Known for his Italian-inspired California dishes, celebrity chef Michael Chiarello’s death from anaphylaxis came as a shock to many. Chiarello’s company announced on Oct. 7 that its founder had died after a week-long hospital stay due to a severe allergic reaction. Chiarello was home at the time of the reaction. A spokesperson tells Allergic Living that an attempt to drive Chiarello to hospital was made, but 911 had to be called on the way. Once there, he was placed on life support.
However, neither his family nor his doctors know what caused the reaction. Severe allergic reactions can be caused by food, medications, or insect stings, yet Chiarello’s family was unaware he had any allergies.
The 61-year-old’s fatal reaction serves as a stark reminder that new allergies can crop up in adults who have never had them before. It also reminds that allergic reactions can be unpredictable – a mild reaction in the past can be an anaphylactic reaction the next time.
“Just because you have always had mild reactions to a given food does not mean you will not have a very severe, life-threatening reaction on your next exposure,” says Dr. Christopher Warren, PhD. The epidemiologist is the director of population health research at the Center for Food Allergy and Asthma Research at Northwestern University.
Co-factors – such as alcohol, vigorous exercise, lack of sleep, and certain illnesses or medications – can combine to make what under other circumstances would be a mild allergic reaction more severe. “Co-factors can affect how reactive the immune system is any given moment,” Warren explains. And “there are likely factors we don’t understand yet.”
Adult Allergies Rising
About 10.8 percent of U.S. adults, or 26 million people, have a food allergy, according to a large survey published in JAMA Network Open 2018. That number was double what other studies had found just a few years prior.
Although most food allergies are discovered in childhood, that’s not always true. In the survey by Warren and his colleagues at Northwestern, about half of the food-allergic adults reported at least one, adult-onset allergy.
Often, it’s a food that they may have eaten many times before without issue. The most common was to crustaceans, or shellfish.
Adults and Allergy Risks
But adults can also play fast and loose with allergies in ways that might make many food allergy parents shudder. In focus groups, adults will sometimes say that they know they are allergic to a food, but they like it so much, they eat it anyway.
“They will eat it until they start feeling bad, or they will eat until they start feeling oral symptoms or symptoms in their chest, which is terrifying,” Warren says. “Usually, it something they’ve dealt with for a while and they think, ‘I’ve got this under control. This isn’t a big deal.’ But we would not recommend this to anybody.”
He hears about that risky approach more often in adults than in kids with allergies.
Adults Less Likely To See a Doctor
While worried parents often whisk off food-allergic kids to an allergist for testing, that’s often not the case for adults. They are less likely to see a doctor about their symptoms, Warren says.
In the Northwestern study, only half of adults with food allergies had followed up with a physician for diagnosis, and 24 percent carried epinephrine.
There is no information about whether Chiarello had been diagnosed with an allergy, or was prescribed epinephrine. Indeed, “The doctors don’t know what caused the allergic reaction and neither does the family,” the spokesperson said. “They may never know.”
Fatalities due to anaphylaxis in adults remain rare, Warren says. But epinephrine is very effective in preventing death from allergic reactions, especially when administered promptly.
“That is why it’s so important for people to get a proper diagnosis of their allergies, have an epinephrine auto-injector, and be ready to treat a serious reaction,” he says.
Chiarello’s Rich Legacy
Born in California, Chiarello learned to cook in his mother’s kitchen and dreamed of becoming a chef. He opened his first restaurant, Tra Vigne in Napa Valley, when he was 25. He went on to open several other critically acclaimed eateries, including Bottega, Ottimo, and Coqueta.
Chiarello believed in using seasonal, sustainable ingredients, and supporting artisans and farmers. In 1985, Food & Wine Magazine named him Chef of the Year, and other accolades followed. He opened Chiarello Family Vineyards in 1999.
Chiarello was also a well-known TV host and appeared on numerous cooking shows as a judge and competitor, including Bravo’s “Top Chef Masters” and the Food Network’s “Next Iron Chef.”
“Chef Michael Chiarello’s passion for food and life will forever be etched in our kitchens and our hearts,” his Gruppo Chiarello partners said in a statement.
He died surrounded by family and friends. Chiarello devoted his life to bringing “people together through the joy of shared meals,” said his family in a statement. “As we navigate this profound loss, we hold dear the moments we cherished with him, both in his kitchens and in our hearts. His legacy will forever live on in the love he poured into every dish and the passion he instilled in all of us to savor life’s flavors.”