For airline passengers, dealing with food and animal allergies is a delicate dance

The friendly skies can be downright hostile if you’re one of the millions of airline passengers who suffer animal-related allergies. Add food allergies, and it becomes a transportation jungle.

That’s partly because airlines must consider competing needs: the passenger who needs a service animal versus the flier for whom animal dander is an issue, and the passenger who has a food allergy versus fliers who do not.

Disabled passengers who need service animals and passengers who suffer asthma and allergies are legally protected groups under the U.S. Department of Transportation’s Air Carrier Access Act.

“If a passenger has an allergy that rises to the level of a disability [e.g., produces shock or respiratory distress that could require emergency or significant medical treatment], and there is an individual with a service animal seated nearby, airlines have an obligation to accommodate both passengers under the ACAA,” DOT rules say. “One disability does not trump another.”

But sometimes someone is inconvenienced.

On a February 2018 Allegiant Air flight, a 7-year-old boy had an allergic reaction to a service animal on board. The boy and his parents were asked to disembark before the flight took off.

“There are two disability groups, and there has to be room for both,” said Kenny Mendez, president and chief executive of the Asthma and Allergy Foundation of America.

The solutions to these problems are imperfect and, in some cases, not yet in place. For now, here is what you need to know when passengers’ needs conflict and you or a loved one must be protected.

Animal issues

►Let the airline know ahead of time about your pet allergy and ask to be seated away from any animals.

►For additional protection, a passenger with a severe animal allergy should do a sinus rinse (salt, baking soda and water) immediately before boarding and immediately after deplaning, said Dr. Rita Kachru, an allergist/immunologist and assistant professor at UCLA.

►The passenger also should take an antihistamine before and after, and consider using a steroid nasal spray such as Flonase or Nasacort, she said.

As always, check with your doctor before taking medications or using procedures new to you.

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Food allergies

Food is the other potential threat to some passengers. About 15 million Americans have food allergies, according to the Centers for Disease Control and Prevention.

But many people don’t realize they have an allergy until there’s an emergency.

A near-fatal incident occurred March 10 on American Airlines when a 10-year-old boy consumed a cashew, something he had eaten before without a problem. He experienced a first-time anaphylaxis event, a life-threatening allergic reaction that can occur within seconds or minutes of exposure to an allergen, according to the Mayo Clinic. It requires immediate intervention and administration of epinephrine.

All airlines are required to have epinephrine on board, but most airlines carry the less expensive epinephrine in a vial, to be administered with a syringe, instead of an epinephrine auto-injector. (United is one of a handful of airlines that stocks epinephrine auto-injectors, such as EpiPen. )

In the case of the 10-year-old boy, two passengers volunteered their personal EpiPens and a nurse, also a passenger, assisted. The boy has since recovered.

The problem with epinephrine in the vial: Only a medical professional can administer it.

Here are some steps to help ward off problems:

► Let the airline know you have a food allergy.

“When we’re talking about food allergies, we tell patients to call the airline the day before — and some airlines are better than others — to let them know that you have a food allergy and request that they not serve those foods,” Kachru said.

Mendez recognizes that being forthcoming can have consequences. “Some people are afraid to raise their hand and say they have allergies because they’re afraid they’re going to get bumped from the flight,” Mendez said. “But it’s better to disclose this information and work with the airlines, find out what their policy is, call ahead of time.”

►Experts recommend cleaning your seating area to help prevent accidental exposure to food allergens such as peanuts or tree nuts that could have been left by previous passengers.

“One of the best practices we advise is to wipe down your seat area,” Mendez said. “At least for food allergies, it’s a contact thing. You touch your mouth or your face 40 times an hour. If you wipe it down, you reduce your chance of cross-contamination.”

►Ask to preboard in order to clean your area. In a recent change in its policy, American Airlines announced it will allow preboarding for this purpose.

Kachru notes asthmatics and those with food allergies should always carry rescue medications — an inhaler and epinephrine auto-injector.

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