Avarie's story: Confronting the deadly gaps in food allergy education and emergency response

Patient advocate Lianne Mandelbaum discusses her article, "What Avarie's death in Rome teaches us about the gaps in food allergy education." Lianne reflects on the tragic death of Avarie, a young American student with a known tree nut allergy who died in Rome due to anaphylaxis, contrasting this loss with the promising advancements in food allergy research and treatment. She meticulously outlines the systemic failures in Avarie's case: despite informing the restaurant of her allergy, she was served pesto containing cashew; her first epinephrine auto-injector reportedly failed; and the responding ambulance lacked the appropriate medication. Lianne underscores how lived experience with anaphylaxis shapes risk perception and highlights the urgent need for comprehensive, lifelong food allergy education starting from a young age. This education must cover crucial skills such as safe food ordering, self-advocacy in various settings including when studying abroad, and clear emergency response protocols. She points to a pervasive societal underestimation of food allergies and calls for widespread education at all levels—for patients, families, schools, universities, the hospitality industry, physicians across specialties to ensure timely allergist referrals, and particularly for first responders to be properly equipped and trained. Lianne advocates for making the knowledge and use of epinephrine as normalized and accessible as CPR, urging the community to translate knowledge into action to prevent further avoidable deaths.

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