Fish Allergy

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Fish allergy is a commonly found allergy in fish eaters and people who come in close contact with fishes. It affects approximately 0.4 per cent population globally among which 30 per cent are reportedly children and 66 per cent are adults. People affected with fish allergy are basically allergic to finned fishes. An individual allergic to one particular fish is not necessarily allergic to other fishes as well.

What is fish allergy?

Fish allergy is an abnormal immune system response to the proteins present in finned fishes.

Causes of fish allergy

Like all other food allergies, the primary cause of fish allergy is the malfunctioning of the immune system. If any among 20,000 species of finned fishes is consumed, the immune system misperceives the fish proteins to be harmful pathogens and triggers the production of Immunoglobulin E (IgE) antibodies to combat with the foreign invaders. The antibodies attack the foreign particles during recurrent consumption and signal the immune system to release histamines and other chemicals that trigger allergic reactions in the body.

Symptoms of fish allergy

The symptoms of fish allergy may be mild or fatal anaphylaxis, depending on the intensity of allergic reaction. The onset of mild symptoms is usually within few minutes to hours of consuming fish protein. The mild signs and symptoms include the following:

  1. Hives
  2. Skin rash
  3. Nausea or vomiting
  4. Stomach cramps
  5. Diarrhea
  6. Indigestion problems
  7. Stuffy/runny nose
  8. Headache
  9. Sneezing

Symptoms of severe anaphylactic reaction include the following:

  1. Asthma or breathing troubles
  2. Chronic indigestion problems
  3. Vomiting
  4. Loss of consciousness
  5. Death (sometimes)

The onset of anaphylaxis is rapid and may cause death to an individual.

Risk factors

The factors that put people at risk of developing allergy to fish are cited below:

Age

Fish allergy affects people primarily in their adulthood. Very few children suffer from this allergy. The rate of fish allergy among adults vs. children is 0.5 per cent vs. 0.2 per cent.

Gender

More women as compared to men are allergic to fish. The rate of fish allergy among women vs. men is 0.6 per cent vs. 0.2 per cent.

Cross contact

Cross contact between two different fishes while purchasing fish from a market or while dining out can put an individual at considerable risk of developing allergy.

Contamination of cooking area

There is always a risk associated with the area where fish is cooked because there is a chance of transmission of fish proteins in the air.

Allergies associated with fish allergy

Shellfish allergy is very much associated with fish allergy. It is not an obvious case that every person suffering from fish allergy is allergic to shellfish. Cross-reactivity does not occur between finned fish and shellfish but there is a great risk of cross contact between both. Moreover, some people are allergic to both concomitantly.

Complications

Fish allergy can be as complicated as causing death to an individual. Unlike most other food allergies, the end result of severe anaphylaxis reaction of fish allergy is mostly death.

Treatment of fish allergy

The first and foremost treatment for fish allergy is strict avoidance of fish that one is allergic to. Usually antihistamines are used to treat the symptoms of fish allergy. Anaphylaxis can be treated with dosages of epinephrine only. Epinephrine is available in the form of an auto-injector. People who are prone to anaphylaxis are advised to carry auto-injectors of epinephrine all the time with them. The first line of treatment for anaphylaxis is certainly epinephrine and later the patient should be moved to emergency medical care. There is a myth that epinephrine is a substitute for antihistamine but both are different drugs and cannot act as substitute for each other.

Lifestyle changes in fish allergy

If fish allergy is confirmed after diagnosis, one should be very careful with his/her lifestyle. Avoiding the food stuffs that have possible potential to be containing the allergen should be strictly avoided. Eating out at a seafood restaurant, while ordering non-sea food one might be inviting unknown danger home. So, seafood restaurants should be avoided at large. Areas of cooking fish have high chances of being contaminated with fish proteins, therefore such areas are better avoided by people with fish allergy.

Diet and caution

If allergists ask to avoid some particular species of fishes and eat the rest, one should take extra care while purchasing those fishes because there are chances of cross contact. Before avoiding a set of foodstuffs, people should be aware of some surprising sources of fish.

  • Worcestershire sauce
  • Caponata (Sicilian eggplant relish)
  • Caesar salad and dressing
  • Barbecue sauce
  • Fish sauce
  • Fish oils
  • Gelatin
  • Caviar
  • Fish roe (eggs)
  • Artificial fish used in sushi

If there is a strict advice from the allergists that all kinds of finned fishes should be avoided, the regimen should be followed. It is always better that an individual suffering from fish allergy does not go himself to buy or cook fishes. Coming in contact with fishes might put an individual at risk. Reading food labels is almost mandatory for a fish allergy patient. Besides foods, medicines, lotions and cosmetics might as well have a content of fish. So, the labels should be checked for. Any confusion associated with labeling can be cleared by directly contacting the manufacturer. Being curious and diligent is important while having food at a restaurant. One should not hold himself back to ask questions regarding the ingredients while ordering food.

Utmost caution may help in reducing the frequency of problems associated with fish allergy.

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