naphylaxis is considered the most serious form of an allergic reaction. It develops swiftly and may even cause death. There are many potential causes of anaphylaxis; however the most common triggers are food and insect stings. In Canada, the most common allergenic foods are peanuts, tree nuts (almonds, cashews, hazelnuts, pistachios and others), milk, eggs, shellfish, fish, sesame, soy and wheat. Canadian food labeling refers to the above foods as ‘priority allergens’. Mustard is slated to be added to the list, while other emerging food allergies include mango and kiwi. Stinging insects include yellow jackets, hornets, wasps and honey bees.      Less common causes of anaphylactic reactions are medications, latex rubber, and allergy shots (one of the side effects of the shots can be an allergic reaction). While uncommon, there are individuals who react to a specific food only if they exercise after eating it.
Knowing the signs The symptoms of a severe allergic reaction usually occur within minutes of exposure. The reaction can involve: the skin, respiratory, gastrointestinal and/or cardiovascular systems. Symptoms vary but include: itchiness and hives on the face and body; swelling in the mouth and throat; stomach cramps, vomiting or diarrhea; coughing or wheezing; and sometimes feeling faint. In its most severe form, anaphylaxis can cause airway obstruction and loss of blood pressure. Without immediate treatment, anaphylaxis can lead to death.  Staying safe Whether at home, school, work, travelling or at the cottage, there are many challenges to staying safe. The only real treatment for food allergy is avoidance of allergy triggers. Despite best efforts, accidents can and do happen, which is not surprising since food is a staple consumed daily. The good news: anaphylaxis can be managed and fatalities are relatively rare. If you suspect you have an allergy, seek a referral to an allergist. An allergist will perform the appropriate diagnostic testing since symptom history is not enough to accurately predict allergies to a particular protein. With proper diagnosis, a person can adopt a plan of practical and rational avoidance measures, and learn to manage the allergy properly.  Key strategies for the food allergic • Avoid the food culprit (not always easy) • Carry an epinephrine auto-injector (the brands are EpiPen® or Twinject®) to be used in the event of accidental consumption of an allergenic food • Wear a medical identification bracelet (e.g. MedicAlert®) • Do not share foods, utensils or containers • Read ingredient lists on packaged food labels carefully • Teach allergic children to wash their hands before and after eating • Ensure adult supervision of young allergic children when they are eating. Anaphylaxis action plan An action plan is a must; outlining some key steps goes a long way toward helping individuals at risk of anaphylaxis for children’s care givers, and the community at large in an emergency.		Allergies placing people at risk for severe allergic reactions are on the rise. About 6% of children and 4% of adults may be at risk of serious reactions from food allergy alone. Anaphylaxis is a growing public health concern, and successful management requires the empathy and involvement of a whole community to protect those at risk. Together, anaphylaxis can be managed.  H&L
6 KEY RECOMMENDATIONS FOR ANAPHYLAXIS   1 Epinephrine is the first line medication for emergency management. All symptoms should be taken seriously in an individual at risk, do not ignore. There’s no downside to receiving epinephrine; it works by protecting the blood pressure and opening the airways, both of which may be affected during an allergic reaction. Research on those who have died from anaphylaxis shows they either did not receive epinephrine or it wasn’t administered fast enough. Those at a high risk of a fatal reaction also have asthma which can predispose to a more severe reaction.   2 Antihistamines and asthma medications must not be used as first line treatment for an anaphylactic reaction, and should only be given after epinephrine, the life-saving medication, has been administered. 3 All individuals receiving epinephrine must be transported to hospital for observation, a high percentage may experience a secondary reaction even with no further exposure to the allergen. For this reason, a period of  observation in hospital and possible treatment is recommended. 4 A second injection of epinephrine may be given within 5-15 minutes if symptoms continue, such as breathing difficulties and a decreased level of consciousness. This is why it’s best for allergic people to carry two epinephrine auto-injectors (or a double-dose injector) at all times.  5 Individuals who feel faint or dizzy should lie down unless they are vomiting or short of breath.  6 No person should be expected to be fully responsible for self-administration of an epinephrine auto-injector. This is one of those emergency situations in which help from others may be very important.