ALBANY (The Albany Times Union) -- For all the associations that come to mind with peanuts - cracking the shells at baseball games, those little packets on airplanes, salty fistfuls at cocktail parties - suffocating to death isn't usually one of them.

Unless you are one of the 3 million Americans who are allergic to peanuts. Then you know one bite can kill. "I made a peanut butter sandwich for Colleen and one for me," says Catherine Tretheway, recalling lunch with her 1-year-old daughter nearly six years ago. "I turned around to pick mine up and by the time I looked back, Colleen's face and neck were covered in hives. I grabbed the sandwich away from her. Only the tiniest corner was bitten off. She was wheezing for air. It was terrifying."

After a trip to the doctor, Colleen soon recovered. Tests with an allergist confirmed her peanut allergy and the Tretheway household became a peanut-free zone. Tretheway figured that was enough.

That is, until the "peanut kiss incident."

Half a year had passed. Tretheway ate a peanut butter sandwich at her parents' house and went shopping. Three hours later, she returned to her home in Valatie, N.Y., and planted a big kiss on her daughter.

"This huge welt formed on Colleen's cheek. That was it. I never touched peanuts again. The whole family stopped eating anything with peanuts," says Tretheway, 42, an attorney and the coordinator for special services at Columbia-Greene Community College.

Nearly 7 million Americans, including more than 2 million school-age children, suffer from food allergies. Severe food-allergy reactions account for an estimated 30,000 emergency room visits, 2,000 hospitalizations and 200 deaths each year, according to Food Allergy and Anaphylaxis Network, or FAAN.

Eight foods account for 90 percent of allergic reactions: peanuts, tree nuts (walnuts, pecans, cashews, pistachios, etc.), shellfish, fish, eggs, milk, soy and wheat. For young children, the main culprit is peanuts, and physicians report that the prevalence of peanut allergy in the United States is on the rise.

Peanuts are the leading cause of fatal and near-fatal allergic reactions, making the legumes the most dangerous of all food allergies. For some, even a small amount of peanut protein can cause anaphylactic shock - the blood pressure drops, the throat swells up and breathing stops - and it's fatal if not treated immediately.

Avoiding problematic foods requires careful detective work. Parents of children with food allergies read every label on every food they buy. Peanut products, for example, permeate an array of foods, including sauces, crackers, processed snacks, brown gravy and soups.

"It's very difficult because there are many unexpected sources of peanut products, and ingredients change and the labels can be hard to decipher," says Dr. Jocelyn Celestin, chief of the allergy and immunology unit for Albany Medical Center. "People with food allergies need consistent and reliable food labels."

The cry is being heard. Two weeks ago, Rep. Nita Lowey, D-N.Y., and Sen. Edward M. Kennedy, D-Mass., introduced legislation to improve ingredient labeling on foods. The Food Allergen Consumer Protection Act would require clear, complete labels naming ingredients in common language, and manufacturers would have to take steps to reduce the chance of cross-contamination during food processing.

Tretheway vigilantly monitors the foods around Colleen, now 6, especially when they're at social functions.

"At a birthday party recently, 20 little girls dug into their treats and suddenly, all around Colleen, they were eating peanut butter cups," says Tretheway. "I slapped my hand over Colleen's mouth and nose and ran her out of there."

In the first four years of life, 6 to 8 percent of kids have food allergies, because their immune systems are not yet mature and they are more sensitive to allergens than adults, according to Dr. Hugh Sampson, chief of pediatric allergy at Mount Sinai School of Medicine in New York City. Many kids outgrow food allergies, but allergies to shellfish and peanuts tend to be lifelong.

Such difficulties led Lori Ira, who lives in Schenectady, to form the New York Nut Allergy Awareness Group, or NYNAAG. Her 2-year-old, Katlyn, has nut allergies.

"When Katlyn was 4 or 5 years old, it was hard to find anyone she could play with. So I decided to find other parents of kids with peanut allergies and I ended up forming NYNAAG. We started a play group for the kids and a support group for the parents," says Ira.

Today, NYNAAG (pronounced Nye-nag because it does "a lot of nagging to food companies," says Ira) meets monthly and has four dozen families participating. The parents share updates on food products and coping strategies.

"We are constantly calling manufacturers and checking on what's safe. It's a lot of homework. It's not a project. It's a career," says Ira, who has full-time work as a staffing coordinator for a home health care agency and also works in the nut-free school cafeteria she helped to establish at the middle school Katlyn attends.

Working with the state attorney general's office, Tretheway was the lead author on a petition for improved food labeling. She presented the petition and testified before a panel of federal Food and Drug Administration officials last summer in Washington, D.C.

In case a serious reaction occurs, Celestin and other physicians recommend that people with food allergies carry a shot of self-injectable epinephrine known as EpiPen, which slows a reaction until medical attention can be given. Colleen Tretheway and Katlyn Ira both carry EpiPen everywhere they go, as do their parents. Thankfully, Colleen's younger sister, Meaghan, and Katlyn's younger sister, Alyson, do not have food allergies. But the uneasiness goes on.

"I'm concerned about the psychological impact," says Tretheway. "Colleen is afraid to eat anything away from home. She's very fearful and that's very sad."

Copyright 2002 The Albany Times Union. All rights reserved.