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Anaphylaxis

Our backyards are supposed to be an oasis for us but for many people with allergies they can be uncomfortable at best—or downright dangerous for individuals who suffer from anaphylaxis.

Why Peanut Allergies are So Dangerous

This video from the American Chemical Society provides a great explanation of how peanut allergies are triggered and what happens during an episode of anaphylaxis.  It contains a reference that peanut proteins can be inhaled, thus triggering an anaphylactic reaction. With support from our medical advisory board, we have a different view. While it is theoretically possible to inhale enough peanut proteins to trigger an anaphylactic response in those highly sensitized to them, it is very rare. In light of that, we consider the risk of inhaling peanut proteins statistically insignificant. It is our hope that this gives our readers confidence to pursue their usual efforts to manage their peanut allergies as prescribed by their physician.

This is how anapylaxis feels.

NYS Assembly Representative, Bill Nojay tells us his experience having an anaphylactic attack and treating others while working as a volunter EMT.

To understand the science about what Assembly Representative Bill Nojay exerpienced, click on the topics below.

What is anaphylaxis?

Put simply, anaphylaxis is a severe allergic reaction.   While typical allergies are caused by the body’s immune system overreacting to otherwise harmless substances, anaphylaxis is an allergic reaction in overdrive.

Causes vary by individual but common triggers include some foods, certain medications, insect stings and latex.

 

Why does anaphylaxis develop and how?

This is what an attack of anaphylaxis looks like at the cellular-molecular level

Anaphylactic shock is an exaggerated allergic response. Immune cells such as B cells, plasma cells, mast cells, basophils, and antibodies participate in anaphylaxis. Anaphylaxis generally occurs in two steps – the first exposure to an allergen results in sensitization, with subsequent exposures potentially resulting in an allergic reaction and anaphylaxis.

 anaphylaxis affects on cells

 

Who is at risk for an anaphylactic attack?

Anyone can become a victim of anaphylaxis after they have been exposed once before to the allergen.  In other words, the first time a susceptible person eats peanuts or is stung by a stinging insect little or no reaction may result.  However, following the first exposure the body builds up a sensitization so that the next ingestion of peanuts or encounter with insect venom can result in a full-fledged anaphylactic attack.

Leaves and Vine, Good to Know

Good to Know

leafbulletPeople don’t always realize or remember they have had that initial exposure, so don’t automatically assume no reaction will occur.

leafbulletIndividuals who have had an anaphylactic reaction before are definitely at risk for another on the next exposure.  There’s no way to predict if it will be the same or more severe, so take it seriously and be on guard.

What are the symptoms of an anaphylactic attack?

Just like symptoms can vary in severity, they can also differ in presentation. Skin is most often affected with feelings of itching, tingling, warmth and/or hives. Coughing, wheezing, difficulty breathing, swelling of the mouth and throat and other respiratory symptoms are also relatively common.

Gastrointestinal issues including cramping, vomiting and diarrhea can occur in anywhere from one-third to almost half of anaphylactic patients. Very serious symptoms such as a drop in blood pressure, loss of consciousness and difficulty breathing are rare but need to be addressed immediately. Don’t wait to see what happens—call 911.

Leaves and Vine, Good to Know

Good to Know

leafbulletSymptoms can begin immediately or up to several hours after the exposure.

leafbulletReactions can worsen over time and with repeated exposure.

leafbulletGenerally speaking, the faster the reaction happens the more severe it may be.

leafbulletSome people can have a late phase reaction—both an immediate response to exposure and a second attack up to 2 to 24 hours later (without re-exposure).

What can cause anaphylaxis?

Extreme allergic reactions vary by individual.  Some common triggers include:

leafbulletFoods (most often peanuts, tree nuts like cashews and walnuts, fish and shellfish, milk, soy and eggs)

leafbulletMedications (while any medication can cause an extreme allergic reaction, antibiotics including penicillin are one of the most common; aspirin and ibuprofen are other possibilities)

leafbulletInsect Stings (wasps, yellow jackets, hornets, honey bees, etc.)*

leafbulletLatex Rubber (and/or other rubber products)

Leaves and Vine, Good to Know

Good to Know

  • Occasionally even exercise itself can bring on anaphylaxis—especially if a person has eaten a food he or she is sensitive to before working out.

What should be done during an attack of anaphylaxis?

There’s no doubt an anaphylactic attack can be scary for the sufferer and those around him or her.  Most importantly, everyone should try to stay calm and do the following:

leafbulletAdminister epinephrine (using an epinephrine auto-injector) if it’s available.  This will help contract the blood vessels, relax the bronchial tubes and allow a return to normal breathing.  It can also stop symptoms like hives, itching and stomach cramps.

leafbulletCall 911.  After using the epinephrine auto-injector, call 911.  Even if the person starts feeling better he or she should still be checked out by a medical professional.

leafbulletLie down and elevate the feet.

leafbulletConsider giving a second epinephrine auto-injector injection after 5 minutes or more if symptoms have not improved or if they worsen again and medical professionals are not on the scene.

leafbulletBe prepared for the possibility that IV fluids, oxygen and/or other medications such as antihistamines and steroids might be given by EMTs.

leafbulletOnce the danger has passed, make an appointment with an allergist if this is the first time an extreme allergic reaction has occurred.  The doctor will likely take a health history and want to know exactly what was going on (i.e., activities, foods eaten, any medications taken, any contact with rubber, etc.) before the reaction to try to pinpoint a cause.  Blood and/or skin tests may also be used to help find the trigger.

Leaves and Vine, Good to Know

Good to Know

leafbulletInject the epinephrine into the upper outer thigh.

leafbulletIt’s okay to administer the epinephrine through light clothing.

How can anaphylaxis be prevented?

Unfortunately despite much diligence, sometimes extreme allergic reactions cannot be avoided.  However, depending on the allergy there are steps you can take:

leafbulletAsk about the ingredients of food dishes and inform friends, family and restaurants of specific allergies.  Read all food labels when eating at home.

leafbulletTake medications by mouth as there tend to be fewer reactions that way than from injections.  Make sure all health care personnel know the allergy history.

leafbulletDon’t wear anything like perfume, hair spray or bright colors that could attract insects.   Cover up with long sleeves, pants and shoes to keep exposed skin to a minimum.

leafbulletStay away from latex products—and make sure health care providers do too.

leafbulletWear a medic alert bracelet that lists trigger(s) and any medications being taken that might reduce the effectiveness of epinephrine (like beta-blockers).

Leaves and Vine, Good to Know

Good to Know

Allergy shots can be effective in eliminating reactions to insect stings while desensitization to penicillin, sulfa, and other drugs by slowly ingesting larger amounts over time may be possible.  These interventions must be done under the supervision of a physician usually in a medical facility.

 

The information provided on this site is in no way intended to be a substitute for medical advice,
diagnosis, or treatment with a licensed physician.
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