In the Wake of the Sky Disaster: Everything You Need to Know About Fava Bean Allergy

The death of the 32-year-old Israeli on a plane before his wife's eyes is a tragic event, intensified by the feeling that his sudden death could have been naturally prevented.

The disaster occurred while the couple was flying from Madrid to Florida for their honeymoon, two months after their wedding. The young man consumed the meal served on the plane and shortly after lost consciousness. A doctor on the flight provided medical assistance, but ultimately had to pronounce him dead.

Following the disaster, Professor Aharon Cassel, Chairman of the Israel Association of Allergists, urged authorities to immediately instruct airlines to include life-saving EpiPens in the first aid kits on planes, similar to restaurants and public places in the country. "We are aware of severe allergic food reactions on planes, though no fatalities have been recorded until today. Passengers should not be put in life-threatening situations just because there are no injectors on planes," says Prof. Cassel.

The 'Yated Ne’eman' newspaper published an article this morning (Sunday) clarifying the allergy, which is caused by a genetic defect (mutation) of deficiency or functional disorder in the enzyme G6PD, fully known as Glucose-6-phosphate dehydrogenase. This enzyme is involved in many vital processes in the body, including maintaining the integrity of red blood cells. A deficiency in the enzyme causes damage to the cells, and the individual suffers from "hemolytic anemia."

The mutation is hereditary and requires only one parent to pass it on to a child. Most affected individuals are men.

It's important to understand that even for those with enzyme function impairment, the normal amount of enzyme in red blood cells is usually sufficient for required activity. Problems arise when a person with the genetic defect is exposed to substances (like fava beans) or situations requiring a higher enzyme quantity.

Hundreds of millions worldwide suffer from fava bean allergy. It is the most recognized allergy connected to ethnic origin. The mutation is particularly common among people of Middle Eastern descent – Greeks, Italians, Spaniards, and Armenians. Among Jews, fava sensitivity is most common among descendants from Morocco, Kurdistan, and Northern Iraq. The genetic defect is also prevalent, though less so, among those from Yemen, Iran, and Georgia.

Amazingly, fava sensitivity also offers life-saving benefits: those with the genetic defect causing enzyme deficiency have greater protection against malaria! Ironically, researchers speculate that one of the side effects of enzyme deficiency G6PD is better resistance to malaria, and statistics support this.

Fava sensitivity should not disrupt daily life. In most cases, enzyme deficiency is unnoticed and causes no particular problems. Most who carry the genetic defect aren't aware of it unless they undergo specific tests to identify the mutation.

For people with the enzyme deficiency, simply avoiding consumption of fava beans and exposure to forbidden substances is usually enough to prevent any issues.

Professor Cassel explains that typically, fava intolerance doesn't result in immediate severe damage. The enzyme deficiency causes the destruction of red blood cells upon exposure to fava beans, but it's a more prolonged reaction, potentially fatal but not immediately apparent.

Symptoms of fava sensitivity include fever, fatigue, rapid heartbeat, shortness of breath, dizziness, pallor, and jaundice. Often, testing for fava sensitivity is conducted in infants born with neonatal jaundice as there is a possibility the jaundice results from enzyme deficiency.

Fava exposure isn't the only condition threatening the health of those with the genetic defect. Use of sulfa-containing drugs, such as certain antibiotics, and severe infection scenarios can also damage red blood cells.