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Allergy & Asthma Advocate: Winter 2006
Seafood AllergyBy Kathleen A. Sheerin, MD, FAAAAI Those of us who are members of the baby boomer generation grew up on a staple of meat and potatoes- roast beef, pot roast, steak and chicken. Even those who lived on the coast consumed more meat than fish. The more exotic seafood was never a part of the everyday diet. Today, the diets of baby boomers, their children and grandchildren are much more exciting and varied- coconut shrimp, fried calamari, halibut, talapia and muscles. In 2003 Americans consumed on average 16.3 pounds of seafood a year including all kinds of fish, crustaceans (ie. shrimp, crab and lobster) and mollusks (ie. scallops, clams and mussels).
Allergy to seafood is more common in adults than children. Women are affected more often than men. Children are more allergic to fish such as tuna, cod and salmon, in comparison to adults in whom the rate of reaction to shrimp, crab and lobster is higher. This is probably a reflection of our eating habits. As our younger “gourmets” sample from adult menus and shellfish is added to the junior menu in many restaurants, we may see more shellfish allergy in younger children.
A frightening statistic that emerged form the 2003 survey was that only 8.6% of patients with a seafood allergy carried autoinjectable epinephrine (EpiPen, TwinJect), an emergency treatment that could save their lives in the event of a bad reaction. The assumption from this statistic is that patients did not discuss their allergy with their physician and/or that their physician did not prescribe an autoinjectable epinephrine. I developed a shrimp allergy in my mid 20's. I know first hand the challenge of avoiding shrimp, crab and lobster especially when eating out. As many as 5-7 items or more on the menu may be “off limits.” There is also that ever present concern that the kitchen staff has not taken proper precautions in preparing the meal. Cross contamination can lead to significant symptoms even when you have properly informed everyone. Some simple suggestions for you to follow if you are one of the growing number of Americans with seafood allergy are:
Unfortunately, most people with seafood allergy must adapt to a lifetime of alternatives. There is no cure or treatment at this time. Make informed choices and be prepared for emergencies. |
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As the consumption of seafood has increased across all generations so has the incidence of allergic reactions. According to a study by Scott A. Sicherer, MD, FAAAAI and colleagues in the JACI in July of 2004, seafood is now a more common cause of allergic reactions (anaphylaxis) than peanuts. Estimates from the telephone survey put the prevalence of seafood allergy at 2.3% of the US population-almost 6.6 million people. Peanut/ tree Nut allergy in comparison affects three million Americans. 
Most patients who suffer from seafood allergy have multiple reactions to different species. It is possible to have an isolated reaction to cod or shrimp but odds are good that if you are allergic to one you may be allergic to another (at least in the same class). Most shellfish allergic patients can eat fish. Most fish allergic patients can eat shellfish. Only 14 % of patients who are allergic to crustaceans react to mollusks. The rule of thumb to follow, unless you have done extensive allergy testing with your allergist/immunologist, is: 
All shellfish allergic patients should know that they can safely get Radiocontrast media…unless they are allergic to it. The myth that shellfish allergy means that you can not get “iodine” dyes has been handed down by generations. Another misconception is that shellfish allergic patients can not take glucosamine. Glucosamine is made from shells, not the protein that causes allergy to shellfish.