Food Allergy & Anaphylaxis
Food Allergy Basics
- Food allergies affect as many as 32 million Americans, including 6 million children.
- A food allergy is an immune system response to a food the body mistakenly believes is harmful.
- When a person with food allergy eats the food, his or her immune system releases massive amounts of chemicals, including histamine, that trigger a cascade of symptoms that can affect the respiratory system, the gastrointestinal tract, the skin, and/or the cardiovascular system.
- There is no cure for food allergies.
- The prevalence of food allergies appears to be increasing among children under the age of 18, that is 2 students in every classroom.
- Although food allergy desensitizations are being studied, these are not yet proven treatments, so strict avoidance is the only way to prevent an allergic reaction.
- Managing a food allergy on a daily basis involves constant vigilance.
- Trace amounts of an allergen can trigger an allergic reaction in some individuals.
- Unfortunately, food allergy deaths do occur, even among persons with a history of mild reactions in the past.
- 9-1-1 must ALWAYS be called with every anaphylactic reaction.
- Is a serious allergic reaction that comes on quickly and has the potential to become life-threatening.
- Symptoms can develop rapidly after exposure to an allergen, often within minutes and usually within 30 minutes. However, it can take up to 2 hours for symptoms to occur after exposure to a food allergen.
- Sometimes a second round (or “phase”) of allergic reactions can occur after the initial anaphylactic reaction. This is called “biphasic anaphylaxis”. A second reaction may happen as early as an hour after the first reaction or as long as 72 hours later (the average is 10 hours later) and can be less severe, as severe, or even more severe than the initial reaction.
- Must be treated immediately with epinephrine (adrenaline).
Prompt administration of epinephrine is crucial to surviving a potentially life-threatening reaction. Epinephrine has very few side effects. It is prescribed as an auto-injector device (Auvi-Q®, EpiPen®).
A food allergy is NOT:
- A food intolerance (lactose intolerance, gluten intolerance, etc.).
- An intolerance does not involve the immune system – it involves the digestive system because the body lacks an enzyme needed to digest and process a particular food.
- Symptoms of an intolerance include gas, bloating, and abdominal pain.
- A food preference (vegetarian, kosher, etc.).
- Celiac Disease (is a NON-IgE mediated food allergy).
Eight foods account for 90 percent of all food allergy reactions:
- Tree nuts (cashews, pecans, walnuts, etc.)
- Fish (halibut, salmon, etc.)
- Shellfish (crab, lobster, shrimp, etc.)
However, almost any food can cause a reaction.
To learn more about food allergy, we recommend the video “Understanding Food Allergy” by the National Institute of Allergy and Infectious Diseases.
Avoid high-risk types of restaurants
Persons with food allergies should generally avoid high-risk types of restaurants, including:
- Buffets and deli stations (risk of cross-contact).
- Asian cuisine (peanuts, tree nuts used in many dishes).
- Bakeries (risk of cross-contact).
- Ethnic (language barrier).
There are ways to minimize risk of accidental exposures and feel more secure about eating out.
- Look for allergy information from the restaurant. Some chains are food-allergy aware and may post allergen information on their Web site.
- Establish good relationship with manager, staff, etc.
- Consider using a “chef card” to alert the staff about your food allergy.
- Leave the restaurant or bring your own food if you feel uncomfortable about the restaurant’s food preparation.