In the second that the tahini touched the face of Pelag Beilin, son of Reut from Kiryat Shmona, he swelled and reddened before her eyes. Pelag was then only four months old, on his first day at daycare, when the staff prepared breakfast for the children with fruit and tahini. He was rushed to Ziv Hospital, where the family received the diagnosis that would accompany them for years: Pelag suffers from a life-threatening allergy to sesame.

He returned home with an adrenaline injector and instructions that turned every meal into an operation. "We did not sit in restaurants, we did not order food home, we did not fly abroad, nothing," recounts Reut. "Avoiding sesame completely is not simple, especially in Israel - there is no bread without sesame. Out of necessity I bought a taboon and started baking pitas and breads myself."

The story of Pelag is the story of thousands of families in Israel, for whom eggs, peanuts or milk can kill. Food allergy - an extreme immune response to innocent foods found in every home - traps many children in a strict diet regime and constant mental stress from accidental exposure to food that endangers their lives. "It can be called a mistake of the immune system, which mistakenly identifies a friend as an enemy and acts aggressively following exposure to good and healthy foods," explains Dr. Liat Nachshon, senior physician at the Institute of Allergy and Immunology at Shamir Medical Center. "Antibodies are created that trigger a wrong response. It can manifest in rash, skin swelling, vomiting, abdominal pain, runny nose, eye irritation, shortness of breath and choking, up to a drop in blood pressure and loss of consciousness."

Reut, mother of Pelag Beilin: "When they told us that Pelag could eat sesame freely I cried my heart out. Sitting with my child at the shawarma and seeing him dip chips in tahini that almost killed him as a baby - it is moving to tears"

In recent decades there has been an increase in the reported prevalence of food allergy in Western countries. In Israel it rose among young children from 0.85 percent in 2000 to 2.8 percent in 2018, and today it is estimated that about 5 percent of children suffer from it. The main food products causing life-threatening allergies in the country are milk, eggs, fish, sesame, nuts and peanuts, and in recent years cases of death from accidental exposure have also been recorded in Israel.

Until not long ago, the medical instruction for allergy sufferers was complete avoidance of the dangerous food, with a standing prescription for an EpiPen. But as the Beilin family discovered, it is very difficult to avoid exposure completely: when Pelag was three and entered kindergarten, after Reut had made it a sterile environment free of dangerous food and instructed the educational staff, an urgent phone call came - Pelag suffered a severe anaphylactic reaction, this time from a walnut, an allergen the family did not even know he was sensitive to. "If he did not have an EpiPen in his bag because of the sesame, and if the teachers did not know how to use it, he would not have survived," says Reut.

In the last two decades there has been a groundbreaking change in the field, thanks to a treatment called oral immunotherapy: gradual and controlled exposure to small and gradually increasing doses of the allergenic food, aimed at training the immune system to it and preventing a life-threatening reaction upon accidental exposure. "The idea is to teach the immune system to accept the food in question, to treat it as a familiar substance and not to activate destructive processes following it," explains Dr. Nachshon.

The treatment, which lasts one to one and a half years, begins with a day hospitalization under close medical supervision, and after a series of tests the dose at which the patient can consume the food without reaction is determined for each patient. Patients receive dozens of test tubes with small doses of the food tailored to them from the laboratory, and are required to consume them at home every day, while returning to the institute every month to increase the dose under close monitoring. "Every increase in dose can cause severe symptoms, so it must be done in a safe and protected environment," emphasizes Dr. Nachshon.

It was exactly this treatment that Pelag began when he was five years old. After about three years of uncompromising adherence he was completely cured of the sesame allergy. "This is the best thing I have done in my life," says Reut. "We went slowly, step by step, so as not to harm him. As the children grow older and have taste it is harder, because they do not always want to eat what they need." Today he is nearing the end of another three-year treatment cycle, this time for walnut allergy, and the next station on his way will be treatment for cashew and pistachio allergy.

Dr. Liat Nachshon: "The idea is to teach the immune system to accept the food in question, to treat it as a familiar substance and not to activate destructive processes following it. Every increase in dose can cause severe symptoms, so it must be done in a protected environment"

A new study by the institute team at Shamir followed 1,519 patients aged 3.7 to 36.5, who underwent 1,704 treatments with foods such as milk, peanuts, nuts, sesame and egg, and reveals dramatic results: about 90 percent of the treatments ended successfully - full or partial consumption of the food without reaction - with about three quarters of the patients reaching full and unlimited consumption. Such consumption is approved for those who managed to consume without reaction 240 ml of milk, 10 peanuts, nine walnut halves, 12-13 cashews, 17 grams of raw tahini or an omelet from one egg, according to the allergy from which they suffered.

The treatment is not without risks: allergic reactions sometimes occur during it, some life-threatening, requiring adrenaline treatment. Milk allergy is a particularly complex and difficult challenge, with a lower success rate for free consumption - 58 percent compared to about 85 percent for other allergens - and a higher risk of severe anaphylactic reactions. "Milk allergy is mysterious," says Dr. Nachshon. "Two thirds of children born with it recover spontaneously by age five, but those who remain with it suffer from severe allergy. Their treatment is complex and risky, although even among them most patients manage to achieve at least protection from hidden amounts."

To date more than 3,300 patients have been treated at the institute, most of them children. "Our oldest patient was a 55-year-old grandfather, who told us he did not want to be afraid of his grandchildren's Bamba," recounts Dr. Nachshon. The doctors emphasize that the treatment requires high commitment, and that without persistence the immune system may "forget" the tolerance it developed. "The treatment we give does not cure the allergy, it only suppresses it," says Dr. Nachshon. "Those who finish it must continue to consume the food frequently, several times a week, otherwise the immune system will return to the starting point. Data from the US show that within a year of stopping exposure, most patients may return and develop attacks."

The success of the treatment spreads by word of mouth among those suffering from severe allergies, and the waiting list for the institute currently stands at four years. It is not included in the health basket, and families are required to fund it from their own pockets - about 15,000 shekels per allergen, as some patients need several such treatments in parallel. The Beilin family has paid 30,000 shekels so far for the treatments that saved Pelag's life. "Take the funds you pay every month for National Insurance allowances and medical assistants, and invest them in treatments that really save our children," says Reut.

The story of Pelag is also testimony that in this field, Israel not only treats - it leads. The protocol developed at the institute in Shamir, based on years of clinical experience and systematic research on thousands of patients, has become an address to which families seeking a solution that does not always exist elsewhere in the world turn. A child who arrived at the hospital at four months old in a life-threatening condition, and today eats shawarma with tahini without thinking twice, is not only a moving personal story - it is living proof of an Israeli medical achievement.

"It is not magic," summarizes Dr. Nachshon. "We do not cure our patients, but we return to them the confidence and control over their lives." For the Beilin family, this is not a flowery definition but an accurate description of their new daily life. "When they told us that Pelag could eat sesame freely I cried my heart out," says Reut. "Sitting with my child at the shawarma and seeing him dip chips in tahini that almost killed him as a baby - it moves me to tears."