anaphylaxis
Anaphylaxis is the most severe form of allergic reaction and is potentially life threatening. It must be treated as a medical emergency, requiring immediate treatment and urgent medical attention.
Anaphylaxis is a generalised allergic reaction, which often involves more than one body system (e.g. skin, respiratory, gastro-intestinal, cardiovascular). A severe allergic reaction usually occurs within 20 minutes of exposure to the trigger and can rapidly become life threatening.
What causes Anaphylaxis?
Common triggers of anaphylaxis include:
Food
Milk, eggs, peanuts, tree nuts, sesame, fish, crustaceans and soy are the most common food triggers, which cause 90% of allergic reactions, however, any food can trigger anaphylaxis. It is important to understand that even trace amounts of food can cause a life-threatening reaction.
Insect Venom
Bee, wasp and jumper ant stings are the most common causes of anaphylaxis to insect stings. Ticks and fire ants also cause anaphylaxis in susceptible individuals.
Medication
Medications, both over the counter and prescribed, can cause life threatening allergic reactions. Individuals can also have anaphylactic reactions to herbal or ‘alternative’ medicines.
Other
Other triggers such as latex or exercise induced anaphylaxis are less common and occasionally the trigger cannot be identified despite extensive investigation.
Signs and Symptoms
The signs and symptoms of anaphylaxis may occur almost immediately after exposure or within the first 20 minutes after exposure. Rapid onset and development of potentially life threatening symptoms are characteristic markers of anaphylaxis.
Allergic symptoms may initially appear mild or moderate but can progress rapidly. The most dangerous allergic reactions involve the respiratory system (breathing) and/or cardiovascular system (heart and blood pressure).
Common Symptoms
Mild to moderate allergic reaction
• Tingling of the mouth
• Hives, welts or body redness (see example images 1 2 3)
• Swelling of the face, lips, eyes (see example images 1)
• Vomiting, abdominal pain
Severe allergic reaction- ANAPHYLAXIS
• Difficulty and/or noisy breathing
• Swelling of the tongue
• Swelling or tightness in the throat
• Difficulty talking or hoarse voice
• Wheeze or persistent cough
• Loss of consciousness and/or collapse
• Pale and floppy (young children)
Diagnosis
A person who is suspected of having a food allergy should obtain a referral to see an allergy specialist for correct diagnosis, advice on preventative management and emergency treatment. Those diagnosed with severe allergy must carry emergency medication as prescribed as well as an Anaphylaxis Action Plan signed by their doctor. Food allergic children who have a history of eczema and/or asthma are at higher risk of anaphylaxis. Administration of adrenaline is first line treatment of anaphylaxis.
Management & Treatment
Anaphylaxis is a preventable and treatable event. Knowing the triggers is the first step in prevention. Children and caregivers need to be educated on how to avoid food allergens and/or other triggers.
However, because accidental exposure is a reality, children and caregivers need to be able to recognise symptoms of an anaphylaxis and be prepared to administer adrenaline according to the individuals Anaphylaxis Action Plan.
Research shows that fatalities more often occur away from home and are associated with either not using or a delay in the use of adrenaline.
In Australia, adrenaline can be purchased on the PBS in the form of an auto-injector known as the EpiPen®. More information also available from ASCIA.