Protect Schoolchildren from Life-Threatening Allergic Reactions

TMA Testimony by Louise Bethea, MD

House Committee on Public Education
House Bill 2847

April 14, 2015

Good day, Chair Aycock and members of the committee. My name is Louise Bethea, MD, and I’m a physician in The Woodlands. I am board certified in allergy and immunology. I am testifying on behalf of more than 48,000 physician and medical student members of the Texas Medical Association, the Texas Pediatric Society, and the Texas Allergy, Asthma and Immunology Society. 

I appreciate the opportunity to testify in favor of House Bill 2847. Thank you to Representative Crownover for sponsoring this important legislation.  

We believe this legislation is a significant achievement in protecting our young Texans at risk of anaphylaxis, by providing access to lifesaving epinephrine. Anaphylaxis is a severe, whole-body allergic reaction, and can be fatal. An anaphylactic reaction requires immediate medical response that would include an injection of epinephrine and a visit to an emergency department. 

Immediate access to epinephrine during anaphylaxis is critical. And epinephrine is the only treatment for anaphylaxis.

Food allergies are a common cause of anaphylaxis. An estimated one in 13 U.S. children — about 160,000 in Texas — have food allergies.[1]  Up to 25 percent of children could have a serious reaction without having a history or diagnosis of food allergy.[2]  Insect stings are another cause of anaphylaxis, along with medications and latex.

Emergencies happen everywhere in our communities, including schools. For many children, their first episode of anaphylaxis may occur at school, and because they have no history, they will not have available a prescribed auto-injector. To protect our students, our physicians have stepped up and starting working with their local school districts to raise awareness about anaphylaxis and provide training on epinephrine auto-injectors. This legislation not only will strengthen that effort in raising awareness, but also will allow for students throughout Texas to have access to epinephrine for an anaphylactic emergency.   

Equally important to making sure epinephrine is readily available in providing the legal liability protection to the physician prescribers, the pharmacists, and those in the schools trained to administer epinephrine. This is critical for the school districts to be able to carry out this important program.

This bill also would make sure school personnel are trained properly to recognize the signs and symptoms of anaphylaxis. We believe this would support the many students in Texas who already have a diagnosis and carry their own auto-injectors. Seconds matter. Anaphylaxis can be fatal, and epinephrine immediately is the treatment of choice. 

Thank you for your time today, and thank you again to Representative Crownover for sponsoring this important bill. We stand by ready to assist our local schools in this important lifesaving effort.


  [1] Gupta RS, Springston EE, Warrier MR, et al. The prevalence severity, and distribution of childhood food allergy in the United States. Pediatrics. 2011; 128: e9-e17. 

  [2] McIntyre CL, Sheetz AH, Carroll CR, Young MC. Administration of epinephrine for life-threatening allergic reactions in school settings. Pediatrics. 2005; 116(5): 1134-40.

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