Food allergies and anaphylaxis

Food labelling

From the end of 2014 Restaurants and takeaways across Europe have been required by law to inform customers if their food contains ingredients known to trigger allergies. Staff must provide information on 14 everyday allergens.

By law, potential food allergens used as ingredients or processing aids must also be declared on packaging or at the point of sale. Under the EU FIC Food Information for Consumers Regulation, customers must be told if their food contains any of the following:

• Celery – including any found in stock cubes and soup
• Cereals containing gluten – including spelt, wheat, rye, barley
• Crustaceans – eg crabs, lobster, prawns and shrimp paste
• Eggs – including food glazed with egg
• Fish
• Lupin – can be found in some types of bread, pastries, pasta
• Milk
• Molluscs – mussels, land snails, squid, also found in oyster sauce
• Mustard
• Nuts – for example almonds, hazelnuts, walnuts, macadamia
• Peanuts – also found in groundnut oil
• Sesame seeds – found in some bread, houmous, tahini
• Soya – found in beancurd, edamame beans, tofu
• Sulphur dioxide – used as a preservative in dried fruit, meat products, soft drinks, vegetables, alcohol.

Common triggers for allergic reactions

Anything can trigger an allergic reaction. However most common causes are foods such as peanuts, tree nuts (e.g. almonds, walnuts, cashews, and Brazil nuts), sesame, fish, shellfish, dairy products and eggs. Non-food causes include wasp or bee stings, natural latex (rubber), penicillin or any other drug or injection. Exercise can also trigger a delayed allergic reaction following exposure to an allergen.

Going abroad

The holidays will soon be here too, and whilst it’s easy to check the ingredients in your own language, it’s tricky when you are travelling abroad.  If you have a food allergy, that is a risk that you just can’t take, Allergy UK now provide allergy information cards in different languages.  To find out more and stay safe on your travels, visit https://www.allergyuk.org/get-help/translation-cards

How to recognise a serious allergic reaction

Common symptoms include:

• Generalised flushing of the skin
• A rash or hives anywhere on the body
• A feeling of anxiety or ‘sense of impending doom’
• Swelling of throat and mouth and difficulty in swallowing or speaking
• Alterations in heart rate – usually a speeding up of the heart
• Severe asthma attack which isn’t relieved by their inhaler
• Acute abdominal pain, violent nausea and vomiting
• A sudden feeling of weakness followed by collapse and unconsciousness

A patient is unlikely to experience all of the above symptoms.

How to treat anaphylaxis

The key advice is to avoid any known allergens where possible. If someone is having a mild allergic reaction, an antihistamine tablet or syrup can be very effective. However, the medication will take at least 15 minutes to work. If you are concerned that the reaction could be systemic (all over) and life threatening, use an adrenaline auto-injector immediately. It is far better to give adrenaline and not to have needed it, than to give it too late.

Epipen, have launched a version that only needs to be held in place for 3 seconds. Holding it in place for longer will not do any harm and there are many of the older version still in circulation that need to be held in place for a full 10 seconds.

For further information about Food Allergy Awareness Week, please visit https://www.foodallergy.org/education-awareness/food-allergy-awareness-week

For a copy of any of the posters, please email [email protected] and we will email one through to you.

Natasha’s Law

Incorrect labelling of ingredients on a Pret-a-Manger baguette caused the sad death of Natasha Ednan-Laperouse in 2016. She suffered a cardiac arrest while on a flight due to her allergy to sesame, which was not mentioned on the label.

Since then, the authorities have enforced Natasha’s Law, which mandates full ingredient lists and allergen labelling on all pre-packed and food made on site. This law has helped reduce the number of hospital admissions from food allergies and protect those with food allergies from unnecessary harm.

Furthermore, while people with allergies should always have their adrenaline autoinjector with them, many do not. If you have a serious allergy, you should make sure that it is in date and that you always have it with you, especially when eating food you have not prepared.

Xolair

In 2024, researchers discovered that Xolair, a monoclonal antibody used to treat asthma, significantly mitigated the allergic reactions in those allergic to foods like peanuts, milk and eggs, when injected over a number of months, by dampening the immune response. It was subsequently approved in the US by the FDA to treat these allergies, and remains to be approved for this use in the EU and UK. While food avoidance remains the primary treatment for food allergies, it means those suffering can live a more normal life, less concerned about experiencing anaphylaxis from about trace amounts of allergens in their food and surroundings.

It has been described as a game-changer for those at risk of anaphylactic reactions. While Xolair is not yet available in the UK, this is an exciting development in the treatment of allergies and will hopefully drastically reduce the number of deaths caused by allergic reactions in the future.