How to travel with food allergies: Flying rules and precautions

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A family with a daughter who has a severe allergy to peanuts was ordered off a flight to Turkey after they tried to ask passengers not to eat nuts on the four-hour trip.

Georgie Palmer, her husband Nick and their daughters were on a SunExpress flight from London Gatwick to Dalaman. Their 12-year-old, Rosie, has an anaphylactic allergy to peanuts, meaning she could die if she comes into contact with them. They asked the crew to make an announcement requesting passengers not to eat peanuts. This request was turned down, so instead the parents did their best to alert passengers in the plane.

A SunExpress spokesperson said: “Due to the insistent behaviour of the passenger to others on board that they should not consume nuts, the captain decided it would be safest if the family did not travel on our flight.”

The family say they spent £5,000 on new flights the following day with easyJet, and a night’s stay in a hotel.

In 2016, 15-year-old Natasha Ednan-Laperouse died from anaphylaxis in a hospital in France after suffering an allergic reaction on a British Airways flight from London Heathrow to Nice. She had eaten a baguette brought from Pret à Manger at the airport that contained sesame seeds.

These are the key questions and answers about flying with a food allergy.

What is a food allergy?

Some people’s immune system reacts to certain types of food as a threat. In most cases, the reaction is distressing but mild. But in severe cases an allergy can cause anaphylaxis – which the NHS calls “a life-threatening allergic reaction that happens very quickly”. The throat and tongue can swell to such an extent that they stop breathing.

According to the NHS, the most common allergic foods include milk, eggs, wheat and shellfish. But nuts and legumes are the most common sources of allergic reaction. They include: peanuts, cashews, pistachios, brazil nuts, walnuts, almonds, hazelnuts, soybeans, peas and chickpeas. Celery, mustard and sesame seeds are also potentially harmful.

The most effective emergency treatment is an injection of adrenaline. Many people with allergies carry adrenaline auto injectors, often known by the brand name EpiPen. The user injects a dose of the hormone into the thigh. For some people, a second dose may be required.

What are the international rules on flying and food allergies?

There no specific legislation for passengers. In the 580-page Manual of Civil Aviation Medicine, published by the UN body responsible for international aviation, ICAO, the only references to allergies concern flight crew. (The organisation says: “A pilot with allergic symptoms severe enough to require medication should probably not be flying.”)

In lieu of international rules, each airline makes its own policy. These vary dramatically. Virgin Atlantic says: “Peanuts are never knowingly included in any of our meals on board.” Emirates says: “We serve nuts on all our flights, either as a meal ingredient or as an accompaniment to drinks. Traces of nut residue could be passed on to other surfaces of the aircraft as well as through the air conditioning system.”

The International Air Transport Association (Iata), the airlines’ trade body, places the emphasis on the passenger, saying: “Severe allergic reactions on board are an extremely rare occurrence. However, when they do occur, the consequences may be amplified because of the remote environment. In that context, allergen-sensitive passengers susceptible to severe allergic reactions should do everything in their power to prevent these cases or be prepared if it does happen.”

What are the basic precautions?

If you or anyone you are planning to travel with suffers from a food allergy, you should discuss with your doctor whether it is safe to fly.

If they give the go-ahead, check that travel insurance will be valid and identify the best airline on the route you wish to travel on. You can see the food allergy policies on the most commonly flown airlines here:

Tell the airline in advance. Each airline has its own policy; Tui insists it is told at least four days ahead.

Take medication, usually two EpiPens, along with documentation – ideally a letter from your doctor – to avoid problems when passing through airport security. Keep this close by, for example in the seat pocket, during the flight. You might also want to pack sanitising wipes.

At check-in, remind the agent of the allergy issue.

At the gate you can ask if someone in your party can board early to wipe down armrests, meal trays and seats to try to remove nut dust.

When boarding the plane, tell the cabin crew. “Consider bringing your own sanitising wipes if you wish to wipe down the armrests, meal trays and seatback areas of your seats,” says Iata.

British Airways gives specific instructions: “Advise cabin crew and the people seated next to you of your allergy, where you have placed the medication and what to do in an emergency. Our cabin crew can speak to people seated near to you to help explain your allergy.”

Will cabin crew make an announcement about the allergy?

Many airlines will inform passengers that there is someone with an allergy on board and ask fellow travellers not to consume nuts. But some will not. Iata says: “Consider mentioning to the passengers sitting close to you or your allergic child that you or your child has a severe allergy.” It was after doing this that Georgie Palmer and her family were asked to leave the SunExpress aircraft.

A spokesperson for SunExpress said: “We refrain from making these kinds of announcements as, like many other airlines, we cannot guarantee an allergen-free environment on our flights, nor prevent other passengers from bringing food items containing allergens on board.”

I’ve heard airlines carry EpiPens as part of the inflight medical kit?

Yes, but you should not rely on this. If the carrier knows you have an allergy but do not have the necessary medication, you may be denied boarding.

Jet2 warns passengers: “If you carry medication for a severe allergy, such as an EpiPen, it is very important that you bring this with you on board the aircraft. If we are made aware of a severe allergy and you are not carrying your required medication, you may be refused travel.”

British Airways says: “Cabin crew are trained to recognise symptoms of anaphylaxis and administer treatment but if you are travelling with family, friends or guardians, they would be expected to treat you first.”

Why can’t airlines simply ban nuts on planes?

As an action that could potentially save lives at very little cost to other passengers in terms of enjoyment, that appears a solid idea. But the airlines say it would be nigh-impossible to enforce:

  • Inflight meals cannot be guaranteed to be produced in a nut-free environment, so may contain traces.
  • Airlines cannot prevent other passengers from bringing their own food onboard, which may include items that trigger an allergic reaction. Security staff at airports are looking for weapons, not potentially lethal foods.
  • Nut dust may be carried on passengers’ clothing.

Do other allergic conditions cause concern?

Yes, as Valerie Coleshaw from Bolton found to her considerable financial cost. Her cabin baggage – including her asthma inhaler – was taken away from her at Manchester airport because the flight to Amsterdam was so full. She understood that it would be returned at Amsterdam. Instead, it was checked through to her final destination, Buenos Aires.

Ms Coleshaw informed ground staff, who told the captain, who decided she couldn’t fly in case there was a medical emergency requiring a diversion. In that case, she lost an entire Antarctic cruise, which had cost her in total over £10,000.

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