Fish Allergy

Finned fish can cause severe allergic reactions (such as anaphylaxis). Therefore it is advised
that people with fish allergy have quick access to an epinephrine auto-injector (such as an
Epien!" #uvi-$! or #drenaclick!) at all ti%es. This allergy usually is lifelong.
#pproxi%ately &' percent of people with fish allergy experienced their first allergic reaction
as adults.
(
To prevent a reaction" strict avoidance of fish and fish products is essential.
#lways read ingredient la)els to identify fish ingredients.
*al%on" tuna and hali)ut are the %ost co%%on kinds of finned fish to which people are
allergic. +ore than half of all people who are allergic to one type of fish also are allergic to
other fish" so allergists often advise their fish-allergic patients to avoid all fish. ,f you are
allergic to a specific type of fish )ut want to have other fish in your diet" talk to your doctor
a)out the possi)ility of allergy testing for specific fish.
Finned fish and shellfish do not co%e fro% related fa%ilies of foods" so )eing allergic to one
does not necessarily %ean that you %ust avoid )oth.
Avoiding Fish
The federal Food #llergen -a)eling and .onsu%er rotection #c (F#-.#) requires that all
packaged food products sold in the /.*. that contains fish as an ingredient %ust list the
specific fish used on the la)el.
0ead all product la)els carefully )efore purchasing and consu%ing any ite%. ,ngredients in
packaged food products %ay change without warning" so check ingredient state%ents
carefully every ti%e you shop. ,f you have questions" call the %anufacturer.
#s of this ti%e" the use of advisory la)els (such as 1+ay .ontain2) on packaged foods is
voluntary" and there are no guidelines for their use. 3owever" the F4# has )egun to develop
a long-ter% strategy to help %anufacturers use these state%ents in a clear and consistent
%anner" so that consu%ers with food allergies and their caregivers can )e infor%ed as to the
potential presence of the eight %ajor allergens.
0ead %ore a)out food la)els5
,t has )een esti%ated that there are upwards of 6'"''' species of fish. #lthough this is not an
exhaustive list" allergic reactions have )een co%%only reported to7
#nchovies
8ass
.atfish
.od
Flounder
9rouper
3addock
3ake
3ali)ut
3erring
+ahi +ahi
erch
ike
ollock
*al%on
*crod
*wordfish
*ole
*napper
Tilapia
Trout
Tuna
Some Unexpected Sources of Fish*
.aesar salad and .aesar dressing
:orcestershire sauce
8ouilla)aisse
,%itation or artificial fish or shellfish (suri%i" also known as 1sea legs2 or 1sea
sticks"2 is one exa%ple)
+eatloaf
8ar)ecue sauce
.aponata" a *icilian eggplant relish
;<ote7 This list highlights exa%ples of where fish has )een unexpectedly found (e.g." on a
food la)el for a specific product" in a restaurant %eal" in creative cookery). This list does not
i%ply that fish is are always present in these foods= it is intended to serve as a re%inder to
always read the la)el and ask questions a)out ingredients )efore eating a food that you have
not prepared yourself.
Keep the following in mind:
Fish protein can )eco%e air)orne in the stea% released during cooking and %ay )e a
risk. *tay away fro% cooking areas.
,f you have seafood allergy" avoid seafood restaurants. Even if you order a non-
seafood ite% off of the %enu" cross-contact with fish is possi)le.
Ethnic restaurants (e.g." .hinese" #frican" ,ndonesian" Thai and >ietna%ese) are
considered high-risk )ecause of the co%%on use of fish and fish ingredients and the
possi)ility of cross-contact" even if you do not order fish.
#void foods like fish sticks and anchovies. *o%e individuals with fish allergy %ake
the %istake of thinking that such foods don?t 1count as real fish.2
+any people who are allergic to fish or shellfish are allergic to %ore than one kind.
9et tested and have your allergies confir%ed )y a physician so that you know for sure
which foods to avoid.
The protein in the flesh of fish %ost co%%only causes the allergic reaction= however"
it is also possi)le to have a reaction to fish gelatin" %ade fro% the skin and )ones of
fish. #lthough fish oil does not contain protein fro% the fish fro% which it was
extracted" it is likely to )e conta%inated with s%all %olecules of protein and therefore
should )e avoided.
.arrageenan" or @,rish %oss"2 is not fish. ,t is a red %arine algae that is used in a wide
variety of foods" particularly dairy foods" as an e%ulsifier" sta)iliAer and thickener. ,t
appears safe for %ost individuals with food allergies.
#llergy to iodine" allergy to radiocontrast %aterial (used in so%e radiographic
procedures)" and allergy to fish are not related. ,f you have an allergy to fish" you do
not need to worry a)out cross reactions with radiocontrast %aterial or iodine.
Avoiding Cross-Contact
.ross-contact happens when one food co%es into contact with another food and their proteins
%ix. #s a result" each food then contains s%all a%ounts of the other food. These a%ounts are
so s%all that they usually can?t )e seen.
Even this tiny a%ount of food protein has caused reactions in people with food allergiesB The
ter% 1cross-contact2 is fairly new. *o%e people %ay call this 1cross-conta%ination.2
4ownload a one-page su%%ary a)out cross-contact 5
Understanding the difference etween Cross-Contamination vs! Cross-
Contact
:hen dining at a restaurant" you will need to have a discussion a)out cross-contact with one
of the restaurant e%ployees. Even though food allergies are co%%only understood" the ter%
cross-contact is fairly new. Cou %ay know the ter% and how to safely prepare an allergen-
free %eal" )ut this ter% is still not universally used in the food service industry. The
co%%only used ter% is cross-conta%ination. Foodservice e%ployees are trained to prevent
foods fro% )eing conta%inated )y )iological conta%inates. Dnce you know the difference it
will )e easier to discuss this at the restaurant.
.ross-conta%ination is a co%%on factor in the cause of food)orne illness. +icroorganis%s
such as )acteria and viruses fro% different sources can conta%inate foods during preparation
and storage. "roper coo#ing of the contaminated food in most cases will reduce or
eliminate the chances of a food)orne illness.
.ross-contact occurs when an allergen is inadvertently transferred fro% a food containing an
allergen to a food that does not contain the allergen. Coo#ing does not reduce or eliminate
the chances of a person with a food allergy having a reaction to the food eaten.
#s you can see" %any food service e%ployees will hear you say cross-contact" and %ay think
this is the sa%e thing as cross-conta%ination. ,t is your responsi)ility to explain the
difference to the%.
$xamples of Cross-Contact and %ow to Avoid &t
# knife that has )een used to spread peanut )utter is only wiped clean )efore )eing used to
spread jelly. There could )e enough peanut protein re%aining on the knife to cause a reaction
in a person who has a peanut allergy. #ll equip%ent and utensils %ust )e cleaned with hot"
soapy water )efore )eing used to prepare allergen-free food.
Even a trace of food on a spoon or spatula that is invisi)le to us can cause an allergic
reaction.
'al#ing to (estaurant "ersonnel aout Cross-Contact
,t is i%portant to )e aware of cross-contact when dining out. # good exa%ple of this is the use of a flattop grill. 4uring )reakfast the
grill %ay )e used to scra%)le eggs and cook French toast" so the grill would contain egg" %ilk" and wheat proteins. 4uring lunch"
the grill %ay )e used to cook %eats. These ite%s %ay not contain egg" %ilk" or wheat proteins" )ut if the grill was not properly
cleaned )efore lunch" the allergens would still )e present. These %eats would now co%e in contact with these proteins and )e
conta%inated. 8e sure to speak to a %anager a)out their procedures for cooking allergen-free %eals.
4o not )e nervous a)out calling a restaurant you would like to dine at. The chef and
%anagers appreciate your call. They do not want to do anything to cause you an allergic
reaction. The )est ti%e to call is )etween 67'' p% and &7'' p%" when %ost restaurants are
not as )usy. ,f the chef or %anager is not availa)le" ask for the chef or %anager?s na%e and
the )est ti%e to call )ack.
)uestions to as# the chef or manager aout cross-contact
4o you have a separate area to prepare foods for special dietsE
4o you have separate cutting )oards and utensils to prepare %y %eal onE
4o you use a shared grill andFor fryer for cooking regular %eals and allergen-free
%ealsE ,f the answer to this question is yes" the restaurant does not understand food
allergies.
:ho will )e preparing %y %ealE *ervers should not prepare any part of your %eal.
-adles and tongs used for serving soups and salad ingredients can )e inadvertently
placed )ack with the wrong food. This could cause your %eal to co%e in contact with
other foods you %ay )e allergic to.
3ow will %y %eal )e la)eled and deliveredE ,t should )e delivered separately"
prefera)ly )y the chef or %anager. +any servers )alance several plates on their ar%s"
or set several plates overlapping on a tray. Cou do not want your plate next to another
plate that %ight contain an allergen.
.an %y ta)le )e sanitiAedE
0ead %ore tips for dining out5
$ffective Cleaning
To effectively re%ove food protein fro% surfaces" wash the surfaces with soap and water.
*i%ply wiping the cru%)s fro% spatulas" cookie sheets" cutting )oards" or surfaces is not
enough. To )e safe" purchase a cutting )oard" plates" and kitchen utensils that will )e used for
allergy-free foods only. *tore these ite%s in a designated area.
*tudies have shown that conventional cleaning %ethods are effective in re%oving the protein
of a food allergen such as peanut. 8ar and liquid soap is effective for re%oving protein fro%
your hands" while alcohol-)ased sanitiAer is not" according to a study pu)lished in the Gournal
of #llergy and .linical ,%%unology=. That study also showed soaps and co%%ercial
cleaning agents effectively re%oved peanut protein fro% ta)letops" while dishwashing liquid
alone did not.
Dne ta)lespoon of concentrated )leach per gallon of water at nor%al roo% te%perature is the
standard for cleaning food preparation surfaces. 3otter water te%peratures decrease the
effectiveness of )leach solutions. utting the solution in a spray )ottle is convenient for
travelling. #llow the surface to air dry after sanitiAing. The effectiveness of a )leach solution
di%inishes over ti%e.
Smart Coo#ing at %ome
:hen cooking allergen-free %eals" use utensils and pans that have )een thoroughly washed with soap and water. ,f you?re cooking
several foods at the sa%e ti%e" cook the allergen-free %eal first. Heep it covered and away fro% any splatter that %ay )e caused )y
other foods that are cooking. ,f you have handled an allergenic food" wash your hands with soap and war% water )efore serving the
allergen-free %eal.
Fish Allergy - What You Need To Know
*verview:
ollock" sal%on" cod" tuna" snapper" eel" and tilapia are a%ong the fish that co%%only trigger
fish allergies. Fish allergies are si%ilar to shellfish allergies in that they are %ore likely than
%any food allergies to start during adulthood and less likely than other allergies to )e
outgrown. :hile fish is easier than %any other allergens to avoid" a fish allergy is often quite
severe.
Fish Allergy Symptoms:
Fish allergy is linked to an increased risk of severe asth%a in adult patients. Fish has )een
linked with the oral allergy syndro%e (in which the %outh itches or tingles after eating an
allergen) in people with occupational contact with fish. The greatest risk fro% fish allergies is
anaphylaxis" a severe syste%ic reaction in which the )ody releases large a%ounts of
hista%ine" causing tissues throughout the )ody to swell. This can cause life-threatening
)reathing" cardiac" and gastrointestinal sy%pto%s. #nyone with a fish allergy should carry
any %edication prescri)ed )y their doctor at all ti%es.
Cross-(eactivity:
There is high allergic cross-reactivity a%ong different types of fish" %eaning that people with
allergies to one type of fish are likely to have (or to develop) allergies to others. This is
)ecause of a protein (parval)u%in) that is present in %any fish. For this reason" %ost people
with an allergy to one fish are advised to avoid all fish (including eel and shark). *o%e fish
-specifically tuna and %ackerel - are considered less allergenic than others. ,f you would like
to include so%e fish in your diet" ask your allergist a)out arranging additional allergy testing
to assess what %ight )e safe for you.
"arasites and Fish Allergies:
Dne allergy that %ay %asquerade as a fish allergy is an allergy to a fish parasite called
Anisakis simplex. This parasite is considered a %ajor allergen and" like fish allergies" can
cause severe allergic reactions including anaphylactic shock. ,f you have a severe allergic
reaction after eating fish )ut tests co%e up negative" consider asking your allergist to test you
for an allergy to this parasite. <ote that while Anisakis larvae can )e killed )y freeAing or
cooking" they can still trigger allergies after )eing killed" so people with Anisakis allergies
should avoid fish and shellfish altogether.
Fish Allergies and +aeling +aws:
#s one of the @)ig eight@ %ost co%%on allergens in the /nited *tates" fish is covered under
the Food #llergy -a)eling and .onsu%er rotection #ct (F#-.#). This requires that
%anufacturers la)el the presence of fish in clear language on food la)els" either in the list of
ingredients or following the word @contains@ after the ingredient list. Fish is not a particularly
co%%on hidden ingredient and generally appears as its own species in ingredient lists. 8ut
people with fish allergies should learn the na%es of %any different types of fish for
%axi%u% safety when reading la)els.
Foods Commonly Containing Fish:
.aesar salad dressing
:orcestershire sauce
.eviche (fish or shellfish @cooked@ in an acidic citrus %arinade)
.aviar
9elatin
.ioppino
Nam pla (Thai fish sauce)
8ouilla)aisse
Fu%et (fish stock)
*uri%i
issaladiIre
D%ega-J supple%ents (if you would like to take these" look for vegan varieties %ade
fro% flaxseed or other plant-derived oils)
.aponata
$ating *ut with Fish Allergies:
There are recorded instances of inhalation reactions due to aerosoliAed fish proteins" so
people with fish allergies should avoid hi)achi-style co%%unal grill restaurants if fish is on
the %enu. *eafood restaurants and sushi )ars are high risks for cross-conta%ination due to the
close proxi%ity of fish and non-fish ite%s. #nother source of potential cross-conta%ination is
frying oil= if fish has )een fried in oil" people with fish allergies should avoid eating any other
food fried in the sa%e oil.
+iving with Fish Allergies:
Fish is an easier allergen to avoid than %any of the other @)ig eight@ allergens. ,t is far less
pervasive in the :estern diet than" for exa%ple" wheat" soy" or dairy.
ThatKs not to say that living with a fish allergy is easy. The %ajor challenges are avoiding
high-risk situations for contact with fish and %anaging the risk of severe asth%a (where
applica)le) and anaphylaxis. 0eading la)els for fish is reasona)ly si%ple in grocery stores.
.o%%unication in restaurants" however" is vital= higher-end restaurants" especially" %ay use
s%all a%ounts of fish to flavor dishes that %ay not indicate the presence of fish on the %enu.
For %ore infor%ation" see7
Tips for Eating Dut with Food #llergies
3ow to #void #llergy .ross-.onta%ination
+anaging asth%a and anaphylaxis risk )oth depend on co%%unication with your doctor and
keeping any prescri)ed %edication close at hand - a rescue inhaler" in the case of asth%a" and
injecta)le epinephrine (Epien" TwinGect" or si%ilar %edication) in the case of anaphylaxis.
For %ore infor%ation" see7
Types of #sth%a +edication
3ow to Treat #naphylactic *hock
,efinition:
.ross-conta%ination is a pheno%enon that occurs when a food that does not itself contain
any allergens is tainted with an allergen during food preparation" cooking" storage" or serving.
$xamples:
.ross-conta%ination could occur in these and %any other settings7
:hen food is chopped on a cutting )oard on which allergens have previously )een
cut=
:hen )aked goods are )aked on a cookie sheet that hasnKt )een thoroughly washed
after )aking cookies containing allergens=
:hen foods are cooked on a grill on which foods %arinated with allergens are also
grilled=
:hen spoons on a salad )ar are used to serve )oth allergenic foods and safe foods=
:hen knives are used to cut allergenic foods and safe foods without washing in
)etween.
Fish Allergy
#stoundingly" there are %ore than 6'"''' species of finfish. #llergists generally reco%%end
that individuals with fish allergy avoid all fish" even though it is possi)le for so%e who are
allergic to one type of fish to safely eat other types. For exa%ple" so%eone %ight )e allergic
to hali)ut" )ut %ay regularly eat sal%on without a reaction.
,f you are allergic to a specific type of fish" )ut would really like to have other varieties of
fish in your diet" speak to your allergist a)out specific allergy testing. 4o not change your
diet without guidance fro% your allergist.
,f your allergist has deter%ined that you %ay eat certain types of fish" take extra precautions
to avoid cross-contact (when two foods co%e into contact with each other and their proteins
%ix) when purchasing fish fro% a %arket or when dining out. There?s also the widespread
issue of %isla)eling of fish" as so%e restaurants have )een found to su)stitute cheaper types
of fish instead of what is advertised on the %enu. .learly co%%unicate your allergy with
food service staff.
4ue to the increased risk for cross-contact during food preparation" it is )est to avoid seafood
restaurants in general" even if you plan to order a non-seafood dish. #void areas where fish is
)eing cooked" as proteins %ay )e released into the air during cooking.
#s with other foods" the sy%pto%s of a fish allergy %ay include hives or skin rash" nausea"
sto%ach cra%ps" indigestion" vo%iting" diarrhea" stuffyFrunny nose" sneeAing" headaches" and
asth%a. *y%pto%s %ay range fro% %ild to severe. # severe allergic reaction is known as
anaphylaxis" which is rapid in onset and %ay cause death.
Treat%ent for fish allergy includes strict avoidance of the fish to which you are allergic.
8ecause fish is %ost co%%only i%plicated in cases of food-induced anaphylaxis" allergists
advise fish-allergic patients to treat sy%pto%s of a reaction with epinephrine (adrenaline).
Epinephrine is availa)le via prescription in an auto-injector. Dther %edications" such as
antihista%ines" %ay )e prescri)ed. ,t is i%portant to note that while antihista%ines %ay help
treat sy%pto%s" it is not an appropriate su)stitute for epinephrine" which is the first-line
treat%ent for anaphylaxis.
Fish allergy is thought to )e lifelong" and is often developed in adulthood. 0esults of a
seafood prevalence study pu)lished in 6''& in The Journal of Allergy and Clinical
Immunology. concluded that fish allergy affects approxi%ately '.&L of the population and
that J' percent of children and approxi%ately MML of adults reacted to %ultiple types of
finfish. The study also found that %ore wo%en than %en are allergic to fish ('.ML vs. '.6L)"
and the rate of fish allergy is higher a%ong adults than it is a%ong children ('.NL vs. '.6L).
Frequently #sked $uestions
Do fish-allergic individuals need to avoid shellfish?
Those with fish allergy do not need to avoid shellfish" and vice-versa" )ecause there appears
to )e no cross-reactivity )etween fish and shellfish. There is" however" the potential for cross-
contact )etween the two. ,t should also )e noted that an individual can )e allergic to )oth fish
and shellfish (conco%itant allergy)" just as so%eone can )e allergic to egg and peanut.
hat are some hidden sources of fish?
Fish is often found in :orcestershire sauce and .aesar salad" and is so%eti%es found in
i%itation cra) products in the for% of suri%i" a processed food %ade %ainly fro% #laskan
pollack. Fish is also prevalent in #sian cuisine" which uses fish-)ased stock for %any dishes.
Managing Food Allergies
Food allergy is a ter% that enco%passes %any clinical situations. Food allergy" defined as an
adverse reaction to a food" is co%%only )ased on patient self report. hysician diagnosed is a
%ore relia)le esti%ate" and is generally esta)lished in only a third of self reports.
*ensitiAation to a food" that is the detection of allergy anti)odies to a food does not always
correlate with clinical sy%pto%s when the food is consu%ed. ,t?s i%portant to know what
causes food allergies.
:ith the a)ove in %ind" parent?s self reports of food allergy in their infants and children
occurs in (6L of the population and adults self reports of food allergy occurs in (JL of the
population. hysician diagnosis in children puts the prevalence at around JL while that in
adults in unknown.
The foods most associated with food allergy in children are eggs, cow milk and
peanuts. Foods most associated with food allergy in adults are fruits, tree nuts and
fish and shrimp.
As children grow older, many of them, but not all, no longer exhibit the same clinical
reactions to eggs. Fewer children may exhibit the same natural course to peanuts.
In infants, cow milk and soy symptoms may not be hives and/or asthma, but may be
colic or blood in the stools.
4ietary %aneuvers that %ay assist in the %anage%ent of allergy to food in infancy include7
xclusive breast feeding for !"# months
$elaying the introduction of solid foods
$elaying the introduction of highly allergenic foods
.hildren and adults with esta)lished diagnosis of food allergies require special precaution7
Avoiding the allergenic food remains the mainstay of preventing food allergy
reactions. %are givers of children with food allergy and adults with food allergy should
be informed on how to manage an allergic reaction, including the administration of
epinephrine &adrenaline'.
(ecause fatal and near fatal food allergy reactions often occur outside the home and
sometimes in a school setting, parents need to make sure the school has a written
emergency action plan providing instructions on preventing, recogni)ing and
managing food allergies in the school and during other school related activities such
as sporting events and school trips.
Cooking and Baking with Food Allergies
,f you or your child has recently )een diagnosed with a food allergy" you %ay find yourself
looking for a new way to prepare food. 3ow does one go a)out %aking a )irthday cake
without wheatE #re pancakes now off-li%its )ecause you are not a)le to use eggsE :ill you
have to give up froAen desserts )ecause of a %ilk allergyE Fortunately" the answers to these
questions are 1no2B
:ith ti%e" experi%entation" and patience" allergy-friendly cooking can )e fun and enjoya)le.
#nd" today there are %ore special diet cook)ooks on the %arket than ever )efore" and several
we)sites offer favorite tried-and-true allergy-free recipes.
-etting Started
-earn what ingredients you should avoid" and read food la)els carefully so that you can
successfully avoid your food allergen. Food %anufacturers are required )y law to use si%ple
ter%s for food allergens (such as 1%ilk2 or 1egg2) on food la)els and %ust list these
ingredients if they are present in any a%ount in the food.
lan for extra ti%e when grocery shopping so that you can read la)els when you are not in a
rush. 4o not take short-cuts with la)el-readingB
*et up your kitchen and pantry so that it is allergy-friendly. For exa%ple" designate special
shelves in the pantry or refrigerator where allergy-friendly products" such as specialty flour
)lends or powdered egg replacer %ixes" are stored.
+earn Sustitutions
*o%e co%%on allergy-causing foods (i.e." fish" shellfish" peanuts" or tree nuts) are easy to
avoid when cooking fro% scratch. Dther co%%on allergens will require an ingredient
su)stitution.
,f you are avoiding %ilk" you %ay )e a)le to tolerate a %ilk alternative" such as those %ade
fro% soy" rice" or coconut" which can )e su)stituted in equal a%ounts.
There are co%%ercial powders that will replace eggs when )aking fro% scratch" and others
have had success with replacing each egg in a recipe with ( packet gelatin %ixed into 6
ta)lespoons of war% water.
8aking without wheat is particularly challenging" since no single flour will produce the sa%e
results in a )aked good as standard wheat-)ased flour. # co%)ination of flours %ade fro%
rice" potato starch" tapioca often works )est. Cou %ay need to experi%ent to find the
co%)ination that works )est in your recipe. There are also several co%%ercial wheat-free
flour %ixes availa)le on the %arket that are convenient and work well in a %ultitude of
recipes.
Understand Cross-Contact
.ross-contact occurs when proteins fro% two or %ore different foods %ix )ecause they have
co%e into contact with one another. :hen preparing allergy-free foods" clean all equip%ent"
utensils" and surfaces prior to their use with hot" soapy water.
-et *rgani.ed
:hen cooking or )aking" prepare extra portions so that you %ay freeAe the extra for later use.
3aving a %eal ready to go will save you ti%e and energy on hectic days.
,f you find a recipe you like (either one that is allergy-free" or one that you have successfully
%odified)" keep it in a )inder" or enter it into an online %enuFrecipe-planning application.
Avoidance Measures for the Food-allergic
,f you or your child has )een diagnosed with a food allergy" you?ll often hear the word
1avoidance.2 That?s )ecause there is no cure for food allergy" and avoidance of the food
allergen is the only way to protect against a food allergy reaction. The sy%pto%s of an
allergic reaction can range fro% %ild to severe" including anaphylaxis" a serious allergic
reaction that is rapid in onset and %ay cause death.
Educating yourself a)out food allergies" how to recogniAe sy%pto%s of a reaction" ingredient
la)els" and when to ad%inister epinephrine are the keys to successfully %anaging food
allergies.
Dnce a food allergy diagnosis is %ade" your allergist will likely prescri)e an epinephrine
auto-injector and provide you with instructions on how to use it. :hen getting your
prescription filled" check the expiration date of your auto-injector and ask a)out what auto
prescription renewal re%inder services the phar%acy offers. #s an extra precaution" note the
expiration on your calendar" too" and )e sure to replace all units.
#lways carry your epinephrine auto-injector or have i%%ediate access to it. *econds count in
cases of anaphylaxis" and epinephrine is the only %edication that can reverse the sy%pto%s
of anaphylaxis. ,f you have %ultiple auto-injectors" store the% at roo% te%perature and do
not expose the% to extre%e cold or hot te%peratures.
#sk your allergist to provide a written food allergy action plan" outlining the treat%ent course
you should follow in the event of an allergic reaction. +ake sure school staff and all
caregivers have a copy of this plan. To help co%%unicate your food allergy to others during
an e%ergency" wear %edical identification jewelry.
These preparations are essential O no %atter how carefully you avoid your allergen" accidents
can happen" so )e prepared.
'ips for Avoiding Food Allergens
*ead ingredient labels thoroughly, and at least twice, even if it is an item you
wouldn+t think would contain your food allergen. If a food does not have an ingredient
label, it is safest to avoid that food.
%heck packaging thoroughly , sometimes an ingredient listing is placed on one side
of a product and an advisory label &i.e., -may contain.' is placed on another side.
Avoid products with advisory labels for your specific allergen. The use of such
labeling communicates some level of risk.
*ead ingredient statements for non"food products, such as lotions, soaps, hair care
products, and medications, to ensure these items do not contain an ingredient to
which you are allergic.
/peak to a restaurant+s manager and chef about the accommodations you need
before dining out. 0rder food that is simply prepared, and avoid desserts, as they
often contain or have come into contact with food allergens.
(efore traveling, plan for how food allergies will be managed. For example1 2ill you
pack your own food for the trip3 4ave food shipped to your destination3 2ill you
need additional medication3
If your child has food allergies, teach him or her which foods are to be avoided and
what these foods look like. *ole"play with your child so that he or she understands
how to respond if a well"meaning person offers food or drink.
2ork with caregivers and with school staff to eliminate or reduce exposure to an
allergen while still allowing your child to e5ually participate in an activity alongside his
or her peers/classmates. (e sure all those caring for or teaching your child are aware
of the food allergy action plan and when/how to use medication to treat symptoms.
For %ore infor%ation a)out food allergy %anage%ent" including a chef card to help you
convey food allergy infor%ation to restaurant staff" visit www.foodallergy.org.