Avoiding Anaphylaxis this Advent

christmas-partyChristmas parties, meals out with friends and family, stockings full of candy, chestnuts roasting on the open fire…

While all this sounds like great fun, there’s a risk that more people than usual will be accidentally exposed to foods they are allergic too. Food allergies are common. An estimated 9 million, or 4%, of adults and nearly 6 million or 8% of children have food allergies with young children being those most affected.

Although childhood allergies to milk, egg, wheat and soy generally resolve in childhood, they appear to be resolving more slowly than in previous decades, with many children still allergic beyond age 5 years. And allergies to peanuts, tree nuts, fish, or shellfish are generally lifelong.

If you’re one of those affected by food allergy, what can you do to avoid accidental exposure this holiday season?

Remind people! Sure you might once have told your hosts that you have an allergy, but a gentle reminder is always helpful, especially at Christmas when things get busy and the alcohol starts flowing!

PeanutButterAllergyJust say ‘no’ – if you don’t know what’s in it, don’t eat it. And even if you do, can you really be sure there was no cross-contamination in the kitchen.

Bring snacks, rather than rely on your hosts to have food you can eat…or

Stay home. Host the party yourself – then you know it’s safe.

Bring your epinephrine auto-injector with you –and keep it close to hand! Make sure somebody else at the party knows you have food allergies, where your auto-injector is and how to use it.

Know the Symptoms – within minutes, an allergic reaction may turn into a life-threatening severe allergic reaction. Sometimes the reaction can occur in two phases, with another reaction occurring up to 48 hours after the initial reaction.

Use epinephrine immediately after you have been exposed to your allergy trigger – it may prove to be life-saving.  If you are even thinking should I give myself epinephrine, the answer is almost certainly yes!

epipen jpegAfter giving epinephrine, seek emergency medical attention – call or have someone else call 9-1-1 or your local emergency medical services.  In most individuals, epinephrine is effective after one injection. However, symptoms may recur and further injections may be required to control the reaction. Epinephrine can be re-injected every 5 to 15 minutes until the severe allergic reaction stops completely.

Do you have your anaphylaxis Action Plan ready?  If not, make it part of your holiday preparations. It could be the best Christmas present you give yourself this year.

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Some VERY strange allergies

According to the Centers for Disease Control and Prevention (CDC), 90% of all food related allergies are caused by milk, eggs, peanuts, tree nuts, shellfish, fish, soy and wheat.

While these are the most common, there are other allergy triggers you may not be so familiar with.

How about water?  Yes, it is possible to be allergic to one of the most abundant substances in the world, including the water in our own bodies. People with this condition, properly known as aquagenic urticaria, can experience severe itching and hives within five minutes of coming into contact with water, regardless of its source or temperature.

This condition is rare – only around 30 cases have been reported in the literature and the reason for it isn’t known. Worse still for those affected, histamine levels — the usual allergy culprit — don’t actually increase in these patients, meaning that traditional antihistamines don’t work.

While it might be hard to envision a life without water, spare a thought for women who are allergic to their own female hormones.  Although it’s not uncommon for women to suffer from acne, water retention and premenstrual syndrome (PMS) at certain times their cycle, a small number of women suffer from a condition called autoimmune progesterone dermatitis (APD). This skin disorder is triggered by progesterone hypersensitivity after ovulation.

And speaking of women’s problems – just imagine if you were allergic to semen.  While it’s more common in women, we need to point out that it’s also possible for men to be allergic to their own sperm.

Dutch researchers recently reported 45 cases of post-orgasmic illness syndrome. In both cases, the men experienced allergic symptoms around their eyes and nose, and transient flu-like symptoms within seconds, minutes or hours after sex, masturbation or spontaneous ejaculation. Yikes!

As if life without water or sex is difficult to contemplate, imagine if you were allergic to the weather.  In some people, a drop in the temperature can set off an inflammatory disorder known as cold urticaria.  Patients with the condition can experience redness, itching, swelling, hives and, in rare cases, death when they come in contact with cold air, cold water or even cold drinks. For others it’s the sun that’s the problem. Solar urticaria, can cause similar symptoms within minutes of exposure, in affected individuals.

And if all of this has left you feeling a little faint, be careful where you lie down! Although as we told you earlier soybeans are a common food allergen, and sufferers need to omit soy products from their diet, soybean allergies can be triggered by beanbags. According to a case study reported in the Annals of Allergy, Asthma & Immunology, a 6-year-old boy experienced respiratory distress while playing at school. His reaction was apparently triggered by dust from the dry soybeans in the beanbag.

Are you allergic to anything strange?  Share your stories and suffering with us!

Egging on Allergies?

Friends, family, colleagues and regular readers of SRxA’s Word on Health already know about my egg allergy.  What they may not know about is my egg aversion.  Just typing the “e” word makes me queasy.  Thinking about eggs makes me cringe and actually seeing them, especially hard boiled, fills me with revulsion.

So, with some trepidation, I bring you this breaking health story.

According to a study just published in the New England Journal of Medicine by giving children with egg allergies increasingly higher doses of the very food they are allergic to researchers found they could eliminate or ease reactions in most of them.

The study conducted at Johns Hopkins Children’s Center and four other U.S. institutions treated 40 egg allergic children with escalating doses of eggs – an approach known as oral immunotherapy.

In the 10 month study, 40 children, aged 5 -18, received escalating doses of egg-white powder while 15 received a cornstarch placebo.  35 of the 40 children treated with egg immunotherapy experienced improvement. Five dropped out of the study, four of them due to allergic reactions. Eleven of the 35 patients experienced complete long-term elimination of egg-related allergic reactions. The rest of the children were able to tolerate higher doses of egg with only mild or no symptoms.

More than a quarter of the children in our study lost their egg allergies altogether, but we also saw dramatic improvements in those who didn’t, which in and of itself is an important therapeutic achievement,” says Robert Wood, M.D, director of allergy and immunology at Johns Hopkins Children’s Center. “These children went from having serious allergic reactions after a single bite of an egg-containing cookie to consuming eggs with minimal or no symptoms.”

This is important because it can protect against serious allergic reactions from accidental or incidental exposures and give patients and parents a peace of mind at restaurants, parties and other venues where food control is difficult or impossible.

But while this may be good news for the estimated 3% of U.S. with egg allergies, this blogger is not so sure she’d be a candidate.  The thought of having to eat escalating doses of the dreaded “e” word is more abhorrent to me than the thought of a future filled with quiche and ice cream!

On a more serious note, we’d also like to brings readers some sage advice from allergist David Amrol MD : “Although oral immunotherapy is our best chance for a food allergy cure, it is not ready for mainstream use until protocols are further refined. Patients who are not enrolled in clinical trials must continue to rely on allergen avoidance, patient education, and self-injectable epinephrine.”