People with allergies often experience mild to moderate symptoms like a rash, runny nose, or watery eyes. However, exposure to an allergen can at times cause a severe reaction commonly known as Anaphylaxis. This type of reaction could occur in different ways:
Uniphasic: This is when a reaction occurs rapidly. Symptoms will get worse very fast but once treated, they go and don’t return. They are the most common pattern and often resolve within an hour.
Bi-phasic: This reaction begins with mild or severe symptoms, followed by a period of time with no symptoms, and later the symptoms increase accompanied by breathing and blood-pressure problems.
Protracted: These are the most severe and rarest form of anaphylaxis. They are persistent and could last several days or weeks.
How Serious Can Anaphylaxis Be?
Although most cases are mild, any anaphylactic reaction can become life-threatening, especially if left untreated. Within minutes of exposure to an allergy-causing substance, one can begin to develop serious symptoms in various parts of the body such as low blood pressure, loss of consciousness, anaphylactic shock, and breathing difficulties. People with asthma, allergies, or have a family history of this type of hypersensitivity reaction are susceptible to an anaphylactic reaction. With this in mind, it’s crucial to seek medical attention if you or anyone around you begins to have an allergic reaction.
Symptoms occur within 5-30 minutes of coming into contact with what you are allergic to. The early symptoms are often mild, ranging from a runny nose to a skin rash. But these initial symptoms can escalate rapidly, reaching peak severity within 3-30 minutes. The skin is the most affected area followed by respiratory, gastrointestinal, cardiovascular, and central nervous system. Since anaphylaxis is a systemic event, two or more of these areas can be affected during an attack. Watch out for the following signs and symptoms:
Skin: Hives, swelling, itchiness, flushing, and blue-tinged skin due to lack of oxygen
Respiratory: Shortness of breath, pain with swallowing, cough, wheezing, hoarseness, chest pain/tightness, etc.
Gastrointestinal: Stomach pain, crampy abdominal pain, diarrhoea, vomiting, nausea, faecal/urinary incontinence
Oral: Swelling of the lips, tongue, or throat
Cardiovascular: Weak pulse, dizziness and/or fainting, rapid heartbeat, cardiac arrest, etc.
Feeling of anxiety or of “impending doom”
The most dangerous symptoms such as low blood pressure, loss of consciousness, and breathing difficulties, can have adverse effects on one’s health and even be fatal. Should you experience any of these signs, particularly after coming in contact with the common causes of anaphylaxis that we’ll discuss later, seek medical care immediately. People who’ve had a severe reaction are more susceptible to future reactions. And, even if a prior reaction was mild, you could still experience more severe reactions in the future. We’ll see how you can minimise risk later on, but first:
What Causes Anaphylaxis?
When your body’s immune system views something as dangerous, it reacts. This severe reaction can occur in response to virtually any foreign substance. Some of the common causes include:
Any food can cause a severe allergic reaction, but the most common culprits include: peanut, milk (cow, goat), chicken eggs, tree nuts (almond, cashew, walnut, Brazil nut), fish, shellfish (oyster, crab, shrimp, lobster), seeds (sesame, mustard, cottonseed), wheat, fruits (avocado, banana, kiwifruit), as well as food preservatives like sulfur dioxide and sulfites. Food sensitivity mostly occurs upon ingestion, but some people can develop severe reaction by simply coming into contact with the allergen or particle inhalation. Food sensitivity mostly affects children and young adults. Some children can, however, outgrow their allergies or tolerate these foods by age 16.
Any medicine also has the potential to trigger an allergic reaction. The most common ones are antibiotics such as penicillin, aspirin and aspirin-related products, NSAIDs, insulin, pain medication like morphine, and sulfa drugs. Also, certain muscle relaxants widely used in general anaesthesia, post-surgery fluids, herbal preparations, vaccines, radiocontrast agents, and chemotherapy drugs may also cause severe reactions. Medication triggers are common in older adults.
Insect bites and stings
Venom from sting insects (fire ants, wasps, bees, yellow jackets) and biting insects (kissing bug, tick, and deer fly) can cause severe reactions in some people. These are also common in older adults.
Direct contact with latex products such as rubber bands, balloons, gloves, and condoms can cause a reaction in some people. Medical staff may develop latex allergy through continual use of latex gloves. Most severe reactions occur if you inhale small latex particles, or when such items come into contact with internal surfaces during surgery or moist areas of the body. This type of reaction can complicate medical procedures; for instance, gloves are necessary during surgeries.
Although it’s rare, physical activity can also cause severe reactions. But it mostly occurs when an individual exercises after coming into contact with the above allergens. This means that both allergens and physical activity have to be present for someone to experience a severe allergic reaction.
With proper evaluation, allergists are able to identify most of these causes. Some people may, however, have severe allergic reactions with exposure to unknown allergens, which is commonly known as idiopathic anaphylaxis.
What to Do
First of all, always treat an anaphylactic reaction as a medical emergency. If you or anyone close to you thinks they are having an anaphylactic reaction, follow the following first aid measures:
If the patient has self-injectable epinephrine, inject them with it immediately. The shot should be administered into the upper outer thigh and can be done through clothing. Have the second shot ready in case the symptoms become more severe or a biphasic reaction occurs. You can find instructions on how to use auto-injectors on the side of each device.
Call emergency services
Have the patient lie flat with their legs elevated
But if they unconscious, move them to a recovery position, which should be on their side with the head tilted back
In case they stop breathing or don’t have a pulse, perform cardiopulmonary resuscitation (CPR) –only if you are trained
Stay with the patient until help arrives
Further treatment should be carried out in the hospital
The patient should remain under observation in hospital for 2-24 hours in case of a biphasic reaction
Preventing Future Episodes
Even though there’s no cure for anaphylaxis, there are things you can do to manage it and reduce its effects on your health.
Know Your Trigger
If you have a severe allergic reaction, an allergist will review your medical history and conduct diagnostic tests to find out your allergy triggers. Since we’ve already discussed the most common triggers, it’s important you remember if you’ve come into contact with any of them.
Avoid Your Trigger
Once the trigger has been identified, you need to take the necessary steps to avoid it in the future. Be sure to talk to your doctor to know more about how to avoid these reactions.
How to avoid some common triggers:
Check food labels and ingredients every time you buy a product
If you are eating out, let the restaurant staff or your host know what you are allergic to
Remember that some foods may contain small traces of your triggers
Always tell your healthcare provider about any medicine allergies you have so they can prescribe safer alternatives
Become aware of any medicines that may cause a cross-reaction
Know both brand and generic names of the medicines you are allergic to
Use an insect repellent when outdoors
Avoid walking barefoot
Move away from such insects without panicking or waving your arms, and don’t swat at them
Some specialised allergy centres provide a preventative treatment (Venom Immunotherapy) for insect sting allergy
More Safety Tips
Informing others: Friends and family should know of your condition, your triggers, symptoms, as well as where you keep your epinephrine and how to use it.
Wearing or carrying identification that notes your condition and potential allergens. This can come in handy if you lose consciousness.
Most importantly, always carry two doses of epinephrine. Epinephrine is the primary treatment for anaphylaxis.
Conclusion on Anaphylaxis
Although severe allergic reactions are rare, people of all ages can be affected. But with proper health care and prompt treatment, you will definitely make a full recovery.
If you’ve enjoyed reading this article, please feel free to check out more articles from the team here at Dalaric Ltd. Head over to our blog here.