Anaphylaxis is the most severe form of allergic reaction. It can be caused by:
• any food (nuts, peanuts, sesame seeds, fish, shellfish, cow’s milk and egg are the most likely culprits),
• exercise (often after eating a particular food)
• insect stings,
• latex
• medicines
Anaphylaxis may have no known cause – idiopathic anaphylaxis.
Anaphylaxis can occur at any age, and there are no rules to establish why it occurs. All we can say is that atopic people are more likely to suffer from anaphylaxis than any other section of the population. The incidence of anaphylaxis is unclear, since cases are often underreported, however, it is estimated that 1.24% to 16.8% of the US population—3.3 to 4.3 million persons—are at risk for anaphylaxis, and 0.002% is at risk for a fatal reaction.
It is important to mention anaphylaxis in this website, so that people are aware of it, and what to do if faced with it.
Symptoms of anaphylaxis vary in severity and speed; however they can include the following:
• generalised flushing of the skin
• nettle rash (hives) anywhere on the body
• sense of impending doom
• tingling lips or mouth
• nasal congestion
• swelling of throat and mouth
• difficulty in swallowing or speaking
• alterations in heart rate
• severe asthma
• abdominal pain, nausea, diarrhoea and vomiting
• sudden feeling of weakness (drop in blood pressure)
• collapse and unconsciousness
• The casualty may move from alert to unresponsive, and may stop breathing.
Anaphylaxis, if not promptly treated can lead to suffocation, as the mouth and throat swell.
The correct First Aid treatment for anaphylaxis, according to St John Ambulance, is as follows :
Send for an ambulance. If the casualty is conscious, help them sit up to ease breathing, and assist them in the use of any medication they may have. An asthma inhaler can be given if appropriate. Unconscious casualties should be put in the recovery position, with airway, breathing and circulation monitored very closely – it may be necessary to use CPR. The ambulance can administer oxygen, and will give further medical attention.
When to give medication is a matter of debate; but it is important not to force medication onto any patient. There is no way of telling how severe a reaction may be, however, the following act as a guide.
• Rash, sneezing, itchy throat with no shortness of breath or faintness – use antihistamines.
• If symptoms include shortness of breath and/or faintness, administer adrenaline immediately; if there is antihistamine available, but breathing difficulties are present from the start, then use adrenaline from the start. Call an ambulance, since the beneficial effects may wear off quickly
• If in doubt, use adrenaline, since the risk of not having the adrenaline when it is needed far outweighs the negligible risk of taking or giving the adrenaline unnecessarily.
Never give a person medicine that has not been prescribed for them. If in doubt, call an ambulance. It is better to be safe than sorry.
The author is not in a position to give authoritative advice on the management of anaphylaxis specifically; but will happily repeat the main advice given by the Anaphylaxis campaign.
• be ultra careful when reading ingredient lists, and when eating out
• be open about your condition and make sure your family and friends not only know about it, but also know how to help administer your medication
• be alert to all symptoms and take them seriously
• develop a crisis plan and carry it with you (and make sure, if it is a child, that all teachers and friends’ parents have a copy)
• Wear a MedicAlert talisman.
One patient with anaphylaxis suggests making sure that you have pen and paper with you, and that, if a reaction occurs, if you can, write down (or have someone write down for you) that you are having an allergic reaction, and what dose of medication has been given: this will assist the emergency services.
Always read the label, and, if in doubt, do not consume the food or drink. It is always hard to start a restrictive diet, but it gradually becomes easier; particularly if you have support.
Taking an antihistamine when you are poised on the brink of an allergic reaction is a good idea; however, if you are at risk of anaphylaxis, it is a good idea to record what you have taken and when, in case further medical intervention is required.
It is worthwhile searching the internet for help regarding your specific sensitivity; various societies exist to help sufferers, and many of them are online. This website is intended as an overview and introduction to the problem; you have the power to look further.
Most supermarkets will produce, on request, lists of their products which are free from specific allergens. Ask at the customer information desk for help in acquiring them, since procedures vary from supermarket to supermarket. Manufacturers may also produce lists: information on how to contact the manufacturer should be printed on product labels.
In the UK, Allergy News and The Food Magazine, in addition to publications produced by Allergy UK, and The Anaphylaxis Campaign are useful sources of information.
Your local library is a good place to ‘taste’ books before you buy a copy for yourself (make sure that you don’t allow the book to become overdue. There is nothing more galling than realising that you could have bought the book for yourself with the fine you’ve managed to rack up!).
If you are offered professional help by your local healthcare provider, then take it. If you are not offered help, then fight for it.