there's peanut residue on the tray table or armrests from the previous flight, which you unwittingly get on your hands and that makes its way into your mouth. The most sensitive people only need a tiny amount of peanut proteins to have an adverse reaction (about 1% of a peanut), so it doesn't take much.
"That's probably how most people get reactions on a plane: The tray tables aren't always wiped down or cleaned," Greenhawt said. "People don't realize they've touched a contaminated surface."
He suggested that tray tables and armrests are probably the true culprit when people say they developed allergic reactions from peanut dust on planes. Simply using a sanitary wipe to wipe down the tray tables before you use them has been shown to significantly decrease the odds of you having an allergic reaction on a flight.
"Here's something you can do on your own and on the cheap that can actually be effective, and you don't have to rely on the airline to do it for you," Greenhawt said.
Note that we're talking sanitizing wipes, not hand-sanitizer gel, which won't destroy the allergy-causing proteins. ("They just kind of trap them and move them around," Sanaz Eftekhari, director of corporate affairs for the Asthma and Allergy Foundation of America, said.) Eftekhari said Wet Ones are an example of a wipe that is particularly effective at removing food allergens.
If you're not sure whether the airline will offer a peanut-free meal or snacks during the flight, prepare and bring your own.
Finally, if you really don't want to take any chances, you could always try to bring non-peanut snacks to share with your seatmates.
"If you think the flight is serving peanuts, you could bring safe foods to offer your cabin mates and the people next to you," Eftekhari said. "It's not always going to work, but it's something to consider."
Take medication before the flight, if necessary
Even though airborne peanut dust isn't going to kill you, getting some of the stuff in your eyes or nose can be annoying and make the flight unpleasant. Windom suggested sufferers who feel the need take basic medications before getting on the flight to prevent that.
"Take an Afrin in the nose before the trip and an antihistamine, and you'll be fine," he said.
Take advantage of preboarding
Get to your gate early, make friends with the gate agent and let them know you're dealing with peanut allergies. This will give you an extra few minutes to wipe down your tray tables and armrests with those wipes you packed. Remember: Wiping down your area is perhaps the most effective way of reducing your chances of having an allergic reaction during a flight.
Don't worry about the other passengers (most of the time)
For the most part, you don't need to be overly concerned about what the other people in your cabin are doing, even if they're ripping open bags of peanuts and digging in. Sure, it'll make you nervous, but keep calm and remind yourself that the peanut proteins that cause severe reactions simply haven't been shown to aerosolize, and keep your own area clean. In fact, Greenhawt said, studies have shown there's no evidence peanut-free zones actually decrease the rate of peanut-allergy reactions. So there's no need to fret if the flight attendants don't make the entire cabin a peanut-free area, or even if the people in the row ahead of you are eating peanut butter out of the jar — kicking peanuts off the plane likely wouldn't make you any safer anyway.
"Whenever the crew announces on an airplane that there's someone with a peanut allergy aboard and could everyone please refrain from eating peanut-based foods, I want to just put my hand up in the air and open up a bag of peanuts to show, as an allergy doctor, that it's perfectly safe," Windom said. "People expect the worst, but it's not going to happen."
If, however, the person sitting right next to you is eating peanuts messily enough, large-enough particles could make their way into your food or mouth or onto your hands, or the proximity could cause a mild reaction like a runny nose or sneezing, Windom said. In that case, if your seatmate refuses to stop, you should notify a flight attendant and see if you can switch seats with someone a row or two back.
Eat your own food
Those meals you packed for yourself before you left for the airport? Now's the time to eat 'em.
As with most things, fear and misinformation can often cause more damage than the primary problem itself. In the case of peanut allergies, inaccurate reporting, dodgy facts (there's no such thing as a medically recognized "class 6" or "level 6" allergy, Greenhawt and other doctors said, for example; that's a mischaracterization of language used in medical tests for allergies) and poorly understood science have led to an atmosphere where fear has led to people and airlines overreacting, potentially causing more harm than good. The key to overcoming the difficulties of traveling with a peanut allergy is knowing what's actually effective in minimizing your risks.
"Flying with an allergy isn't any more of a risk than going to school or any public venue," Greenhawt said.