Thank you for your inquiry.
Although food desensitization is an area of intense research, its standard application in a clinical setting is presently in flux. Perhaps the most thoroughly studied food in terms of food desensitization is peanut. We had a similar question submitted regarding desensitization to peanut which was answered and posted on our website recently. For your convenience, I have copied that question and response below.
As you can see, shellfish desensitization would not be considered at this time a clinical applicable technique.
Unfortunately I cannot comment on why the Navy considers shellfish allergy a contraindication to service. I can only state that in individual cases in the past, I have written directly to recruiting officers involved with individual patients seeking armed forces service when they have been declined for medical reasons. I have obtained the rationale for the decision to decline directly from the service personnel with whom I corresponded. On occasion, when I have questioned the wisdom of this decision, we have appealed, and on some of these cases have succeeded in obtaining a reversal of the decision.
If you wish to pursue the reason that shellfish allergy may be a contraindication to serving in the Navy in regards to your patient, I suggest directly communicating with the Naval recruitment office in your area.
Thank you again for your inquiry and we hope this response is helpful to you.
Previous Entry to Website:
Question:
3/19/2012
Can you pl. give me some information about the current recommendations for oral desensitization to peanuts? I have a pt who has angioedema of the face with contact to peanut butter at aged 2 yrs. At the time he had a positive skin test with a 4+ wheal and a rast level of 8.5 (class IV). Two yrs later his level is 15 (class V). While he has not had a reaction, due to the risk of a reaction from accidental exposure, the parents wanted to find out if oral desensitization was an option. Currently he has an epipen jr. and strictly avoiding peanuts/treenuts. Thanks for any advice and suggestions.
Answer:
Thank you for your inquiry.
The place of oral desensitization in the practice of allergy at this time is in flux, and has recently been a matter of debate. To put this issue into better perspective, I am going to ask Dr. Hugh Sampson, who as you know is an internationally known expert in food allergy, to share his thoughts with us about this issue. When I hear from Dr. Sampson, I will forward his response to you.
Thank you again for your inquiry.
Sincerely,
Phil Lieberman, M.D.
We received a response from Dr. Hugh Sampson. Thank you again for your inquiry and we hope this response is helpful to you.
Sincerely,
Phil Lieberman, M.D.
Response from Dr. Hugh Sampson:
As you may have heard me state in the Pro-Con debate at the AAAAI, neither the NIAID Expert Panel on Food Allergy, the FDA, or the literature support the use of OIT for the treatment of food allergy at this time. This procedure is still viewed as experimental and I would encourage any patients who are interested in OIT to enroll in one of the several ongoing clinical trials around the country that are being monitored by the FDA. Until we complete sufficient, well done clinical trials to produce supportive data, this is never going to be accepted by the FDA (or insurance companies) for standard of care. This procedure carries considerable risk of adverse reactions and there are still many outstanding questions regarding safety and long-term effects that need to be answered.
Hugh A. Sampson, M.D.
Kurt Hirschhorn Professor of Pediatrics
Dean for Translational Biomedical Sciences
Director, Jaffe Food Allergy Institute
Department of Pediatrics; Box 1198
Mount Sinai School of Medicine