While many patients with food allergies will never experience a fatal or near-fatal reaction to a food, there are many deaths that occur each year due to anaphylaxis to foods. Teenagers are among the highest risk group because they are often developing new food allergies during that time of childhood and may be reluctant to always have an epinephrine autoinjector on them. The only lifesaving medication available for an anaphylactic reaction is epinephrine. This is a very safe medication and can work very quickly to begin reversing symptoms such as throat constriction, low blood pressure and asthma symptoms that occur when someone is having a severe reaction. Studies show that the number one risk factor in death from an allergic reaction is a delay in administration of epinephrine. Getting this injection within the first 2 minutes of developing signs of anaphylaxis are critical to the drug’s effectiveness.
Most people are very good at carefully reading food labels to avoid those ingredients that they may be allergic to or simply avoiding foods that don’t have a food label. Some foods, however, may be contaminated with an ingredient and may not be listed on a food label. This would be classified as an accidental ingestion and occurs every 2 years, on average, to someone with a food allergy. So even with very careful attention to reading food labels, it is still quite frequent that someone will be exposed to a food he or she is allergic to.
Using a medication such as diphenhydramine for an allergic reaction will help minimize hives and very slightly swelling, but it will not reverse throat constriction, asthma symptoms or low blood pressure, the most common causes of death from an allergic reaction. The onset of diphenhydramine is around 30 minutes, so waiting to see if an antihistamine will work to reverse an allergic reaction should never be done. If anything more than hives occurs, or if someone ingests a food that they have previously been highly allergic to such as tree nuts, peanuts or shellfish, epinephrine should be administered if it is even suspected that one of these foods has been accidentally ingested. A good rule of thumb is that if you even think you should administer epinephrine, administer it!
It can also be very helpful to see your allergist at least once a year to help reinforce proper use and carriage of the epinephrine autoinjector as well as to renew these medications as they usually expire 12-18 months from the time they are picked up from the pharmacy. Always make sure that the expiration dates are watched carefully so you aren’t in a position to need to medication and to only have expired medication which would not work as effectively. Many people will also outgrow a food allergy, so the allergist will also be monitoring for this to happen in food allergy patients.