General Information
- Reactions to food are common and can be divided into two categories, those caused by food allergy and all other reactions
- Food allergies develop when the body’s immune system has an abnormal reaction to one or more proteins in a food that can lead to serious allergic reactions
- Other food reactions are not caused by the immune system but can cause unpleasant symptoms (examples include lactose intolerance, heartburn, food poisoning, and sensitivities)
- Fish allergy is one of the most common food allergies
Fish Avoidance
- Tell anyone with regular contact with you or your child about the allergy and avoidance of fish
- Read labels every time you buy something. Manufacturers can change products at any time
- Be aware of cross contamination (transfer of fish to a food that does not normally have fish as an ingredient)
- Very sensitive people can react if they are close to where fish is being cooked or fried
- About 30 to 50% of people with fish allergy will have reactions to more than one type of fish
- Only 10% of people with fish allergy have allergies to shellfish (being allergic to fish does not always mean avoiding shellfish as well)
- Some common fish include:
- Anchovy
- Hake
- Sardine
- Bass
- Halibut
- Shark
- Bluefish
- Herring
- Smelt
- Carp
- Mackerel
- Snapper
- Catfish / mud cat
- Mahi - mahi
- Sole
- Char
- Marlin
- Sturgeon
- Cod
- Monkfish / angler
- Swordfish
- Eel
- Pickerel / dore
- Tilapia
- Flounder
- Pike
- Trout
- Grouper
- Pollock
- Tuna/albacore/bonito
- Haddock
- Salmon
- Turbot
- Some food that contain or may contain fish:
- Barbecue sauce
- Gelatin
- Sauce
- Caesar salad dressing
- Hot dogs
- Soups
- Deli meat
- Imitation crab / lobster
- Spring rolls
- Dips
- Marshmallows
- Sushi
- Fish mixtures
- Paella
- Tarama
- Fried rice
- Pizza toppings
- Worcestersire sauce
- Garnishes
- Salad dressing
- Wine / beer fining agent
Allergic Reactions
- Symptoms often occur within minutes up to 2 hours of exposure to fish
- Outside Symptoms
- Face: Redness, itchy eyes / nose, swelling
- Skin: Itching, redness, hives, swelling
- Inside Symptoms
- Face: Swelling lips and tongue, itchy mouth
- Throat: Itching, tightness, hoarse voice, cough
- Lungs: Trouble breathing, shortness of breath
- Stomach: Vomiting, nausea, stomach pain, diarrhea
- General: Dizzy, unsteady, drowsy, fainting
- Not every reaction will look the same, a person can have different symptoms each time
- Symptoms range from mild to life threatening, there is no way to predict if the reaction will be mild or severe
- Anaphylaxis is a severe life threatening reaction with more than one body system affected (skin, breathing, stomach, general) and can occur WITHOUT skin symptoms such as hives
Treatment of Reactions
- Antihistamines such as Benadryl will NOT stop severe reactions
- An epinephrine auto injector such as Allerject or EpiPen MUST be available at all times
- If you are visiting an area without access to a hospital you should have 2 auto injectors available
- A medical identification device such a Medical Alert bracelet should be worn to outline the food allergy and that an epinephrine auto injector is carried
- Give epinephrine in the outer thigh if there are any of the following symptoms (listed in the table on the previous page)
- General symptoms
- Severe outside symptoms
- Any inside symptoms
- If you are in doubt, give the epinephrine
- After epinephrine is given
- Lie down / lie your child down
- Call local emergency service and tell them someone is having an allergic reaction
- If the reaction continues or worsens, give a second dose of epinephrine in 5 - 15 minutes (there is only 1 dose of epinephrine in each auto injector, a second dose requires a new auto-injector)
- Go to the nearest emergency room even if the symptoms are gone because the reaction can worsen or come back
- Stay in the hospital for at least 4 - 6 hours of observation
Outcomes for Fish Allergic Patients
- The majority of people do not outgrow the fish allergy
- Repeat skin testing and blood work every 1 - 2 years will help determine if the allergy is outgrown
- An oral food challenge (eating fish in small steps ONLY in the doctors office) will be offered if your doctor feels it is safe
- Fish products should NEVER be tried outside of a doctors office to see if the allergy is outgrown
Additional information: www.anaphylaxis.ca or www.foodallergy.org