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Fish allergy
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Fish allergy
Fish allergy is an immune hypersensitivity to proteins found in fish. Symptoms can be either rapid or gradual in onset. The latter can take hours to days to appear. The former may include anaphylaxis, a potentially life-threatening condition which requires treatment with epinephrine. Other presentations may include atopic dermatitis or inflammation of the esophagus. Fish is one of the eight common food allergens which are responsible for 90% of allergic reactions to foods: cow's milk, eggs, wheat, shellfish, peanuts, tree nuts, fish, and soy beans.
Unlike early childhood allergic reactions to milk and eggs, which often lessen as the children age, fish allergy tends to first appear in school-age children and persist in adulthood. Strong predictors for adult-persistence are anaphylaxis, high fish-specific serum immunoglobulin E (IgE) and robust response to the skin prick test. It is unclear if the early introduction of fish to the diet of babies aged 4–6 months decreases the risk of later development of fish allergy. Adult onset of fish allergy is common in workers in the fish catching and processing industry.
Food allergies in general usually have an onset of symptoms in the range of minutes to hours for an IgE-mediated response, which may include anaphylaxis. Symptoms may include rash, hives, itching of mouth, lips, tongue, throat, eyes, skin, or other areas, swelling of lips, tongue, eyelids, or the whole face, difficulty swallowing, runny or congested nose, hoarse voice, wheezing, shortness of breath, diarrhea, abdominal pain, lightheadedness, fainting, nausea, or vomiting. Non-IgE-mediated responses occur hours to days after consuming the allergenic food, and are not as severe as IgE-mediated symptoms. Symptoms of allergies vary from person to person and incident to incident.
Potentially life-threatening, the anaphylactic onset of an allergic reaction is characterized by respiratory distress, as indicated by wheezing, breathing difficulty, and cyanosis, and also circulatory impairment that can include a weak pulse, pale skin, and fainting. This can occur when IgE antibodies are released and areas of the body not in direct contact with the food allergen show severe symptoms. Untreated, the overall response can lead to vasodilation, which can be a low blood pressure situation called anaphylactic shock.
The cause is typically the eating of fish or foods that contain fish. Once an allergic reaction has occurred it usually remains a lifelong sensitivity. Briefly, the immune system overreacts to proteins found in fish, primarily to parvalbumin, but sometimes to other proteins, such as fish collagen. The allergic reaction to shellfish and crustaceans such as lobster and shrimp is to a different protein, tropomyosin, so there is no cross-reactivity between fish and shellfish allergy.
Cross-contact, also referred to as cross-contamination, occurs when foods are being processed in factories or at food markets, or are being prepared for cooking in restaurants and home kitchens. The allergenic proteins are transferred from one food to another.
The food-borne parasite Anisakis is a genus of nematodes known to be present in intermediate host salt-water fish, anadromous fish that travel from oceans to rivers to breed, and squid. Anisakis are directly infective to humans when infected fish or squid is consumed raw or slightly processed, causing a condition called anisakiasis. Symptoms include severe abdominal pain, nausea, and vomiting. In addition, there can be an allergic reaction to Anisakis proteins, even if the food in question was frozen, killing the nematodes, or cooked before being consumed, as some of the nematode proteins are resistant to heat. Allergic reactions can include hives, asthma and true anaphylactic reactions.
An industry review conducted in 1990 estimated that 28.5 million people worldwide were engaged in some aspect of the seafood industry: fishing, aquaculture, processing and industrial cooking. Men predominate in fishing, women in processing facilities. Exposure to fish allergenic proteins includes inhalation of wet aerosols from fresh fish handling, inhalation of dry aerosols from fishmeal processing, and dermal contact through skin breaks and cuts. Prevalence of seafood-induced adult asthma is on the order of 10% (higher for crustaceans and lower for fish). Prevalence of skin allergy reactions, often characterized by itchy rash (hives), range from 3% to 11%. The fish-induced health outcomes are mainly due to the protein parvalbumin causing an IgE mediated immune system response.
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Fish allergy
Fish allergy is an immune hypersensitivity to proteins found in fish. Symptoms can be either rapid or gradual in onset. The latter can take hours to days to appear. The former may include anaphylaxis, a potentially life-threatening condition which requires treatment with epinephrine. Other presentations may include atopic dermatitis or inflammation of the esophagus. Fish is one of the eight common food allergens which are responsible for 90% of allergic reactions to foods: cow's milk, eggs, wheat, shellfish, peanuts, tree nuts, fish, and soy beans.
Unlike early childhood allergic reactions to milk and eggs, which often lessen as the children age, fish allergy tends to first appear in school-age children and persist in adulthood. Strong predictors for adult-persistence are anaphylaxis, high fish-specific serum immunoglobulin E (IgE) and robust response to the skin prick test. It is unclear if the early introduction of fish to the diet of babies aged 4–6 months decreases the risk of later development of fish allergy. Adult onset of fish allergy is common in workers in the fish catching and processing industry.
Food allergies in general usually have an onset of symptoms in the range of minutes to hours for an IgE-mediated response, which may include anaphylaxis. Symptoms may include rash, hives, itching of mouth, lips, tongue, throat, eyes, skin, or other areas, swelling of lips, tongue, eyelids, or the whole face, difficulty swallowing, runny or congested nose, hoarse voice, wheezing, shortness of breath, diarrhea, abdominal pain, lightheadedness, fainting, nausea, or vomiting. Non-IgE-mediated responses occur hours to days after consuming the allergenic food, and are not as severe as IgE-mediated symptoms. Symptoms of allergies vary from person to person and incident to incident.
Potentially life-threatening, the anaphylactic onset of an allergic reaction is characterized by respiratory distress, as indicated by wheezing, breathing difficulty, and cyanosis, and also circulatory impairment that can include a weak pulse, pale skin, and fainting. This can occur when IgE antibodies are released and areas of the body not in direct contact with the food allergen show severe symptoms. Untreated, the overall response can lead to vasodilation, which can be a low blood pressure situation called anaphylactic shock.
The cause is typically the eating of fish or foods that contain fish. Once an allergic reaction has occurred it usually remains a lifelong sensitivity. Briefly, the immune system overreacts to proteins found in fish, primarily to parvalbumin, but sometimes to other proteins, such as fish collagen. The allergic reaction to shellfish and crustaceans such as lobster and shrimp is to a different protein, tropomyosin, so there is no cross-reactivity between fish and shellfish allergy.
Cross-contact, also referred to as cross-contamination, occurs when foods are being processed in factories or at food markets, or are being prepared for cooking in restaurants and home kitchens. The allergenic proteins are transferred from one food to another.
The food-borne parasite Anisakis is a genus of nematodes known to be present in intermediate host salt-water fish, anadromous fish that travel from oceans to rivers to breed, and squid. Anisakis are directly infective to humans when infected fish or squid is consumed raw or slightly processed, causing a condition called anisakiasis. Symptoms include severe abdominal pain, nausea, and vomiting. In addition, there can be an allergic reaction to Anisakis proteins, even if the food in question was frozen, killing the nematodes, or cooked before being consumed, as some of the nematode proteins are resistant to heat. Allergic reactions can include hives, asthma and true anaphylactic reactions.
An industry review conducted in 1990 estimated that 28.5 million people worldwide were engaged in some aspect of the seafood industry: fishing, aquaculture, processing and industrial cooking. Men predominate in fishing, women in processing facilities. Exposure to fish allergenic proteins includes inhalation of wet aerosols from fresh fish handling, inhalation of dry aerosols from fishmeal processing, and dermal contact through skin breaks and cuts. Prevalence of seafood-induced adult asthma is on the order of 10% (higher for crustaceans and lower for fish). Prevalence of skin allergy reactions, often characterized by itchy rash (hives), range from 3% to 11%. The fish-induced health outcomes are mainly due to the protein parvalbumin causing an IgE mediated immune system response.
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