For a child with a food allergy just one brief encounter with an allergen can quickly lead to a life or death situation.
7-year-old Amarria Johnson, severely allergic to multiple foods, died after a classmate innocently offered her a peanut on the playground at her Virginia school in 2012.
Amarria's story is an ongoing worry for Dana Stoogenke, whose daughter is allergic to peanuts and shellfish.
In case of an accidental exposure Stoogenke is vigilant about stocking her daughter's school with life-saving medication called epinephrine. It's given most often using an injector called an EpiPen.
"Their reactions are so quick and severe, that I have one in her classroom, I have one at the nurse's office, she wears a Benadryl on her person at all time," Stoogenke says.
Prompted in part by Amarria's death, Virginia passed a law requiring every school to stock epinephrine auto-injectors.
More than a dozen other states have passed similar legislation.
Many others have bills pending.
The auto-injectors come with clear instructions.
A nurse, teacher or other school employee could administer the stocked EpiPens for any child thought to be having a severe anaphylactic reaction.
Food allergies can pop up in kids who've never had a problem before. It's estimated that nearly a quarter of allergic reactions that occur on school grounds happen in kids who've never been diagnosed.
Epinephrine is the only treatment for anaphylaxis and allergists say there are no long term side effects to administering it, even if you're not sure the patient needs it.
"The risk of not getting epinephrine is more tragic than for someone that maybe has increased heart rate or feels like they're running ten miles an hour for a few minutes than not administering epinephrine," explains allergist Dr. Sanjay Khiani.
Allergies aren't limited to food.
Kids can also develop reactions to bee stings.
Signs of a severe reaction include hives, itchiness, wheezing, vomiting and trouble breathing.