How Do You Test For A Shellfish Allergy
If you have any inkling you or your child might be allergic to shellfish, schedule an appointment with an allergist ASAP. First, an allergist will take a history to establish a suspicion for a shellfish allergy. Then, skin-prick testing will be performed to shrimp, crab, and lobster. We may also check IgE levels to shrimp, crab, and lobster. An IgE tests for an allergy, whereas IgG tests for any previous exposure. This is why allergists will only test for the IgE in the blood, said Dass.
If an allergist suspects the likelihood of a true allergy is low, they might recommend an oral food challenge. An oral food challenge occurs when a small amount of the allergen, in this case, shellfish, is given to the patient. The doses are incrementally increased until a specified number is reached. If a patient passes the food challenge, they are deemed as not allergic.
Of course, it goes without saying you should never attempt the food challenge without first speaking to an allergist to rule out the possibility of a serious shellfish allergy.
Can You Suddenly Become Allergic To Shellfish
In short, yes. People can develop shellfish allergies at any age, though its most common in adults specifically, women, according to the Mayo Clinic. This means that some people can spend decades chowing down on bivalves with no problems whatsoever, then, as an adult, suddenly have an allergic reaction.
Managing A Severe Food Reaction With Epinephrine
Shellfish is among the most common food allergens. But all food allergies can be dangerous.
Epinephrine is the first-line treatment for anaphylaxis, a severe whole-body allergic reaction that causes symptoms, including tightening of the airway. Anaphylaxis can occur within seconds or minutes of exposure to the allergen, can worsen quickly, and can be deadly.
Once a food allergy diagnosis is made, your allergist likely will prescribe an epinephrine auto-injector and teach you how to use it. Check the expiration date of your auto-injector, note the expiration date on your calendar and ask your pharmacy about reminder services for prescription renewals.
Be sure to have two doses available, as the severe reaction may recur. Epinephrine should be used immediately if you experience severe symptoms such as shortness of breath, repetitive coughing, weak pulse, generalized hives, tightness in the throat, trouble breathing or swallowing, or a combination of symptoms from different body areas such as hives, rashes or swelling on the skin coupled with vomiting, diarrhea or abdominal pain. Repeated doses of epinephrine may be necessary.
If you are uncertain whether a reaction requires epinephrine, use it right away, because the benefits of epinephrine far outweigh the risk that a dose may not have been necessary.
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Avoiding Shellfish In Restaurants
When going out to eat, it is very important to let the host or restaurant staff know about a food allergy beforehand as there may be a potential risk of cross-contamination of food dishes or cooking materials.
Someone with a severe allergy may even need to stay away from the fumes or vapors that can come out of a kitchen where people are preparing shellfish dishes.
People should not hesitate to let the waitstaff know if that is a potential trigger for an allergic reaction.
Who Gets Shellfish Allergies
Anyone can develop a shellfish allergy even if youve had shellfish before without any problems. Although it can occur at any age, it appears more often in adults than in children. About 60% of people who have a shellfish allergy first get symptoms as an adult. The reason may be that children typically dont eat shellfish. People often eat shellfish for the first time as adults, which may be why symptoms appear later in life.
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Clinical Presentations Of Shellfish Allergy
Symptoms of shellfish allergy can range from mild urticaria to life threatening anaphylaxis. Most reactions are IgE-mediated with rapid onset and may be gastrointestinal, cutaneous, or respiratory. Symptoms may be limited to transient oral itching or burning sensation within minutes of eating shellfish . Recently, a case of food protein-induced enterocolitis syndrome to shellfish has been reported in a 6-year-old boy after ingestion of clam . Food-dependent exercise-induced anaphylaxis has also been described to shellfish . In certain subjects, anaphylaxis may result by a synergistic effect of nonsteroidal anti-inflammatory drugs with shellfish intake .
Shellfish protein is a potent allergen and can provoke symptoms by inhalation or skin contact . Airborne allergens are particularly abundant in the vicinity of cooking shellfish by boiling, steaming, or frying. Occupational exposure, such as in snow crab processing plants, not only can cause symptoms in highly allergic subjects, but can also cause de novo sensitization . Symptoms may be limited to the respiratory tract or affect other systems such as the skin or systemic anaphylaxis. The reported estimate of prevalence of occupational asthma in shellfish-processing workers is 2-36% .
Causes Of Some Common Seafood Allergies
The major identified allergen in fish is parvalbumin, a calcium ion-binding protein.3
Tropomyosin, which is a muscle protein, is a major allergen in shellfish, particularly crustacea and mollusks . In some individuals, when their antibodies sense tropomyosin or any other allergen in their bodies, they trigger the release of histamine and other such chemicals to attack it. This leads to symptoms that can range from mild to life-threatening.4
Arginine kinase , hemocyanin and amylase are some other seafood allergens.5
Apart from these seafood proteins which act as allergens, eating seafood can trigger allergic reactions if it is contaminated in one way or the other. Some such allergic reactions include Scombroid fish poisoning, Anisakis Simplex, Metabisulfite reactions, etc.6
But its not always eating seafood that can bring about an allergy. It can also be triggered by inhaling cooking vapors and handling seafood!7 However, such reactions are not likely to be severe like anaphylaxis. They usually only cause minor breathing difficulties.8
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Stomach Cramps Caused By Seafood Allergies
It is important to note that seafood allergies include sensitivity to any foods from fresh or salty water such as oysters, crabs, shrimps, salmon and trout. If the individual is allergic to seafood, he/she must avoid eating or get in contact with any seafood product. One of the typical symptoms that manifest after consuming seafood is stomach cramps. The other gastrointestinal symptoms that can go along the stomach cramps include vomiting and diarrhea in severe cases. It is best to schedule an appointment with a doctor so that the symptoms will be discussed as well as the appropriate treatment options.
What Are The Symptoms Of Shellfish Allergies
Shellfish allergies are most often the immune systems response to a protein found in shellfish muscles called tropomyosin. Antibodies trigger the release of chemicals such as histamines to attack the tropomyosin. The histamine release leads to a number of symptoms that can range from mild to life-threatening. Symptoms of shellfish allergies tend to lean toward the severe.
It can take some time for symptoms to present after eating shellfish, but most develop within minutes. Symptoms of a shellfish allergy may include:
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Stay Alert Keep Medication Handy
Unfortunately, the only sure shot way of staying away from allergic reactions is to strictly eliminate the allergen. Patients and their families must learn to scrutinize food labels. Buffets, parties, picnics, and cafeterias propose bigger challenges as there is often no clarity. For example, fish or shellfish stock may be used in some dishes and there may be no way to know it. There may be a medley of seafood like prawns, scallops and shrimp in a fried rice dish. In such cases of accidental exposure to allergies, remember to keep your medication handy. For mild allergies like skin hives, gastrointestinal reactions, and asthma, oral medication is prescribed. If you have serious allergic reactions like breathlessness and the life-threatening anaphylaxis, you will need antihistamines or an injectable pen with adrenaline.
What Exactly Is A Shellfish Allergy
Allergies to crustacean shellfish are more common and molluscan shellfish allergies are well known, but do not appear to occur as frequently. The major shellfish allergen has been identified as tropomyosin, a muscle protein that is present in different species of shellfish and could be responsible for cross-reactivity. This is why most people who are allergic to one type of shellfish are often allergic to other types as well.
Shellfish is one of the leading causes of food allergies in adults and is a common cause of food-induced anaphylaxis. In the U.S., a survey involving 14,948 individuals revealed that 2 to 3 percent of people believe to have a seafood allergy: 2.2 percent to shellfish and 0.6 percent to fish. From highest to lowest prevalence, shellfish allergy is most common in shrimp, crab, lobster, clam, oyster and mussels.
The growing international trade of seafood has added to the popularity of frequency of consumption of a variety of seafood products across the country. This increased production and consumption has been accompanied by more frequent reports of adverse health problems among consumers and processors of seafood. Research shows that adverse reactions to seafood are often generated by contaminants, but can also be mediated by the immune system and cause allergies.
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Allergic To Seafood And Shellfish Alternatives Or Remedies
Dear Alice,
A few years ago I became allergic to seafood and shellfish. I miss eating seafood. Are there alternatives or remedies?
Dear Reader,
A frustrating part of developing an allergy as an adult, rather than as a child, is knowing what youâre missing! While allergies might be associated with children, there are some allergies â including ones to seafood and shellfish â that are actually more common in adults. For example, in the United States, 0.5 percent of adults are allergic to fish and 2.5 percent are allergic to shellfish, compared to only 0.2 percent of children allergic to fish and 0.5 percent allergic to shellfish. In some cases, adults may even have more severe reactions to allergens than ones experienced by children. It might also interest you to know that asthma, exercise, alcohol, and certain medications can increase sensitivity to various allergens. Unfortunately, the only proven way to treat seafood and shellfish allergies is to avoid them completely.
Though complete avoidance of seafood and shellfish is recommended in the case of an allergy, you may need to be a bit of a detective to really be able to keep these foods out of your diet. Unfortunately, seafood or shellfish traces may be found in many products that would not seem suspicious, including but not limited to:
- âMeatlessâ hot dogs, sausages, and pizza toppings
- Worcestershire sauce
- Insecticides
- Sauces and seasonings
Shellfish Allergy Treatment Is Obtainable
Both adults and children in Atlanta should be cautious with shellfish as allergic reactions are known to be unpredictable and sometimes severe. On the positive side, food allergy treatment options are available and Dr. Chacko has provided relief for countless allergy sufferers.
Shellfish allergies are among the most common food allergies. Differing from most food allergies, around 60% of shellfish allergy sufferers dont experience an allergic reaction until their adult years.
The two types of shellfish that cause allergies are mollusks and crustaceans. Below are the types of shellfish that fall into each of these categories.
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What Is Seafood Allergy Causes And Symptoms
Seafood has a lot of nutritional value and benefits for health. Collectively used for both fish and shellfish like shrimp, prawns, squid, octopus, crabs and lobsters, seafood is loaded with a lot of minerals, lean proteins and good fats like omega fatty acids.1 Lets not forget, it tastes delicious! While seafood maybe a delicacy of choice for some, it is a cause of deadly allergies for a lot of people.
What Are Shellfish Allergies
Although most major food allergies begin in childhood, one allergy in particular stands apart: shellfish. An allergy to shellfish may develop any time during a persons life, but tends to present in adulthood. It can be caused by foods that youve eaten before with no issues.
Along with fish, shellfish allergies are the most common adult-onset food allergies. Its estimated that more than 6.5 million American adults have allergies to one or both, according to Food Allergy Research & Education .
There are two kinds of shellfish, crustaceans and mollusks. Here are a few examples of crustaceans to watch out for if youre allergic:
- shrimp
- snails
- scallops
Most people who are allergic to one type of shellfish are also allergic to the other type. Theres a chance you may be able to eat some varieties. However, doctors usually recommend that people with shellfish allergies avoid all varieties to be safe.
A shellfish allergy is different from other allergies in other ways, as well. For example, allergic reactions to shellfish are unpredictable, sometimes occurring long after a person has consumed the allergen and has shown no other symptoms. Allergic reactions to shellfish also often become more severe with each exposure.
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Christine Yee Yan Wai
Institution Faculty of Medicine, The Chinese University of Hong Kong
Country Hong Kong
Post-Doctoral Fellowship
2 years
Food allergies affect around 1-3% of adults and 4-6% of children worldwide and studies show its prevalence is increasing. Allergic reactions to food can range from mild to severe, the worst of which is a sudden, potentially life-threatening condition called anaphylaxis. Globally, one of the most common triggers of food-induced anaphylactic reaction is shellfish. However, unlike for other common food allergens like peanuts, tree nuts and eggs, no effective treatment strategy exists. Instead, severe forms of the condition are managed by avoiding the allergen and using epinephrine auto-injectors if accidental exposure occurs. Dr. Christine Yee Yan Wai aims to remedy this shortcoming by developing a clinically useful approach for decreasing sensitivity to shellfish allergens. More specifically, her project seeks to apply a promising new strategy of therapy antiallergic DNA vaccines to shellfish allergy.
Allergen immunotherapy, also known as allergy shots, is a form of vaccination for allergic diseases.
Developing an FDA approved DNA vaccine for shellfish allergies
Food Allergy And Survival
A food allergy in a survival situation can literally be damned if you do, damned if you dont. If that food is the only food available, you cant eat it and try to suppress your allergic reaction. At the same time, you must eat something. Finding out that youre allergic to a food in a survival situation or an emergency is extremely dangerous. The resources needed to treat a severe allergic reaction may not be available and can result in death. Food allergies limit how we can prepare for emergencies or survive in the wilderness.
If you think you have a food allergy, have an allergist confirm it. At times were told we have allergies that we dont really have, but instead develop an aversion. Under a doctors supervision, some allergies can be treated using oral immunotherapy . Doing it on my own could have had a disastrous outcome and I dont recommend it. Once you have a confirmed food allergy, be sure to get an epinephrine auto injector and work with your doctor for possible treatment. Were led to believe that the best course of action is avoidance, but we should try to treat and/or cure it, under medical supervision, if possible. The price of the EpiPen epinephrine auto injector was recently over $600 for 2, just because they can. If we treat food allergies to the point where the reaction to an accidental ingestion is a mild irritation, it can minimize the need for EpiPens and possibly prolong our survival if SHTF.
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What Are The Best Treatments For A Seafood Allergy
A wide range of seafood can cause allergies. Problem seafoods include cod, tuna, lobster, prawns, clams and shrimp and more. Seafood allergies can occur at any time in a persons life. This means its important to stay vigilant by monitoring any allergy symptoms that appear after eating seafood. At the first sign of an issue, contact your allergist. Usually, one or more of the following treatments will be used to manage and treat the allergy.
What Treatments Are Used If I Have An Allergic Reaction
Epinephrine is the main treatment for anaphylaxis. Once your provider has confirmed a shellfish allergy, you will most likely get a prescription for self-injectable epinephrine . Your provider will teach you how to use it.
If you have a severe allergic reaction and inject yourself with epinephrine, the next step is to call 911. Make sure to tell the dispatcher what happened and that you used your epinephrine injection. Emergency medical technicians may need to give you another dose when they arrive.
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Allergic And Toxic Reactions To Seafood
Seafood allergy occurs most commonly where seafood is an important part of the diet, such as in Asia and Scandinavia. Some conditions caused by toxins or parasites in seafood can resemble allergic reactions to seafood.
Seafood allergy is not rare
Whilst figures vary from country to country, approximately 1% of the population is estimated have a seafood allergy. It is more common in teenage and adult life than very early childhood. About 20% will grow out of their allergy with time.
Symptoms of seafood allergy
Many allergic reactions to seafood are mild and cause hives , tingling of the throat and mouth, swelling and/or gut reactions .
The most dangerous symptoms are breathing difficulties or collapse, caused by a drop in blood pressure , either of which can be life threatening. This is known as anaphylaxis, a severe allergic reaction.
Occasionally, breathing difficulties may occur from inhaling fumes when seafood is being cooked, and in seafood processing factories. Children with a history of asthma may be more likely to have severe allergic reactions to seafood.
Varieties of seafood
The major groups of seafood that can trigger allergic reactions are:
- Vertebrates Fish including salmon, cod, mackerel, sardines, herring, anchovies, tuna, trout, haddock, John Dory, eels, rays.
- Invertebrates Shellfish: crustaceans including prawns/shrimps, lobster, crab, crayfish, yabbies and molluscs including oysters, mussels, clams, octopus, squid, calamari, abalone, sea slugs.
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