Anaphylactic Shock

Anaphylactic shock is a severe allergic reaction affecting the whole body.

 

Developing Anaphylactic Shock

The anaphylactic shock may develop within seconds or minutes of contact with a trigger and is potentially fatal. In an anaphylactic reaction, chemicals are released into the blood that widen (dilate) blood vessels. For this reason blood pressure will fall and air passages narrow (constrict), resulting in breathing difficulties. In addition, the tongue and throat can swell, obstructing the airway. The amount of oxygen reaching the vital organs can be severely reduced causing hypoxia.

 

Common Triggers of Anaphylactic Shock

Common triggers of anaphylactic shock include food (such as nuts, shellfish and eggs), wasp and bee stings, latex, certain medications, etc. In the event that a person develops an anaphylactic shock, an emergency treatment with an injection of adrenaline will be required.

It can sometimes be difficult to distinguish anaphylaxis from asthma, fainting, and panic attacks. Asthma however typically does not entail itching or gastrointestinal symptoms, fainting presents with pallor rather than a rash, and a panic attack may have flushing but does not have hives.

 

Anaphylactic Shock and Food

Many foods can trigger anaphylaxis. This may occur after the first known ingestion. Common triggering foods vary around the world due to cultural cuisine. For example, in Western cultures, ingestion of or exposure to peanuts, wheat, nuts, certain types of seafood like shellfish, milk, fruit and eggs are the most prevalent causes. On the other hand, sesame is common in the Middle East, while rice and chickpeas are frequently encountered as sources of anaphylaxis in Asia. Severe cases are usually caused by ingesting the allergen, However, some people experience a severe reaction upon contact. On the positive side, children can outgrow their allergies. By age 16, 80% of children with anaphylaxis to milk or eggs and 20% who experience isolated anaphylaxis to peanuts can tolerate these foods. However, any type of alcohol, even in small amounts, can trigger anaphylaxis in people with Aspirin-exacerbated respiratory disease.

To educate about common food allergens, eLearn Safety has developed a fully online Management of Food Allergens course. The course is designed to introduce participants to understanding food allergens and management of associated risks. Furthermore, after completing the course, participants will be able to understand their requirements under Irish food safety legislation as well as following best work practices.

 

What to do if someone Suffers Anaphylactic Shock

In case someone is developing anaphylactic shock:

1. Call 999/112 for emergency assistance. Specifically, tell the ambulance dispatcher that you suspect anaphylaxis.
2. If the casualty has an auto-injector of adrenaline, help them to use it. If they are unable to administer it, and only if you are trained to use it, apply the injector as trained to do so.
3. Help the casualty to sit up in the position that best relieves any breathing difficulty. If they become pale with a weak pulse, help them to lie down with legs raised and treat for shock.
4. Monitor and record vital signs; breathing, pulse and level of response, while waiting for help to arrive. Repeated doses of adrenaline can be given at five-minute intervals if there is no improvement or the symptoms return.

 

How to Recognise Anaphylactic Shock

Development of anaphylactic shock might have features of allergy:

• Red, itchy rash or raised areas of skin (weals).
• Red itchy, watery eyes.
• Swelling of hands, feet and/or face.
• Abdominal pain, vomiting and diarrhoea.

In addition, the following signs might be present:

• Difficulty breathing, ranging from a tight chest to severe difficulty, causing the casualty to wheeze and gasp for air.
• Pale or flushed skin.
• Visible swelling of tongue and throat with puffiness around the eyes.
• Feeling of terror.
• Confusion and agitation.
• Signs of shock, leading to collapse and loss of consciousness.

Remember, the aim of helping someone in anaphylactic shock is to ease their breathing. In addition, a shock treatment might be required. In the event that the patient’s condition is deteriorating, an urgent transport to the hospital might be required. Unfortunately, anaphylactic shock can develop rapidly and patients’ health might degrade even faster, ultimately resulting in fatality.

 

Online Health and Safety Training

Proactive Health and Safety training is critical to ensure a safe workplace. An effective training program can reduce the number of worker injuries and deaths. It can also reduce instances of property damage, legal liability, illnesses, and missed time from work.

Health and Safety training helps establish a culture in which employees themselves help promote proper safety procedures while on the job. It is important that new employees be properly trained and embrace the importance of workplace safety. The role of training in developing and maintaining effective hazard control activities is a proven and successful method of intervention.

This is why we have established Myelearnsafety school. We pride ourselves in how we guide, support and mentor our students. They receive support throughout their learning experience and into their working lives. Our staff have extensive training experience and also have many years industry experience. We understand the challenges that exist within Environmental and Occupational Health and Safety. Our priority is to ensure that all learners are fully prepared to differentiate themselves in the workplace after completing our Health and Safety courses.

Myelearnsafety offers fully online Health and Safety courses.

To find out more, please check our Courses page.

Alternatively, should you need any additional information, please do not hesitate to let us know via email info@elearn.ie

Difference Between Food Allergy and Food Intolerance

Difference between food allergy and food intolerance is significant. When someone has a food allergy, their immune system wrongly sees the food as hostile and the body’s defence mechanism springs into action. This produces a range of symptoms which can vary from mild itching to severe breathing difficulties or even shock. These symptoms usually happen immediately after eating the food. Unfortunately, in extreme cases, food allergy can have fatal consequences.

When someone is intolerant to a food, the immune system is usually not involved. In this case, the symptoms take much longer to develop and are generally not life-threatening. However, food intolerance can adversely affect long-term health.

 

Are food allergy and intolerance forms of food poisoning?

No. In a case of food poisoning, someone has become ill due to eating food that is contaminated with harmful bacteria or toxins. Contaminated food should not be eaten by anyone. With a food allergy or intolerance, the offending food is safe to eat for the majority of people. However, it triggers an unhealthy reaction in some people. For example, peanuts are nutritious and tasty foods enjoyed by a great many people. However, for someone with a peanut allergy they can be very dangerous.

It is very important that a food hypersensitivity (food allergy, food intolerance or coeliac disease) is diagnosed medically. Self-diagnosis is extremely risky and is not a relevant form of diagnosis. Many of the symptoms associated with these conditions are common to a number of other illnesses. It is important to remember that food poisoning from eating contaminated food, and food aversion where someone just doesn’t like a particular food (but will not be ill if they eat it) are not food hypersensitivities!

If you diagnose yourself, you may cut out of your diet certain foods that are safe and nutritious. At the same time continuing to include foods that may be risky. If you think you have a food hypersensitivity, you need to talk to your General Practitioner.

 

What happens in an allergic reaction?

Essentially, when the immune system reacts to a food ingredient during an allergic reaction, it triggers the release of chemicals such as histamine from cells in the body. This causes some or all of the following symptoms:

• itching or swelling in the mouth and throat,
• hives anywhere on the body,
• runny nose and eyes,
• reddening of the skin,
• feeling sick,
• diarrhoea and/or vomiting.

If the reaction is severe, other symptoms can occur including:

• a sudden feeling of weakness (caused by a drop in blood pressure),
• breathing problems (your throat might start to swell up or close).

This is an anaphylactic reaction, also known as anaphylactic shock, and is life threatening. It requires immediate treatment by adrenaline injection followed by expert medical assistance. Usually the symptoms happen within seconds or minutes of being exposed to the food but the reaction can be delayed for several hours.

 

What are the symptoms of an intolerance to a food?

The symptoms of an intolerance to food include those of an upset digestion e.g., diarrhoea, bloating, upset stomach, etc. Weight loss, lethargy or anaemia can occur as well as migraine headaches and psychological effects such as confusion and even depression. However, these usually manifest over longer periods of time as well as a variety of other symptoms that can result from poor nutrition. In some cases the symptoms of a food intolerance resemble those of a mild allergic reaction.

Many of the symptoms of a food intolerance are also associated with other disorders of the digestive system such as Crohn’s Disease and Irritable Bowel Syndrome.

 

What foods cause an allergic reaction?

Although peanut and nut allergies are probably best known due to the many media reports into related fatalities, any food can cause an allergic response in a susceptible person. To date, allergies to over 180 foods have been documented worldwide. Most of these are very rare and some are associated with particular populations or regions of the world. Cod fish allergy is common in Scandinavia, as is rice allergy in China and celery allergy in France. These allergies are less common on the island of Ireland where, like other Western countries, the more frequently encountered allergies include those to peanuts, tree nuts, egg, crustaceans, milk and wheat.

 

What foods can people be intolerant to?

There is also a wide variety of foods associated with food intolerance. The most frequently encountered in an island of Ireland context include milk (lactose intolerance) and gluten (coeliac disease, wheat intolerance) but also certain food additives such as Monosodium glutamate (MSG).

A person with lactose intolerance cannot digest milk properly (lactose is a milk sugar). Lactose cannot be absorbed by the body resulting in symptoms such as cramps and diarrhoea.

A person with coeliac disease reacts to gluten which is a protein found in foods such as wheat, rye, barley and oats. This results in damage to the gut with effects on nutritional status and general wellbeing.

Some people have reported symptoms such as flushing, temperature increase and headache after eating the flavour enhancer MSG. These symptoms are also known as ‘Chinese Restaurant Syndrome’, related to the fact that MSG is a frequent ingredient in many Chinese dishes.

Other foods to which susceptible people are known to react include red wine, cheese, caffeine and salicylates which are found in certain vegetables, herbs, spices, fruits and chocolate.

 

Can you be allergic or intolerant to more than one food?

It is possible to have allergies to more than one thing. In addition, it is also possible to be intolerant to certain things and allergic to other things. It all depends on how similar the offending chemicals are in the food or pollen or whatever material you are allergic to. This is called cross-reactivity, so if you have an allergy to a food, you can react to another substance (not necessarily another food) if it contains a protein like the protein that causes your allergy in the first place.

For example:

• Cross-reactivity may result in someone who is allergic to prawns also being allergic to shrimps, crab and lobster.
• Quite often peanut allergic people are also allergic to lupin flour.
• Hen’s egg is cross-reactive with other eggs and cow’s milk is cross-reactive with milk from goats and sheep.
• Someone with a wheat allergy can also be allergic to rye and grass pollen.
• Some cross reactions are less obvious: an allergy to house dust mites may lead to an allergy to shellfish (molluscs and crustaceans) while an allergy to latex rubber increases your risk of becoming allergic to certain fruits and vegetables.
• Those who are allergic to pollen, particularly birch or olive pollen, may develop allergic symptoms when they eat hazelnuts, apples, cherries, pears or carrots.

Find out more here: safefood, or here: The Food Safety Authority of Ireland. In addition, you can learn about safe food handling by completing fully online food safety courses developed by eLearn Safety.

 

Online Food Safety Training

Please remember – it is a legal requirement that staff who are involved in a food environment are trained and/or supervised commensurate with their work activity!

Myelearnsafety offers fully online Food Safety (HACCP) courses.

To find out more, please check our Courses page.

Alternatively, should you need any additional information, please do not hesitate to let us know via email info@elearn.ie

Importance of Managing Food Allergens

Importance of Managing Food Allergens in any food handling premises is significant. It is reported that approximately 3% of adults and 5% of children in Ireland have food allergies (IFAN, 2020).

Many people are allergic to certain foods. You must always be aware of all the ingredients contained in the food served by your kitchen. For example, many pre-prepared foodstuffs such as ice-cream contain eggs, and other foods contain traces of nuts. Be very careful when garnishing food, because even if a pre-prepared food type is allergen free, if it is garnished with chopped nuts it can become fatal to certain people.

 

How to Manage Food Allergens

All members of staff should be trained in allergen awareness and observe the house rules, and everyone should be able to recognise the symptoms of an allergic reaction. Of course some restaurants serve shellfish and dishes containing nuts, and the key here is awareness: the staff must be aware of food ingredients and the customers likewise. It is very important that your supplier provides complete ingredient information and alerts you when any changes are made. It is also very important to listen carefully to your customers. If an allergy sufferer asks for information about the ingredients of a certain food it is essential that you understand them completely so that you can give an accurate response. Never guess!

eLearn Safety offers a fully online Management of Food Allergens course. The course is designed to introduce participants to understanding food allergens and management of associated risks. On completion of this food allergen training course, participants will be able to understand their requirements under Irish food safety legislation as well as following best work practices.

 

The 14 Allergens

The EU has a list of 14 food allergens that you must declare the presence of if they are used as ingredients in your food (FSAI, 2024).

1. Cereals containing gluten – wheat (such as spelt and khorasan wheat), rye, barley, oats. Note: The cereal name, e.g., ‘wheat’, must be declared and highlighted, not ‘gluten’.
2. Crustaceans, e.g., crabs, prawns, lobsters.
3. Eggs.
4. Fish.
5. Peanuts.
6. Soybeans.
7. Milk.
8. Nuts (almonds, hazelnuts, walnuts, cashews, pecan nuts, brazil nuts, pistachio nuts, macadamia/Queensland nut). Note: The name of the nut, e.g., ‘almond’, must be declared and highlighted, not ‘nuts’.
9. Celery.
10. Mustard.
11. Sesame seeds.
12. Sulphur dioxide and sulphites (at concentrations of more than 10 mg/kg or 10 mg/L in terms of total sulphur dioxide) – used as a preservative.
13. Lupin.
14. Molluscs, e.g., mussels, oysters, squid, snails.

 

Why is it Important to Manage Food Allergens

Allergies can cause an anaphylactic shock, which is life-threatening.

The symptoms include:

• reddening of the skin, swelling of the lips and eyelids,
• swelling of the throat, difficulty breathing and/or speaking feeling faint due to a serious drop in blood pressure,
• nausea,
• collapse and unconsciousness.

As noted earlier, if someone suffers these symptoms you must render immediate medical attention and call an ambulance.

 

Online Food Safety Training

Please remember – it is a legal requirement that staff who are involved in a food environment are trained and/or supervised commensurate with their work activity!

Myelearnsafety offers fully online Food Safety (HACCP) courses.

To find out more, please check our Courses page.

Alternatively, should you need any additional information, please do not hesitate to let us know via email info@elearn.ie

Allergenic Food Contamination

Allergenic food contamination can produce serious life threatening reactions in some people. Many people are allergic to certain foods, so you must always be aware of all the ingredients contained in the food served by your kitchen. For example, many pre-prepared foodstuffs such as ice cream contain eggs, and other foods contain traces of nuts. Be very careful when garnishing food, because even if a pre-prepared food type is allergen free, if it is garnished with chopped nuts it can become fatal to certain people.

 

Allergen Awareness Training

All members of staff must be trained in Allergen Awareness and observe the house rules. They should be able to recognise the symptoms of an allergic reaction. For a convenient fully online Managing Food Allergens course, please see eLearn Safety course on Managing Food Allergens. It is very important to make sure that food suppliers provide complete ingredient information. This is especially important if any changes to food ingredients are made. The best way to ensure your suppliers are compliant is having a robust and up-to-date Food Safety Management Systems in place. Some useful information can be found in eLearn Safety blog entry from 5th May 2023 titled Food Safety Management System (FSMS).

 

Consequences of Allergenic Food Contamination

Another important task of all food handlers is to listen carefully to customers. If an allergy sufferer asks for information about the ingredients of a certain food, it is essential that all involved in the food business have allergenic food contamination awareness so they can give an accurate response to their customers.

Naturally, there are some food handling establishments whose unique selling point is food that are classified as allergenic. Examples of such establishments are restaurants that serve sea food or dishes containing nuts. The most important word here is awareness – all staff must be aware of food ingredients in each dish. Likewise, customers must be aware that the seafood restaurant will most likely serve fish as a main offering.

Businesses cannot claim they don’t know what allergens are in the food they are serving or use ‘blanket-cover all’ expressions ‘food may contain allergens’ for all food they serve.

 

Anaphylactic Shock Symptoms

Allergic food contamination is a serious issue as allergies can cause an anaphylactic shock. Anaphylactic shock is life-threatening.

The symptoms include:

• Reddening of the skin, swelling of the lips and eyelids.
• Swelling of the throat, difficulty breathing and/or speaking.
• Feeling faint due to a serious drop in blood pressure.
• Nausea.
• Collapse and unconsciousness.

If someone suffers these symptoms, immediate medical attention must be provided. In addition, calling an ambulance is a must.

 

Allergenic Food Contamination – Food Allergens

There are 14 allergens that must be declared by law. These are:

1. Cereals containing gluten – wheat (such as spelt and khorasan wheat), rye, barley, oats. Note: The cereal name, e.g., ‘wheat’, must be declared and highlighted, not ‘gluten’.
2. Crustaceans, e.g., crabs, prawns, lobsters.
3. Eggs.
4. Fish.
5. Peanuts.
6. Soybeans.
7. Milk.
8. Nuts (almonds, hazelnuts, walnuts, cashews, pecan nuts, brazil nuts, pistachio nuts, macademia/Queensland nut). Note: The name of the nut, e.g., ‘almond’, must be declared and highlighted, not ‘nuts’.
9. Celery.
10. Mustard.
11. Sesame seeds.
12. Sulphur dioxide and sulphites (at concentrations of more than 10 mg/kg or 10 mg/L in terms of total sulphur dioxide) – used as a preservative.
13. Lupin.
14. Molluscs e.g., mussels, oysters, squid, snails.

The Food Safety Authority of Ireland published useful information in relation to Food Allergens on their web page titled Food Allergens – Advice for Consumers.

 

Online Food Safety Training

Please remember – it is a legal requirement that staff who are involved in a food environment are trained and/or supervised commensurate with their work activity!

Myelearnsafety offers fully online Food Safety (HACCP) courses.

To find out more, please check our Courses page.

Alternatively, should you need any additional information, please do not hesitate to let us know via email info@elearn.ie