Pre-recorded in December 2016, the webinar Anaphylaxis, Food Allergy and Asthma: Answering Your Questions is presented by Clifford W. Bassett, MD. Dr. Bassett is Medical Director of Allergy and Asthma Care of New York and is on the faculty of New York University School of Medicine, Weill Cornell Medical College, and the State University of New York in Brooklyn.
Throughout the webinar, Dr. Bassett points out connections between food allergy and asthma. Asthma is a risk factor for anaphylaxis and fatal anaphylaxis, especially if the asthma is poorly controlled. Dr. Bassett notes that another risk factor for fatal anaphylaxis is delayed administration of epinephrine. Since different food allergy reactions can have different symptoms, and since future reactions may be more severe than past reactions, Dr. Bassett emphasizes the importance of keeping your epinephrine auto-injectors with you at all times.
Asthma and food allergy have both become more prevalent in recent decades. According to the National Health Interview Survey (NHIS), as many as 1 in 10 children may have asthma. Asthma and anaphylaxis share some symptoms in common, since both asthma and severe food allergy reactions can cause wheezing, cough, chest tightness and shortness of breath. Researchers report that as many as one-third of food allergy reactions result in respiratory symptoms.
The nature of any connection between asthma and food allergy is not clearly understood at this time. There may be an underlying predisposition to allergic conditions, including both food allergy and asthma. Alternatively, there may be a cause-and-effect relationship. Food allergy often develops early in life, before symptoms of asthma develop, and early childhood food allergy may be a risk factor for asthma.
The webinar ends with guidance on food allergy management, emphasizing the importance of confirming any initial diagnosis, reading all food labels, preventing cross-contact, using chef’s cards for dining out, having a written emergency anaphylaxis action plan and always keeping your prescribed emergency medicines with you, including epinephrine auto-injectors as the first-line treatment for anaphylaxis.
Biphasic reactions account for up to 1 in 5 food allergy reactions, so patients are strongly encouraged to carry two epinephrine auto-injectors. Patients should consult with their doctors to learn more about immediate, delayed, and protracted food allergy reactions. Because poorly controlled asthma is a risk factor for anaphylaxis and poor anaphylaxis outcomes, optimizing asthma control can help keep food allergy patients safe.
In reviewing when to use an epinephrine auto-injector, Dr. Bassett offers the following recommendation:
“Most authorities agree that any food-allergic child who has experienced a life-threatening anaphylactic reaction (or who is experiencing severe symptoms) should be given intramuscular epinephrine and transported to a hospital immediately if a food allergen ingestion is suspected.”
Educating patients, family members and caregivers is an essential part of food allergy care. Having accurate information and training is vital. If a reaction occurs, remember to follow the written emergency action plan.