Managing the Risk of Latex Allergy in Spina Bifida

The risk of latex allergy in children with spina bifida is remarkably high. Roughly half of children with spina bifida have an allergy to latex,1 while others report numbers approaching 70%. In some children, the reaction to latex is mild—latex allergens on the skin may cause rash. In others, the reactions are serious and severe, such as life-threatening anaphylaxis.2 Despite aggressive efforts to prevent children with spina bifida coming into contact with natural rubber products, the rate of allergy is still high. Sadly, this means children with spina bifida must take special precautions to avoid developing latex allergy or, if it occurs, from being exposed to it.

How do children with spina bifida get latex allergy?

After several cases of severe reactions to latex in the 1980s, healthcare professionals made fundamental and systematic changes in the use of latex products. Most shifted to using non-latex surgical gloves and nitrile procedure gloves. Manufacturers stopped using rubber in their products (e.g. red rubber catheters). Since most believed that children with spina bifida were become sensitized to latex because of the many medical procedures they have to endure, the concept that removing latex from healthcare would solve the problem.

Unfortunately, it did not.

Limited exposure to latex is essential, but it is more difficult to accomplish than it seems. Many products have small amounts of latex in them from medical tapes and adhesives, blood pressure cuffs, NG tubes and many others. Simply being in a hospital environment is sometimes enough to sensitize children with spina bifida and to cause reactions. In fact, kids with spina bifida may be genetically susceptible to latex allergy.3 

Latex-fruit allergy (Latex-food allergy)

For reasons that aren’t entirely clear, certain fruits and nuts are associated with latex allergy. Latex allergy is a hypersensitivity reaction to Hevea brasiliensis, or more specifically, proteins found in the rubber tree by that name. Many scientists believe that certain fruits and nuts have similar proteins to the ones in natural latex. In other words, if a person with latex allergy comes into contact with one of these fruits and nuts, the immune system reacts as if it has been exposed to latex itself.4 This is called cross-reactivity. The opposite is true, as well. A certain portion of people with food allergy may have a latex allergy.5

Foods with cross-reactivity to latex:

  • Avocado
  • Banana
  • Chestnut
  • Kiwi
  • Papaya 
  • Tomato   
  • White potato

Apples, carrots, celery, figs and peaches may also have some cross-reactivity to latex.

Recognizing latex allergy

Latex allergy causes four major sets of signs and symptoms:

  • Allergic contact dermatitis — Itchy rash that occurs 1 to 4 days after skin contact with latex 
  • Allergic contact urticaria — Hives that occur within 10 to 15 minutes after skin contact with latex 
  • Rhinoconjunctivitis and asthma — Watery eyes, sneezing, runny nose, and chest tightness that occurs within minutes or hours of inhaling latex particles.
  • Anaphylaxis — Serious allergic reaction that causes severe difficulty breathing, a drop in blood pressure, rapid pulse, confusion, loss of consciousness (and possibly death)

How children with spina bifida can avoid developing latex allergy

Avoiding latex is a must. People with spina bifida should not touching anything with latex protein inhalation any powder that contains latex. Fortunately, most healthcare settings have dramatically reduced the number of products that contain natural rubber. Unfortunately, latex is still present in healthcare facilities. Each additional procedure potentially increases a child’s risk. Since it is unwise and potentially dangerous to avoid health care for fear of developing a latex allergy, the goal should be to minimize exposure.

Of course, it is relatively easy to avoid latex gloves, but adhesives in tapes and bandages may not list whether they contain latex. In fact, medical tape and adhesives are perhaps the most important potential hidden source of latex allergens. With dressing changes and repeated taping, the adhesive in medical tape is a prime driver of latex allergy. 

Hy-Tape is a multi-purpose, high quality medical tape that is completely latex-free. The adhesive is zinc oxide-based and the backing does not contain latex or latex proteins. It holds firmly, but also releases cleanly and without traumatizing the skin. Hy-Tape is an excellent choice for children and adults with spina bifida.

People with spina bifida who suffer with urinary retention should use silicone catheters rather than latex. Likewise, nitrile procedure gloves can be used instead of latex gloves. Toys, balloons, pacifiers, teethers, bottle nipples and other household products should be latex-free, too.

Protecting children with spina bifida from latex allergy reactions

Parents must make sure their healthcare providers are taking a latex-free environment seriously. If providers do not know if the medical products they use are latex-free, they probably aren’t taking the issues seriously enough. In the age of COVID-19, more people are wearing gloves to perform routine activities. Parents should consider whether they are bringing products with latex dust into the home. 

Parents should be aware of potential food and nut cross-reactivity with latex. If children seem to be having a sensitivity to a food, consider the possibility of cross-reactivity carefully. Certain food avoidance strategies may be necessary (always talk with your doctor first for changing diet). Children and adults with spina bifida may need to be tested periodically for latex allergy by an allergist or other qualified health care professional.

Once children are old enough, consider making diphenhydramine and epinephrine available in case of a reaction. School nurses should be made aware of the potential for a serious reaction—parents should ask about the school’s anaphylaxis preparedness plan.

Learn More About Latex Sensitivities.

References

1. Kelly KJ, Kurup V, Zacharisen M, Resnick A, Fink JN. Skin and serologic testing in the diagnosis of latex allergy. J Allergy Clin Immunol. 1993;91(6):1140-1145. 10.1016/0091-6749(93)90316-8

2. Kelly KJ, Pearson ML, Kurup VP, et al. A cluster of anaphylactic reactions in children with spina bifida during general anesthesia: epidemiologic features, risk factors, and latex hypersensitivity. J Allergy Clin Immunol. 1994;94(1):53-61. 10.1016/0091-6749(94)90071-x

3. Ausili E, Tabacco F, Focarelli B, Nucera E, Patriarca G, Rendeli C. Prevalence of latex allergy in spina bifida: genetic and environmental risk factors. Eur Rev Med Pharmacol Sci. 2007;11(3):149-153. 

4. Wagner S, Breiteneder H. The latex-fruit syndrome. Biochem Soc Trans. 2002;30(Pt 6):935-940. 10.1042/bst0300935

5. Garcia Ortiz JC, Moyano JC, Alvarez M, Bellido J. Latex allergy in fruit-allergic patients. Allergy. 1998;53(5):532-536. 10.1111/j.1398-9995.1998.tb04092.x