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)
Shellfish allergy is one of the most common food allergies
The majority of people experience their first reaction to shellfish as an adult
Shellfish allergy can occur after eating the food on a regular basis without reaction

Shellfish Avoidance

Tell anyone with regular contact with you or your child about the allergy and avoidance of shellfish
Read labels every time you buy something. Manufacturers can change products at any time - Be aware of cross contamination (transfer of shellfish to a food that does not normally have shellfish as an ingredient)
Very sensitive people can react if they are close to where shellfish is being cooked or fried
About 75% of people with shellfish allergy will have reactions to more than one type of shellfish
Shrimp, crab and lobster cause most shellfish allergies
Only 10% of people with shellfish allergy have allergies to fish (being allergic to shellfish does not always mean avoiding fish as well)
Shellfish are divided into crustaceans (lobster, crab, shrimp) and mollusks (clams, mussels, oyster, scallops)
Common shellfish include:
- Abalone
- Krill
- Quahaugs
- Barnacle
- Limpets
- Sea cucumber
- Clam
- Lobster
- Sea urchin
- Crab
- Mussels
- Scallops
- Crayfish / crawfish
- Octopus
- Shrimp / crevette / scampi
- Cockle
- Oysters
- Snails / escargot
- Conch
- Periwinkle
- Squid / calamari
- Cuttlefish
- Prawns
- Whelks
Some foods that contain or may contain shellfish
- Caviar
- Imitation crab / lobster
- Scrob
- Ceviche
- Kamaboko
- Surimi
- Gravad lax
- Minced fillets
- Sushi
- Fish stock
- Sashimi
- Tarama

Symptoms often occur within minutes up to 2 hours of exposure to shellfish
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

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

The majority of people do not outgrow the shellfish allergy
Repeat skin testing and blood work every 1 - 2 years will help determine if the allergy is outgrown
An oral food challenge (eating shellfish in small steps ONLY in the doctors office) will be offered if your doctor feels it is safe
Shellfish products should NEVER be tried outside of a doctors office to see if the shellfish allergy is outgrown