We hear it all the time: “This is a peanut-free facility, you can’t eat that peanut butter sandwich here!” A person may say, “So what? I am allergic to broccoli, it’s disgusting, keep it far from me.”
We all should realize that food and medication allergies are no laughing matter. Reactions can be so severe that they could lead to death.
Allergic reactions commonly manifest as runny nose, hives, itching, tingling, rashes, vomiting, stomach pain, swollen lips eyes or face, or sneezing and coughing. The most severe reaction is something called anaphylactic shock.
Anaphylaxis is a rapidly progressive allergic reaction that is potentially life threatening. Although there has been an increase in the number of children diagnosed as being at risk of anaphylaxis, deaths are rare. But deaths have occurred, and anaphylaxis is therefore regarded as a medical emergency.
The symptoms of anaphylactic shock could include difficult or noisy breathing, swelling of the tongue, swelling or tightness in the throat, difficulty talking, wheezing, persistent coughing, low blood pressure, loss of consciousness, and collapse. Young children who are going through anaphylactic shock may appear pale and floppy,
Food allergies are the most common triggers to an anaphylactic reaction. Nine foods cause 90 percent of food allergic reactions and can be common causes of anaphylaxis. These are:
peanuts
tree nuts (such as hazelnuts, cashews, almonds)
chicken eggs
cow’s milk
wheat
soybeans
fish
shellfish
sesame
People all over the world live with allergies that trigger anaphylaxis. Some less common food triggers are citrus fruits and vegetables. But any food can cause anaphylaxis. Children frequently outgrow allergies to milk, soy, and eggs, but peanut, tree nut, and fish allergies tend to last a lifetime.
Food allergens account for 30 percent of deaths caused by anaphylaxis. In extreme cases, anaphylaxis can occur from kissing someone who has eaten the offending allergen, or from the food vapor in the case of cooking shellfish.
Medications can also cause anaphylaxis. Penicillins, cephalosporins, aspirin, NSAIDs, antimalarials, anaesthetics, sedatives, antipsychotics, antihypertensives, intravenous contrast dye and the flu vaccine are among the substances that carry risk of severe allergic reaction. Penicillin is the most common medication to cause anaphylaxis. Serious reactions to penicillin occur about twice as frequently following intramuscular or IV administration than taking it by mouth.
In contrast to food anaphylaxis, drug anaphylaxis is characterized by a high frequency of heart failure and rapid onset (within minutes), especially in older people.
Latex products, especially natural latex, commonly found in gloves, balloons, baby bath toys, belts, elastic bands, erasers, gloves, and some shoes can trigger anaphylaxis in those who are sensitive. Synthetic latex appears to be less allergenic than natural latex. Some people with latex allergy will also have an allergy to certain foods such as avocados, bananas, chestnuts, and kiwi because of cross reactivity to latex.
Insect venom from bees, hornets, wasps, and fire ants can also cause anaphylactic shock. Stings are more likely to cause anaphylaxis than bites. Anaphylaxis to insect stings has occurred in three percent of adults and one percent of children who have been stung. These stings can be fatal even on the first reaction.
Exercise is a rare trigger, but is likely to happen in people sensitive to certain foods (e.g. wheat, celery, and cheese) or medications. If the allergen is taken before being physically active, it can cause anaphylaxis. Typical symptoms include extreme fatigue, warmth, red face, rashes or hives, occasionally progressing to swelling of the face, wheezing, upper airway obstruction and collapse.
Extremely uncommon triggers include exposure to airborne allergens (such as animal dander) and cold temperatures. Sometimes a specific cause cannot be identified and this condition is called idiopathic anaphylaxis.
How does Anaphylaxis Happen?
Allergies occur when the immune system (immunoglobulin cell type “E”) produces antibodies against substances in the environment (allergens). These immune system cells set off an inflammatory reaction. The inflammatory response is the cause for most allergic symptoms, especially the closing of the throat, redness and swelling of the skin.
Anaphylaxis can occur within minutes to hours after being exposed to the trigger.
How Anaphylaxis is Treated
Anaphylaxis is a medical emergency and anyone experiencing symptoms should call EMS (Hatzoloh or 911) right away to get medical treatment. Adults may be able to express a feeling of “something not being right.” But children may not be able to communicate that something is wrong. Parents, teachers and caregivers should be accustomed to keeping a wary eye on children who have severe allergies. An “allergy emergency plan” should be made a practiced to benefit a member of the family who might G-d forbid have an anaphylactic episode.
