Egg allergy

About egg allergy

Egg allergy is one of the most common causes of allergies in children. Many children, but not all, outgrow the allergy before adolescence.

Symptoms of egg allergy range from mild reactions to a severe allergic reaction (anaphylaxis). The most common symptoms of egg allergy are allergic skin reactions. Other symptoms include runny nose and itchy and watery eyes (similar to hay fever), cramps, nausea or vomiting.

The best way to manage an egg allergy is to avoid all food containing egg or egg products.

Food allergies can be life threatening. If you, or a child in your care, have a severe allergic reaction (anaphylaxis), call triple zero (000) and ask for an ambulance. Lay the person flat and administer adrenaline injector (EpiPen® or Anapen®), if available. Further adrenaline may be given if there is no response after 5 minutes. Give adrenaline first, then asthma reliever puffer, if required.

Causes of egg allergy

For all allergies, the immune system reacts to specific triggers, also known as allergens. The immune system produces antibodies that detect the allergen and cause inflammatory reactions and the release of chemicals including histamine. Histamine causes hives, hay fever and other allergic symptoms.

The protein that triggers your allergic reaction can either be in egg whites or egg yolks, but allergies to egg whites are more common. The specific allergen in eggs that triggers your allergy may be present in both chicken eggs and duck eggs. Some people can therefore be allergic to both chicken and duck eggs. This is known as cross-reactivity.

Speak to your doctor about cross-reactivity because it is difficult to predict.

Egg allergies and vaccines

Most vaccines in Australia do not contain any egg. While some vaccines are produced from viruses grown in chicken eggs, these may be safe for people with egg allergy. These include influenza (flu) and yellow fever vaccines.

Speak with your doctor about how your egg allergy may impact your vaccination schedule or that of a child in your care. In addition, always inform your doctor or nurse of any allergies before you receive a vaccination.

Symptoms of egg allergy

Everyone’s immune system is different, and egg allergy can cause diverse signs and symptoms, ranging from mild to severe.

Symptoms can appear within a few minutes or a few hours of eating eggs or products containing eggs. Many food allergies do not cause severe symptoms, but they can be life threatening in some people and should be taken seriously.

If you, or a child in your care, have experienced symptoms after eating egg, the risk of having another severe reaction after eating egg is greater than usual. Ask your doctor to refer you to a clinical immunology/allergy specialist.

Some people have other adverse reactions to food (such as headache or bloating) that are not caused by allergies. These can be caused by factors such as food poisoning, toxic reactions or food sensitivities (intolerance) from enzyme deficiencies. Although these are not allergic reactions, they are often mistaken for allergies.

Severe allergic reaction (anaphylaxis)

Eggs are one of the most common foods to cause severe allergic reaction (anaphylaxis). Anaphylaxis is life threatening.

Symptoms of a severe allergic reaction include:

• difficult or noisy breathing
• swelling of the tongue
• swelling or tightness of the throat
• difficulty talking or hoarse voice
• wheeze or persistent cough
• persistent dizziness or collapse
• paleness and floppiness in young children.

Milder allergic symptoms that can occur before a severe allergic reaction include:

• swelling of your lips, face and eyes
• hives or welts
• tingling mouth
• abdominal pain and vomiting.

Allergic skin symptoms from egg allergy

Allergic skin reactions are the most common symptoms of egg allergy. Symptoms include:

• raised red bumps of skin hives (urticaria)
• itchy skin and rash.

Hay fever symptoms from egg allergy

People with an egg allergy can experience hay fever symptoms (allergic rhinitis) including:

• sneezing
• itchy and runny nose
• red, itchy and watery eyes
• itchy roof of the mouth or throat
• cough
• congestion of the nose
• blocked sinuses.

Diagnosis of egg allergy

Diagnosing an allergy can be difficult. If you think you or a child in your care may have an egg allergy, keeping a record or diary of symptoms can help you and your doctor to understand what is causing the symptoms.

Your diary could include information about whether the symptoms occur:

• inside your home, outside or both
• for a short time or longer
• at night, during the day or when you wake up
• after you have had a particular food or drink
• after you have taken a particular medication, either prescription or over the counter from a pharmacy or supermarket
• after you have taken a herbal medicine.

Visiting your doctor about your symptoms

If you have allergic symptoms, visit your doctor who will ask some questions about your allergic reactions. You can also discuss your record of your symptoms. To diagnose your allergy, your doctor may refer you to a clinical immunology/allergy specialist who can test for allergies using a number of possible methods depending on the type of potential allergy. To test for an allergy to eggs, they may:

• do a skin prick test
• do a blood test
• ask you to temporarily avoid all eggs or products containing eggs (elimination diet), then follow up with the introduction of egg back into your diet (food challenge) under strict medical supervision.

Unproven methods to test for allergies

A number of methods claim to test for allergies, but they have not been medically or scientifically proven. They can be costly and could lead to dangerous avoidance of certain foods. The Australasian Society of Clinical Immunology and Allergy (ASCIA) recommends that you do not use certain unproven methods to have potential allergies tested. These methods include:

• cytotoxic food testing
• electrodermal testing
• hair analysis
• iridology
• kinesiology
• pulse testing
• reflexology
• Vega testing.

Always speak with your doctor if you are thinking of using a complementary medicine or therapy for allergies.

Treatment for egg allergy

Research is currently being done into treatment of food allergy. Currently, the only treatment for food allergies is avoidance of the food that causes your allergy. Even if you are careful, it is difficult to avoid all contact with a specific food.

If you are at risk of a severe allergic reaction you should have been prescribed an adrenaline injector by your doctor and given an Australasian Society of Clinical Immunology and Allergy (ASCIA) Action Plan for Anaphylaxis. If you are not at high risk and have not been prescribed an adrenaline injector, ASCIA recommends that you have an ASCIA Action Plan for Allergic Reactions.

To assist with food avoidance, people with food allergies need to become familiar and comfortable with reading food labels. ASCIA has dietary guides to help you understand how to read food labels and what to avoid if you have an egg allergy.

Some people can tolerate eggs in cooked or baked products, because the proteins in eggs change when they are cooked and are then no longer recognised by your immune system as dangerous. Your doctor can advise you about whether you can eat certain products.

If is important to tell food service staff of your allergy when eating out.

Inaccurate diagnosis can lead to expensive and ineffective treatments, and unnecessary food avoidance, which can lead to malnutrition and food aversion, especially in children. Always speak to your doctor about your food allergy diagnosis and treatment options.

More research is needed into the causes, diagnosis and treatment of food allergy.

Emergency treatment for severe allergic reactions (anaphylaxis)

Emergency responses for anaphylaxis are:

• Lay the person flat – do not allow them to stand or walk.
• Administer adrenaline with an injector (such as an EpiPen® or Anapen®) into the outer mid-thigh.
• Always dial triple zero (000) to call an ambulance in a medical emergency.
• Further doses of adrenaline may be given if there is no response after 5 minutes.
• Give adrenaline first, then asthma reliever puffer, if required.
  

If you are at risk of anaphylaxis make sure you:

• Have an Australasian Society of Clinical Immunology (ASCIA) Action Plan for Anaphylaxis.
• Carry an adrenaline injector to treat a severe allergic reaction.
• Consider wearing medical identification jewellery as this increases the likelihood that adrenaline will be administered in an emergency.
• Carry a mobile phone to call triple zero (000).
• Avoid medication (where possible) that may increase the severity of allergic reaction or complicate its treatment such as beta blockers.
• Avoid the food which causes your allergic reaction.
• Tell food staff about your allergy when eating out.
• Seek medical advice from a doctor or clinical immunology/allergy specialist.

Adrenaline autoinjectors are also available over the counter from a pharmacy.

Where to get help

• In an emergency, always call triple zero (000)
• Emergency department of your nearest hospital
• Your GP (doctor)
• NURSE-ON-CALL Tel. 1300 60 60 24 – for health information and advice (24 hours, 7 days)
• St John Ambulance Australia Tel. 1300 360 455
• Australasian Society of Clinical Immunology and Allergy (ASCIA)
  • Dietary avoidance – Egg
  • Introducing foods and allergy prevention
  • Locate a specialist
• Allergy and Anaphylaxis Australia