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Study Shows Nut Allergy Incidents Spike on Halloween

Candy bars cut in half, some containing nuts or nut butter, with a fall/autumn/Halloween lighted background.

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Key Takeaways

  • A recent study has found that nut allergy cases spike on Halloween, particularly among young school-aged kids who don't typically have as much supervision as younger children.
  • Talk about food allergies with your children and make sure that they understand the importance of knowing what’s inside a treat before eating it. Better yet, check treats before allowing your children to have them.
  • If your family has nut allergies, plan ahead to ensure there are nut-free options that everyone can enjoy.

Even though the pandemic has put a hold on trick-or-treating and parties this year, that doesn't mean you have to give up candy on Halloween. That said, there are some precautions to take—one of which might be one you haven't thought much about before.

Nut allergies might already be a concern for your family, but if not, you might worry about someone in your family learning they have a nut allergy after eating holiday treats.

The fear isn't necessarily unfounded: According to a recent McGill University study, incidents of anaphylaxis from tree nut and peanut allergies spike during the holidays—especially on Halloween.

The study included 1,390 cases of anaphylaxis in emergency rooms between 2011 and 2020 across four Canadian provinces. Senior author Moshe Ben-Shoshan, MD, hypothesizes that a similar situation could be happening in the United States.

Trends in Holiday Nut Allergies

When the researchers looked at the cases, they determined that the median age of the children in the ER because of nut allergies was 5.4 years old. Additionally, 62% of the cases were male.

Compared to the rest of the year, the increase in severe daily peanut-allergy cases on Halloween was 85%. For allergic reactions to “unknown” nuts—which could include tree nuts such as cashews, almonds, and hazelnuts—the increase was 70%.

Halloween wasn't the only holiday that saw a spike: Easter was a close second with a 60% increase in peanut allergy incidents and a 70% spike for those associated with “unknown” nuts.

What Parents Need to Know

One of the most important things for parents and caregivers to know is how to spot an allergic reaction. The signs and symptoms of a nut allergy reaction can range from mild to severe and typically occur within one or two hours after someone is exposed, though most reactions occur immediately, says Ben-Shoshan, who is also a pediatric allergy and immunology specialist at Montreal Children’s Hospital. 

If your child is allergic to peanuts (which are actually legumes, not nuts), you might notice hives, redness, or swelling, or your child might complain of an itchy or tingly mouth or throat, or say that their throat feels tight. In more severe cases, they might experience shortness of breath, wheezing, or digestive issues like cramps, nausea, or vomiting.

Peanuts are the top cause of food-induced anaphylaxis, an acute reaction that causes airway constriction, a swollen throat (and subsequent breathing trouble), a severe blood-pressure drop, rapid pulse, and dizziness, lightheadedness, or loss of consciousness. 

Around 35% of children who are allergic to peanuts are also allergic to tree nuts, such as cashews, almonds, and hazelnuts. However, just because a child is allergic to one or more tree nuts doesn’t necessarily mean they are also allergic to peanuts. It's important to know that the symptoms of tree nut allergies are similar to those of peanut allergies and can be as wide-ranging.

If the reaction is mild, such as a scratchy throat, talk to your pediatrician. They might refer you to an allergist who can perform testing. “An allergist can determine if it’s a true food allergy and provide strategies on how to manage it,” Ruchi Gupta, MD, professor of pediatrics and medicine at Northwestern University’s Feinberg School of Medicine, tells Verywell.

If your child is having breathing problems, cardiovascular symptoms, or severe gastrointestinal issues, call 911 or head to the emergency room right away.

Why Kids Are Vulnerable on Halloween

You might assume that by the time kids are old enough to celebrate Halloween, they would know if they are allergic to nuts and know how to avoid them. In truth, it's not always that simple. “Children older than 6 are more likely to experience reactions, likely given the lack of parental supervision at older ages,” Ben-Shoshan says.

Here are some other reasons parents should keep in mind:

  • Kids might dig into candy without supervision. Whether a child knows that they are allergic to nuts or not, the spirit of the season and a bag bulging with treats might be too hard to resist—especially if other kids are digging in. Pre-pandemic, when trick-or-treating was still on everyone’s agenda, a child might reach into their trick-or-treat bags before they even get home.
  • Many bite-size candies don’t have ingredients labels. "Fun-size” treats often distributed on Halloween don’t list the contents of the candy. What’s more, little kids might not be familiar with what’s inside a Snickers bar or Reese's Peanut Butter Cups. 
  • Families might not be aware of the extent of a child’s allergy. Kids might be allergic to more than one kind of nut without realizing it. In particular, small children might encounter certain tree nuts—say, almonds—for the first time when they bite into a candy bar.

What This Means For You

If you have a child with nut allergies—or you’re not sure if they do—remind your child not to eat any treats unless they know what is in it. Prepare safe treats that they can enjoy without fear and inspect all food that you bring into your home.

What Parents Can Do

Halloween might be easier this year because many families will be skipping trick or treating and crowded costume parties. With kids celebrating at home, parents will have an easier time keeping track of what everyone is snacking on.

Here are a few other tips for having a safe Halloween:

  • Educate your child. Tell your child, “If there’s no label or if you’re not sure, don’t eat it." Having safe treats they can enjoy can make it easier to resist the temptation on Halloween. 
  • Plan ahead. Shop for the occasion early and scoop up nut-free candy and non-edible treats, like stickers. This ensures that everyone can partake in the festivities without fear and kids won’t feel like they’re missing out.
  • Put aside candy collected from people outside your home.  While your child is enjoying the nut-free treats you’ve prepared, Ashlesha Kaushik, MD, medical director of UnityPoint Clinic Pediatric Infectious Disease, in Sioux City, Iowa, advises that you wipe down the packaging of any treats from outside your home with disinfecting wipes. You can also let them sit for a couple of days. Not only will this give any viruses on the surface time to deactivate, but it also gives you some time to inspect your child's Halloween stash. You can get rid of the questionable or obviously unsafe treats and replace them with something your child can safely enjoy.
  • Make sure your child carries an epinephrine auto-injector. If your child is prone to anaphylaxis from nuts, it’s “crucial,” says Ben-Shoshan, to have it in their own pouch when participating in Halloween activities—particularly if they are away from home. This way, should a reaction occur, treatment is readily available. 

Teal Pumpkins

When the pandemic is over and trick-or-treating returns in future years, you and your kids can keep an eye out for some specially colored gourds. Teal pumpkins let people know that nut-free treats are available.

"Kids with nut allergies are so happy when they see it,” says Gupta, who is also the director of the Institute for Food Medicine, Center for Food Allergy & Asthma at Northwestern Medicine. “They think, ‘That’s a house that supports me.”

To help make sure other kids feel included, consider collecting a stash of nut-free treats, such as Smarties or Skittles or stickers, and put a teal pumpkin out on your doorstep at home.

Talk to Your Pediatrician

A recent study found that only about a third of pediatricians fully follow the most current peanut allergy prevention guidelines for infants. The guidelines, which were issued in 2017, recommend an assessment of risk and the introduction of peanut-containing foods into the diets of babies between 4 to 6 months to prevent peanut allergy.

Pediatricians have to cover a lot of ground during an appointment. Gupta says that “it’s important for parents to be proactive about discussing nut allergies."

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Article Sources
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  1. Leung M, Clarke AE, Gabrielli S, Morris J, Gravel J, Lim R, et al. Risk of peanut- and tree-nut–induced anaphylaxis during Halloween, Easter, and other cultural holidays in Canadian childrenCMAJ. 2020;192(38):E1084-E1092.

  2. Mankad V. Kids with Food Allergies. Asthma and Allergy Foundation of America. Food Allergies and Cross-Reactivity. Updated July 2015.

  3. Food Allergy Research & Education (FARE). Teal Pumpkin Project.

  4. Gupta RS, Bilaver LA, Johnson JL, Hu JW, Jiang J, Bozen A, et al. Assessment of pediatrician awareness and implementation of the addendum guidelines for the prevention of peanut allergy in the United StatesJAMA Netw Open. 2020;3(7):e2010511.

  5. American Academy of Pediatrics (AAP). Peanut Allergies: What You Should Know About the Latest Research & Guidelines. Updated January 17, 2020.