A man in his early twenties is presently receiving critical care at the Rambam Health Care Campus in Haifa following a severe allergic reaction to peanuts. He had consumed ice cream, which presumably contained peanuts, at a party. This situation raises several important questions about severe food allergies, such as what happens to the body during a severe allergic reaction, what is anaphylactic shock, and whether it's possible to develop a tolerance to food that triggers severe allergies. Dr. Joseph Pansoff, a specialist in general allergology, provides answers to these critical inquiries.
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What is a food allergy?
A food allergy is an abnormal reaction of the immune system that responds in a non-beneficial way to the body when exposed to various factors. This reaction is mediated by a group of antibodies called IGE antibodies. When eating that food product, an immediate reaction of varying severity may develop in someone who is allergic: from a slight scratch in the throat to a general rash, shortness of breath, choking, a drop in blood pressure, and in extreme cases even death.
So, what is an anaphylactic shock that can cause death?
Anaphylactic shock is an extreme allergic reaction. During such a reaction, there is a massive release of several chemical substances from cells called mast cells. These cells are at the heart of every allergic reaction. This massive release of substances causes a general dilation of blood vessels with a drop in blood pressure. As a result, significant swelling of the respiratory system's airways develops with difficulty breathing and oxygen disturbance and even choking due to that swelling in the vocal cord area.
What is the prevalence of food allergies?
Food allergy is a problem that mainly develops in the first years of life after exposure to various types of food. About 5% to 10% of infants will develop a food allergy. In a significant part of the cases, these are mild reactions.
How does a peanut allergy manifest?
A peanut allergy manifests similarly to allergies to other food products. Depending on the degree of sensitivity, so are the reactions: from a mild reaction to life-threatening.
How common is a peanut allergy in Israel?
In Israel, peanut allergy is actually less common for the well-known and research-based reason that most infants are exposed to peanuts before the age of one in the form of a soft snack ("Bamba"). The common allergies are to nuts and their derivatives, milk, tahini/sesame, and eggs.
Can an allergy appear at any time or is it a congenital phenomenon?
Food allergy is mainly a problem of young children, because then they are exposed to different types of food and as a result, the immune system will develop a desirable tolerance or develop an allergy which is of course the undesirable option. There is a familial genetic tendency for allergic reactions. A reaction to one food or another depends on many factors that occur after we are born. The appearance of an allergy to food that we have consumed without a problem for years is a rather extreme scenario.
If an allergy appears in childhood, is there a chance it will stop in adulthood?
A significant part of food allergies disappear gradually over the first years. Therefore, it is important to follow up with an allergy specialist who can perform the necessary tests to determine whether the allergy still exists or has disappeared. A vital part in dealing with allergic problems in general and food in particular is the close monitoring of the allergy clinic: the teams of doctors and nurses in those departments are the right address for diagnosis, guidance, and treatment of these problems.
Dr. Joseph PansoffHow can one immediately treat cases of food allergy, and what medication should one be equipped with?
Immediate treatment for severe food allergies is given through an automatic injector of a drug called adrenaline - an Epipen injector. In any prominent allergic reaction, the Epipen should be used. There is nothing to fear from its mild side effects. Our recommendation is always that it is better to inject, even if it turns out that there was no need rather than to refrain for various reasons. It can be fairly certain that Epipen saves lives. When it is given as early as possible, its effect is greater in stopping the process and improving life-threatening components.
Are asthma patients at increased risk during an allergic attack?
Asthmatic patients are a risk group in the sense that general allergic reactions may be more respiratory severe in them.
Is it possible to develop tolerance to food that causes allergies?
Many studies in recent years prove that early exposure to food products - mainly until the age of one - increases the chance of developing tolerance to those food products. This has of course been proven primarily for peanuts but also applies to other food.