The death of a schoolboy with a dairy allergy after cheese was thrown at him could be the first known case of its kind, an expert said.
Karanbir Singh Cheema, 13, known as Karan, went from “absolutely fine” to unconscious in less than 10 minutes after the incident at William Perkin Church of England High School in London on June 28, 2017.
Adam Fox, a consultant pediatrician brought in by the Metropolitan police to review the case, told an inquest at St Pancras Coroner’s Court on Friday that anaphylactic shock brought about by skin contact was “extraordinarily unusual” and he had never heard of it resulting in death.
“Severe allergic reactions through skin contact are very uncommon... If it was skin contact alone that caused, in this case, fatal anaphylaxis, I believe that would be unprecedented,” he said.
Fox said that he had consulted global and domestic literature, and found previous examples of contact with an allergen through the skin resulting in “bronchospasms” (caused by construction of the airways), but no fatalities.
The rarity of the event suggested that there could be other factors at play — Karan also had asthma and eczema, he said.
However, the fact that Karan was scratching his neck after the cheese was thrown at him by a fellow pupil suggested that he went into anaphylactic shock as a consequence of contact with the food, as that was known to be the point of impact, Fox said.
Karan’s scratching, which witnesses have said was so frenzied it drew blood, could have inadvertently exacerbated the situation, he added.
The high pollen count on the day in question could also have had an adverse effect on Karan, and that being Asian, a boy and a teenager increased the probability of him having a severe allergic reaction, Fox said.
Karan died after his parents agreed to gradually withdraw the drugs that were keeping him alive, said Andrew Jones, a pediatric consultant at Great Ormond Street Hospital.
The boy who flicked the cheese and another who passed it to him told the inquest on Wednesday that they were unaware Karan had an allergy to the food.
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