5 Things You Should Know About Anaphylaxis

Every year, anaphylaxis kills approximately 225 people in the United States. Whether you have anaphylaxis yourself, are close to someone who does, or just want to educate yourself a bit more, here are 5 things you should know about anaphylaxis.

1. Anaphylaxis can happen within seconds.

In most cases, the symptoms of anaphylaxis occur within minutes of being exposed to the trigger, but some people may only begin to feel ill hours later. The symptoms of anaphylaxis may start off mild but can progress rapidly, and include:

• Feeling generally unwell
• Hives or rashes
• Flushed or pale skin
• Low blood pressure
• Rapid heartbeat
• Tightness of the throat or the feeling of a lump in the throat
• Difficulty breathing
• Nausea and vomiting
• Fainting or dizziness

Even if the early symptoms seem to be relatively harmless, like itchy skin, don’t forget that anaphylaxis can very quickly escalate to life-threatening breathing problems, and treatment shouldn’t be delayed.

2. Anaphylactic reactions can be biphasic.

This means that the symptoms return even after successfully treating the initial reaction, even without a second exposure to the allergen. This is most likely to occur 8-11 hours after the first episode and happens in up to 20% of cases. It’s important to remain vigilant for a second episode, even if the initial symptoms appear to have subsided, as the second round can be just as fatal.

3. The most common allergens in children are foods.

Peanuts, fish and shellfish, wheat, soy, sesame, eggs, and dairy are the most frequently linked triggers to anaphylaxis in children. Adults can also experience anaphylaxis to common food triggers, certain medications, and insect venom. Latex hypersensitivity is a growing concern and can also cause an anaphylactic reaction in some people.

4. Some people are anaphylactic to the cold.

Less than 8% of people with chronic hives and itching are triggered by cold exposure, a rare condition known as cold urticaria. Swimming in cold water or drinking a cup of icy water can trigger hives and skin swelling, which can usually be managed with oral antihistamines. In up to 20% of this group, cold exposure can result in anaphylaxis, including the symptoms of breathing problems, vomiting, and tummy pain, and needs to be treated as an emergency.

5. You can have anaphylaxis and not know it.

It is not uncommon for anaphylaxis to be misdiagnosed or go completely undiagnosed. In fact, more than 50% of people who come to the emergency room of a hospital are initially misdiagnosed because symptoms can be so variable from person to person, and not everyone presenting with anaphylaxis has a history of allergy or anaphylaxis. Anaphylactic reactions may be dismissed as asthma, anxiety, or other causes of fainting and low blood pressure. Most worryingly, 25% of severe allergic reactions that happen in schools are in children who have no known diagnosis of anaphylaxis.

Anaphylaxis Treatment

Anaphylaxis can be diagnosed and managed by an allergist, a medical doctor with specific training in allergy and anaphylaxis. Making a diagnosis involves taking a thorough medical history, including all past episodes of allergic or anaphylactic reactions, and running tests to determine which allergens trigger reactions. This may be done using the skin prick test or blood tests.

In addition to learning how to identify and avoid your triggers, your management plan may involve:

• Always being prepared with an epinephrine pen on hand, and ensuring it isn’t expired
• Taking daily medications
• Purchasing medical jewelry or getting a medical tattoo so others realize you have anaphylaxis and know how to help during a reaction
• Making those around you aware of your situation and how to help you during a reaction – this may include your colleagues and family members, or teachers and nurses at your child’s school
• Learning to recognize the early signs of when you’re having an anaphylactic reaction so you can seek help immediately