🕷️ Crawler Inspector

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Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 52 (from laksa050)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa052.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.allergy.org.au/patients/food-allergy/allergic-and-toxic-reactions-to-seafood\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.allergy.org.au/patients/food-allergy/allergic-and-toxic-reactions-to-seafood\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.allergy.org.au\/patients\/food-allergy\/allergic-and-toxic-reactions-to-seafood","crawl_time":1776328907,"first_indexed_time":1420359391,"http_code":200,"src_unparsed":"au,org,allergy!www,\/patients\/food-allergy\/allergic-and-toxic-reactions-to-seafood s443","src_root_hash":"4294978528692114452","history_drop_reason":null,"meta_title":"Allergic and Toxic Reactions to Seafood - Australasian Society of Clinical Immunology and Allergy (ASCIA)","meta_descriptions":["Seafood allergy occurs most commonly where seafood is an important part of the diet, such as Asia and Scandinavia. It is more common in adults than children, us"],"attrs_boilerpipe_text":"Frequently Asked Questions\nThis document has been developed by\nASCIA\n, the peak professional body of clinical immunology\/allergy specialists in Australia and New Zealand. ASCIA information is based on published literature and expert review, is not influenced by commercial organisations and is not intended to replace medical advice.         \nFor patient or carer support contact\nAllergy & Anaphylaxis Australia\nor\nAllergy New Zealand\n.\nASCIA PC Seafood Allergy FAQ 2024\n187.78 KB\n Q 1: Is seafood allergy common?\nSeafood allergy occurs most commonly where seafood is an important part of the diet, such as in Asia and Scandinavia. Approximately 1% of the population is estimated to have a seafood allergy. It is more common in teenage and adult life than very early childhood. About 20% of people will grow out of their seafood allergy with time.\nQ 2: What types of seafood cause allergic reactions?\nThe major groups of seafood that can trigger allergic reactions:\nFish\n(vertebrates - with a backbone)\nIncluding salmon, cod, mackerel, sardines, herring, anchovies, tuna, trout, haddock, eels and rays.\nShellfish\n(invertebrates – without a backbone)\nCrustaceans including prawns\/shrimps, lobster, crab, crayfish, and yabbies.\nMolluscs including oysters, mussels, clams, octopus, squid (calamari), abalone, and sea slugs.\nThe protein allergens present in one seafood group can be very different to those in other seafood groups. This means that a person can be allergic to fish only, shellfish only, or members of both groups. People who are allergic to one fish are usually (but not always) allergic to most other fish.\nQ 3: What is cross reactivity?\nCross reactivity means that a similar protein is present in a range of different foods. If the same protein is present in several foods, then that person may have allergic reactions to any food containing that protein. Examples of cross reactivity include people allergic to similar proteins present in one fish that are also present in other fish, or those allergic to proteins present in prawn, crab and lobster.\nAllergy to one crustacean usually means that all must be avoided. People with allergy to seafood from one group (such as crustaceans) may tolerate seafood from another group (such as molluscs). This can only be confirmed with allergy testing and guidance from a clinical immunology\/allergy specialist.\nQ 4: How are people exposed to the seafood allergen?  \nEating seafood is the major trigger for allergic reactions.\nSensitive people may sometimes have breathing difficulties from inhaling fumes when seafood is being cooked, and in seafood processing factories. They may also have symptoms from touching seafood, such as when cleaning and handling fish.\nSymptoms caused by allergic reactions to seafood usually appear within minutes. Delayed reactions and exercise-induced anaphylaxis can occur, particularly after eating shellfish such as oyster, abalone, squid, and shrimp.\nQ 5: What are the signs and symptoms of allergic reactions to seafood?\nSigns and symptoms of\nmild to moderate allergic reactions\nto foods include:\nSwelling of the lips, face, eyes\nHives or welts on the skin\nAbdominal pain, vomiting\nSigns of\nanaphylaxis\nto foods include any one of the following:\nDifficult or noisy breathing\nSwelling of the tongue\nSwelling or tightness in the throat\nWheeze or persistent cough\nDifficulty talking or hoarse voice\nPersistent dizziness or collapse\nPale and floppy (in young children)\nAnaphylaxis is the most severe type of allergic reaction and should always be treated as a medical emergency. Anaphylaxis requires immediate treatment with adrenaline (epinephrine), which is injected into the outer mid-thigh muscle. Delayed treatment can result in fatal anaphylaxis.\nQ 6: How is a food allergy diagnosed?\nAccurate diagnosis of food allergy is important. A doctor (GP) will ask questions that may help to narrow down the list of likely causes of allergy such as foods or medicines consumed that day, or exposure to stinging insects. This approach will also help to exclude conditions that can sometimes be confused with food allergy. A referral to a clinical immunology\/allergy specialist may be given.\nSkin or blood allergen specific IgE allergy tests help confirm or exclude potential triggers. While the results of allergy testing by a specialist are a guide to whether the person is allergic, results will not be able to tell you whether your reaction will be mild or severe.\nIt may not be possible to test for all seafood species using commercial skin prick or blood allergy testing, since these are not available for all seafood species. For this reason, some allergy clinics will recommend that you bring samples of fresh food for testing.\nQ 7: Are there ‘allergy testing’ methods which are unproven and not recommended?\nSome unorthodox\/alternative practitioners offer unproven, non-evidence-based allergy ‘tests’ and ‘treatments’ that are not recommended by ASCIA.\nThese include cytotoxic food testing, kinesiology, hair analysis, vega testing, electrodermal testing, pulse testing, reflexology, bioresonance, Bryan’s or Alcat tests, VoiceBio, allergy elimination techniques and immunoglobulin G (IgG) to foods. These tests can result in misdiagnosis, ineffective treatments, costly and often dangerous dietary restrictions.\nQ 8: How is seafood allergy managed?\nPeople can learn to manage their seafood allergy with the guidance of their clinical immunology\/allergy specialist. It is important for people with confirmed food allergy to:\nAvoid confirmed food allergens.\nKnow the signs and symptoms of allergic reactions and know what to do when a reaction occurs.\nCarry their adrenaline injector (if prescribed) and ASCIA Action Plan at all times.\nQ 9: How can seafood be avoided?\nAvoidance of one or more groups of seafood is often advised to manage confirmed seafood allergy. Accidental exposure is more likely to happen when eating away from home.\nOther potential sources of accidental exposure and cross-contamination include:\nSeafood platters and buffets.\nAsian foods often contain shellfish as a common ingredient or contaminant such as prawns in fried rice or soups, and seafood extender.\nTakeaway food which may be rolled in the same batter or cooked in the same oil as seafood.\nCommercial pizzas where contamination may happen during preparation.\nAnchovies in Caesar salads, and as an ingredient in Worcestershire sauce.\nContaminated barbeques where seafood has been cooked.\nIsinglass is sometimes used as a fining agent to remove cloudiness from beer and wine. Made from the swim bladder of certain types of fish, it consists almost entirely of collagen, and is considered unlikely to cause allergic reactions. Use of isinglass in beer and wine has been exempted from mandatory labelling regulations in Australia.\nWhile the risk of allergic reactions to fish oils is low in those allergic to fish due to the method of purification, people with fish allergy are advised to seek medical advice before consuming. Other sources of omega-3 fatty acids include evening primrose oil and flaxseed oil.\nQ 10: Does cooking seafood affect tolerance?\nSeafood allergens are usually heat stable and cannot easily be destroyed through cooking. Some people can tolerate tinned fish (intensely heat treated) yet are unable to tolerate the same fish when freshly cooked.\nQ 11: Are seafood allergy and iodine allergy related?\nPeople with seafood allergy react to proteins in the seafood, not to iodine in the fish or shellfish. People who are allergic to seafood are not at an increased risk of allergic reactions to iodine in topical antiseptics such as Betadine or Povidine, or intravenous x-ray radio-contrast agents.\nPeople with iodine allergy are not at increased risk of seafood allergy.\nQ 12: Is allergy to glucosamine common?\nAllergic reactions to glucosamine are not common. Glucosamine is a popular complementary medicine used to treat osteoarthritis. It is derived from the outer coatings of shellfish such as crustaceans. Sometimes chondroitin sulfate is added, usually derived from shark cartilage. \nProducts containing glucosamine registered in Australia and New Zealand carry labels warning against their use in people allergic to shellfish\/crustaceans. Vegetarian glucosamine is available which does not contain seafood allergen as it is produced in bacteria cultures.\nQ 13: What toxic reactions look like seafood allergy?\nSome conditions caused by toxins or parasites in seafood can resemble allergic reactions to seafood.\nScombroid Fish Poisoning\nAn allergy-like reaction that occurs after eating fish that has high levels of histamine because it has not been properly stored or processed. This is more common in fish which turns brown upon cooking. This including mackerel, tuna, king fish, herring, sardines, marlin, anchovies and bluefish. Affected fish often have a metallic or peppery taste.\nScombroid poisoning symptoms usually start within 30 minutes of eating. These include flushing, itch, hives (urticaria), nausea, vomiting, stomach cramps, dizziness, palpitations and headache. Severe reactions may result in wheezing and dizziness or a drop in blood pressure. Urgent medical assistance is required. Treatment usually involves taking antihistamines, and sometimes adrenaline is given in a hospital setting. Scombroid poisoning can be identified by the pattern of symptoms and the absence of reactions with skin or blood allergy testing.\nAnisakis Simplex\nThis is a nematode (worm) that is a fish parasite found in most parts of the world, including Australia. The parasite is killed when cooked at temperatures above 60\no\nC or if stored in industrial freezers for two days. Anisakis can cause two major problems in people:\nAnisakis\ninfection\n(anisakiasis) can result from eating raw or undercooked seafood. Infection may cause nausea, vomiting, stomach pain, and sometimes appendicitis, bowel blockage or bleeding. Symptoms occur due to inflammation in the gut. Diagnosis requires an endoscopy where a specialist doctor uses a tube to observe the inside of the stomach and bowel. The parasite usually gets destroyed by our immune system after three weeks, but surgery may be required.\nAnisakis\nallergy\nresembles other allergic reactions to food. In this case, the allergy is to the fish parasite, not to the fish itself. Reactions occur sometimes after eating seafood, rather than on every occasion. The allergens of Anisakis simplex are not destroyed by heat or cooking and so allergic reactions may be triggered by dead parasites in fish that have been well cooked. Blood allergy testing is available to confirm suspected sensitivity to this parasite.\nCiguatera Poisoning, Paralytic Shellfish Poisoning\nand Diarrhoetic Shellfish Poisoning\nCiguatera poisoning is caused by eating seafood that has been contaminated by algae-derived toxins. Ciguatera toxins are only present in fish, particularly large reef fish in the tropics. Paralytic shellfish poisoning and diarrhoetic shellfish poisoning is caused by shellfish contaminated with microorganisms (i.e. algae producing toxins), in particular mussels and oysters. These toxins or poisons interfere with the function of nerve endings.\nSymptoms occur within two to three hours of eating contaminated food, and consist of tingling of the lips, tongue and throat, often followed by stomach upset, headache, fever, muscle aches and pains and in the case of ciguatera poisoning, sometimes changes in blood pressure and heart rhythm. Numbness, collapse, coma and confusion have also been described. Most people recover within a few days or weeks with supportive treatment.\nMetabisulfite\nReactions\nMetabisulfite preservative can sometimes be used to stop crustaceans (such as prawns) from discolouring. This preservative is also used in wine, beer and some dried fruit as a preservative. Adverse reactions include wheezing\/tight chest (more common in those with asthma), stomach irritation (such as nausea and pain), and rarely itch\/rashes.\nToxic and other adverse reactions to seafood are outlined in the table below.\nTable: Toxic and other adverse reactions to seafood\nCause\nSeafood \nimplicated\nClinical symptoms\nTime of \nonset\nAllergy test\nBacterial infection\nSalmonella, Vibrio,\nAeromonas, Listeria\nCrustacean, Mollusc, Fish\nDermatological\nGastrointestinal\nNeurological\nRespiratory\nMinutes to\nseveral\nhours\nNegative\nViral infection\nHepatitis A, Rota-\nAstrovirus,\nSmall round Viruses etc.\nCrustacean, Mollusc\nNegative\nSeafood parasites\nAnisakis\nDiphyllobothrium\nAll fish and some molluscs\nNegative\nToxins\n1)   \nScombrotoxin\nMarine Toxins\n2)   \nCiguatera toxin\n3)   \nAlgae toxins\n1)  Fish, particularly with dark meat\n2)  Reef fish\n3)  All Mollusc species\nNegative\nAllergens\nShellfish\nCrustacean\nMollusc\nFish\nPositive\n© ASCIA 2024\nContent updated April 2024\nFor more information go to\nwww.allergy.org.au\/patients\/food-allergy\nTo support allergy and immunology research go to\nwww.allergyimmunology.org.au\/donate\n ","attrs_markdown":"[Skip to main content](https:\/\/www.allergy.org.au\/patients\/food-allergy\/allergic-and-toxic-reactions-to-seafood#tm-main)\n\n[![ASCIA](https:\/\/www.allergy.org.au\/templates\/yootheme\/cache\/43\/ascia-logo-blue-trans-238-43e8de40.png)](https:\/\/www.allergy.org.au\/)\n\n- [Home](https:\/\/www.allergy.org.au\/)\n- [About Us](https:\/\/www.allergy.org.au\/about-ascia)\n  - 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Patient and Carers](https:\/\/www.allergy.org.au\/hp\/drug-allergy\/checklist-testing)\n  - [Food Allergy](https:\/\/www.allergy.org.au\/hp\/food-allergy)\n  - [Food – Other Adverse Reactions](https:\/\/www.allergy.org.au\/hp\/food-other-adverse-reactions)\n  - [Respiratory Allergy - Allergic Rhinitis (Hay Fever), Asthma and Sinusitis](https:\/\/www.allergy.org.au\/hp\/allergic-rhinitis)\n    - [Checklist: Non-Allergic Rhinitis, Allergic Rhinitis and Chronic Rhinosinusitis with Nasal Polyps](https:\/\/www.allergy.org.au\/hp\/allergic-rhinitis\/nar-ar-crwnp)\n  - [Venom Allergy](https:\/\/www.allergy.org.au\/hp\/venom-allergy)\n  - [Other Allergy](https:\/\/www.allergy.org.au\/hp\/other-allergy)\n  - [Allergen Immunotherapy](https:\/\/www.allergy.org.au\/hp\/immunotherapy)\n  - [Allergy Prevention](https:\/\/www.allergy.org.au\/hp\/prevention)\n  - [Allergy Testing](https:\/\/www.allergy.org.au\/hp\/tests)\n  - [Skin](https:\/\/www.allergy.org.au\/hp\/skin)\n    - [Checklist: Acute Urticaria and Chronic Urticaria](https:\/\/www.allergy.org.au\/hp\/skin\/acute-chronic-urticaria)\n  - [Autoimmunity](https:\/\/www.allergy.org.au\/hp\/autoimmunity)\n  - [Laboratory Tests for Autoimmune Diseases](https:\/\/www.allergy.org.au\/hp\/autoimmunity-laboratory-testing)\n  - [Immunisation](https:\/\/www.allergy.org.au\/hp\/immunisation)\n  - [External Links](https:\/\/www.allergy.org.au\/hp\/external-links)\n  - [ASCIA Action, First Aid, Management, Transfer, Travel and Treatment Plans](https:\/\/www.allergy.org.au\/hp\/ascia-plans-action-and-treatment)\n  - [Health Professionals e-training](https:\/\/www.allergy.org.au\/hp\/hp-e-training)\n    - [Anaphylaxis - short film](https:\/\/www.allergy.org.au\/hp\/hp-e-training\/anaphylaxis-short-film)\n    - [HP e-training feedback](https:\/\/www.allergy.org.au\/hp\/hp-e-training\/hp-e-training-feedback)\n  - [Podcast - Antibiotics and Allergy](https:\/\/www.allergy.org.au\/hp\/podcasts)\n    - [Antibiotics and Allergy in our Community](https:\/\/www.allergy.org.au\/hp\/podcasts\/antibiotics-and-allergy)\n  - [Webinar - Immunodeficiency](https:\/\/www.allergy.org.au\/hp\/immunodeficiency-webinar)\n  - [A career in Clinical Immunology and Allergy](https:\/\/www.allergy.org.au\/hp\/a-career-in-clinical-immunology-and-allergy)\n  - [Awards\/Grants](https:\/\/www.allergy.org.au\/hp\/awards-grants)\n    - [ASCIA Grants for Medical Students](https:\/\/www.allergy.org.au\/hp\/awards-grants\/ascia-grants-for-medical-students)\n    - [ASCIA Grants for Members](https:\/\/www.allergy.org.au\/hp\/awards-grants\/ascia-grants-for-members)\n    - [ASCIA Media Awards](https:\/\/www.allergy.org.au\/hp\/awards-grants\/ascia-media-awards)\n    - [ASCIA Award, Grant & Scholarship Recipients](https:\/\/www.allergy.org.au\/hp\/awards-grants\/ascia-award-grant-scholarship-recipients)\n  - [Research Studies](https:\/\/www.allergy.org.au\/hp\/research-studies)\n  - [ASCIA ID Register](https:\/\/idregister.ascia.org.au\/)\n  - [Resources for Health Professionals](https:\/\/www.allergy.org.au\/hp\/resources-for-health-professionals)\n  - [ASCIA Position Paper - IFNAR1 Deficiency](https:\/\/www.allergy.org.au\/hp\/ifnar1-deficiency)\n  - [Drug (Medication) Allergy Challenges Position Paper](https:\/\/www.allergy.org.au\/hp\/challenges)\n- [Patients](https:\/\/www.allergy.org.au\/patients)\n  - [Patients and Carers](https:\/\/www.allergy.org.au\/patients)\n  - [Allergy and Clinical Immunology Services](https:\/\/www.allergy.org.au\/patients\/allergy-and-clinical-immunology-services)\n    - [What is a Clinical Immunology\/Allergy Specialist](https:\/\/www.allergy.org.au\/patients\/allergy-and-clinical-immunology-services\/clinical-immunologist-allergy-specialist)\n  - [Locate a specialist](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist)\n    - [ACT](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist\/act)\n    - [NSW](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist\/nsw)\n    - [NT](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist\/nt)\n    - [QLD](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist\/qld)\n    - [SA](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist\/sa)\n    - [TAS](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist\/tas)\n    - [VIC](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist\/vic)\n    - [WA](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist\/wa)\n    - [New Zealand](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist\/new-zealand)\n  - [Patient support organisations](https:\/\/www.allergy.org.au\/patients\/patient-support-organisations)\n  - [Anaphylaxis e-training](https:\/\/www.allergy.org.au\/patients\/anaphylaxis-e-training-schools-and-childcare)\n    - [Resources](https:\/\/www.allergy.org.au\/patients\/anaphylaxis-e-training-schools-and-childcare\/etraining-resources)\n    - [Anaphylaxis e-training feedback](https:\/\/www.allergy.org.au\/patients\/anaphylaxis-e-training-schools-and-childcare\/anaphylaxis-e-training-feedback)\n  - [Anaphylaxis e-training first aid (community)](https:\/\/www.allergy.org.au\/patients\/anaphylaxis-e-training-first-aid-community)\n    - [Anaphylaxis e-training first aid feedback](https:\/\/www.allergy.org.au\/patients\/anaphylaxis-e-training-first-aid-community\/anaphylaxis-e-training-first-aid-feedback)\n  - [Fast Facts](https:\/\/www.allergy.org.au\/patients\/fast-facts)\n    - [Fast Facts Home](https:\/\/www.allergy.org.au\/patients\/fast-facts)\n    - [Adrenaline (Epinephrine) Devices](https:\/\/www.allergy.org.au\/patients\/fast-facts\/adrenaline-devices)\n    - [Allergic Rhinitis (Hay Fever )](https:\/\/www.allergy.org.au\/patients\/fast-facts\/hay-fever-allergic-rhinitis)\n    - [Allergy Testing](https:\/\/www.allergy.org.au\/patients\/fast-facts\/allergy-testing)\n    - [Allergy Treatments](https:\/\/www.allergy.org.au\/patients\/fast-facts\/allergy-treatments)\n    - [Anaphylaxis](https:\/\/www.allergy.org.au\/patients\/fast-facts\/anaphylaxis)\n    - [Asthma and Allergy](https:\/\/www.allergy.org.au\/patients\/fast-facts\/asthma-and-allergy)\n    - [Autoimmune Diseases](https:\/\/www.allergy.org.au\/patients\/fast-facts\/autoimmune-diseases)\n    - [Cow’s Milk (Dairy) Allergy](https:\/\/www.allergy.org.au\/patients\/fast-facts\/cows-milk-dairy-allergy)\n    - [Drug (Medication) Allergy](https:\/\/www.allergy.org.au\/patients\/fast-facts\/drug-allergy)\n    - [Eczema (Atopic Dermatitis)](https:\/\/www.allergy.org.au\/patients\/fast-facts\/eczema-atopic-dermatitis)\n    - [Eczema and Food Allergy](https:\/\/www.allergy.org.au\/patients\/fast-facts\/eczema-and-food-allergy)\n    - [Evidence-based Allergy Tests and Treatments](https:\/\/www.allergy.org.au\/patients\/fast-facts\/evidence-based-allergy-tests-and-treatments)\n    - [Food Allergy](https:\/\/www.allergy.org.au\/patients\/fast-facts\/food-allergy)\n    - [Immune System](https:\/\/www.allergy.org.au\/patients\/fast-facts\/immune-system)\n    - [Immunodeficiencies](https:\/\/www.allergy.org.au\/patients\/fast-facts\/immunodeficiencies)\n    - [Infant Feeding and Allergy Prevention](https:\/\/www.allergy.org.au\/patients\/fast-facts\/infant-feeding-and-allergy-prevention)\n    - [Insect and Tick Allergy](https:\/\/www.allergy.org.au\/patients\/fast-facts\/insect-and-tick-allergy)\n    - [Peanut Allergy](https:\/\/www.allergy.org.au\/patients\/fast-facts\/peanut-allergy)\n    - [Seed Allergy](https:\/\/www.allergy.org.au\/patients\/fast-facts\/seed-allergy)\n    - [Tree Nut Allergy](https:\/\/www.allergy.org.au\/patients\/fast-facts\/tree-nut-allergy)\n  - [Allergy and anaphylaxis](https:\/\/www.allergy.org.au\/patients\/about-allergy)\n    - [Allergy and anaphylaxis](https:\/\/www.allergy.org.au\/patients\/about-allergy)\n    - [What is allergy?](https:\/\/www.allergy.org.au\/patients\/about-allergy\/what-is-allergy)\n    - [Allergy glossary of terms](https:\/\/www.allergy.org.au\/patients\/about-allergy\/glossary-of-allergy-terms)\n    - [Idiopathic Anaphylaxis](https:\/\/www.allergy.org.au\/patients\/about-allergy\/idiopathic-anaphylaxis)\n    - [Anaphylaxis](https:\/\/www.allergy.org.au\/patients\/about-allergy\/anaphylaxis)\n    - [Checklist - Anaphylaxis](https:\/\/www.allergy.org.au\/patients\/about-allergy\/checklist-anaphylaxis)\n    - [Anaphylaxis translations](https:\/\/www.allergy.org.au\/patients\/about-allergy\/anaphylaxis-translations)\n    - [Anaphylaxis translations - New Zealand](https:\/\/www.allergy.org.au\/patients\/about-allergy\/anaphylaxis-translations-nz)\n    - [Common myths about allergy and asthma](https:\/\/www.allergy.org.au\/patients\/about-allergy\/common-myths-about-allergy-and-asthma)\n    - [Fact Sheet for Parents - Anaphylaxis](https:\/\/www.allergy.org.au\/patients\/about-allergy\/facts-parents-anaphylaxis)\n  - [Allergic rhinitis (hay fever) and sinusitis](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis)\n    - [Allergic rhinitis (hay fever) and sinusitis](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis)\n    - [Allergic rhinitis (hay fever)](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis\/allergic-rhinitis-or-hay-fever)\n    - [Allergic Rhinitis Treatment Plan](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis\/allergic-rhinitis-treatment-plan)\n    - [Allergic conjunctivitis](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis\/allergic-conjunctivitis)\n    - [Nasal polyps](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis\/nasal-polyps)\n    - [Non-Allergic Rhinitis](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis\/non-allergic-rhinitis)\n    - [Pollen allergy](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis\/pollen-allergy)\n    - [Pollen calendar - guide to common allergenic pollen](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis\/guide-to-common-allergenic-pollen)\n    - [Sinusitis and allergy](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis\/sinusitis-and-allergy)\n    - [Vocal Cord Dysfunction](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis\/vocal-cord-dysfunction)\n  - [Allergy and the skin](https:\/\/www.allergy.org.au\/patients\/skin-allergy)\n    - [Allergy and the skin](https:\/\/www.allergy.org.au\/patients\/skin-allergy)\n    - [Angioedema](https:\/\/www.allergy.org.au\/patients\/skin-allergy\/angioedema)\n    - [Chronic Spontaneous Urticaria](https:\/\/www.allergy.org.au\/patients\/skin-allergy\/urticaria-hives-chronic)\n    - [Contact dermatitis](https:\/\/www.allergy.org.au\/patients\/skin-allergy\/contact-dermatitis)\n    - [Eczema (Atopic Dermatitis)](https:\/\/www.allergy.org.au\/patients\/skin-allergy\/eczema)\n    - [ASCIA Eczema Action Plan](https:\/\/www.allergy.org.au\/patients\/skin-allergy\/eczema-action-plan)\n    - [Hives (urticaria)](https:\/\/www.allergy.org.au\/patients\/skin-allergy\/urticaria-hives)\n    - [Orofacial granulomatosis](https:\/\/www.allergy.org.au\/patients\/skin-allergy\/orofacial-granulomatosis)\n  - [Allergy prevention](https:\/\/www.allergy.org.au\/patients\/allergy-prevention)\n    - [Allergy prevention](https:\/\/www.allergy.org.au\/patients\/allergy-prevention)\n    - [ASCIA Information on how to introduce solid foods to babies for allergy prevention](https:\/\/www.allergy.org.au\/patients\/allergy-prevention\/ascia-how-to-introduce-solid-foods-to-babies)\n    - [Allergy prevention](https:\/\/www.allergy.org.au\/patients\/allergy-prevention\/allergy-prevention)\n    - [Food Allergen Starter Packs for Babies that Contain Common Allergy Causing Foods](https:\/\/www.allergy.org.au\/patients\/allergy-prevention\/infant-feeding-products)\n    - [Checklist: Introducing Solid Foods to Babies for Food Allergy Prevention](https:\/\/www.allergy.org.au\/patients\/allergy-prevention\/infant-feeding-checklist)\n  - [Allergy testing](https:\/\/www.allergy.org.au\/patients\/allergy-testing)\n    - [Allergy testing overview](https:\/\/www.allergy.org.au\/patients\/allergy-testing)\n    - [Allergy testing](https:\/\/www.allergy.org.au\/patients\/allergy-testing\/allergy-testing)\n    - [Food allergen challenges](https:\/\/www.allergy.org.au\/patients\/food-allergy\/food-allergen-challenges)\n    - [Food Allergy Testing](https:\/\/www.allergy.org.au\/patients\/allergy-testing\/food-allergy)\n    - [Mastocytosis](https:\/\/www.allergy.org.au\/patients\/allergy-testing\/mastocytosis)\n    - [Evidence-Based Versus Non Evidence-Based Tests and Treatments](https:\/\/www.allergy.org.au\/patients\/allergy-testing\/evidence-based-versus-non-evidence-based-tests-and-treatments)\n    - [What is causing your allergy](https:\/\/www.allergy.org.au\/patients\/allergy-testing\/causes-of-allergy)\n  - [Allergy treatments](https:\/\/www.allergy.org.au\/patients\/allergy-treatments)\n    - [Allergy treatments](https:\/\/www.allergy.org.au\/patients\/allergy-treatments)\n    - [SCIT Treatment Plan](https:\/\/www.allergy.org.au\/patients\/allergy-treatments\/scit-treatment-plan)\n    - [Allergen Immunotherapy](https:\/\/www.allergy.org.au\/patients\/allergy-treatments\/allergen-immunotherapy)\n    - [Allergen minimisation](https:\/\/www.allergy.org.au\/patients\/allergy-treatments\/allergen-minimisation)\n    - [Venom Immunotherapy FAQs](https:\/\/www.allergy.org.au\/patients\/allergy-treatments\/venom-immunotherapy-faqs)\n    - [Adrenaline for severe allergies](https:\/\/www.allergy.org.au\/patients\/allergy-treatments\/adrenaline-for-severe-allergies)\n    - [Transitioning from paediatric to adult care](https:\/\/www.allergy.org.au\/patients\/allergy-treatments\/transitioning-from-paediatric-to-adult-care)\n    - [Oral immunotherapy (OIT) for food allergy](https:\/\/www.allergy.org.au\/patients\/allergy-treatments\/oral-immunotherapy-for-food-allergy)\n  - [Asthma and allergy](https:\/\/www.allergy.org.au\/patients\/asthma-and-allergy)\n    - [Asthma and allergy](https:\/\/www.allergy.org.au\/patients\/asthma-and-allergy)\n    - [About asthma and allergy](https:\/\/www.allergy.org.au\/patients\/asthma-and-allergy\/about-asthma-and-allergy)\n    - [Asthma and anaphylaxis](https:\/\/www.allergy.org.au\/patients\/asthma-and-allergy\/asthma-and-anaphylaxis)\n    - [Asthma Issues: sport, travel, and pregnancy](https:\/\/www.allergy.org.au\/patients\/asthma-and-allergy\/asthma-issues-sport-travel-and-pregnancy)\n    - [Thunderstorm asthma](https:\/\/www.allergy.org.au\/patients\/asthma-and-allergy\/thunderstorm-asthma)\n  - [Autoimmunity](https:\/\/www.allergy.org.au\/patients\/autoimmunity)\n    - [Autoimmunity overview](https:\/\/www.allergy.org.au\/patients\/autoimmunity)\n    - [Autoimmune diseases](https:\/\/www.allergy.org.au\/patients\/autoimmunity\/autoimmune-diseases)\n    - [Systemic Lupus Erythematosus (SLE)](https:\/\/www.allergy.org.au\/patients\/autoimmunity\/systemic-lupus-erythematosus-sle)\n    - [Sjögren’s Disease](https:\/\/www.allergy.org.au\/patients\/autoimmunity\/sjoegrens-disease)\n    - [Vasculitis disorders](https:\/\/www.allergy.org.au\/patients\/autoimmunity\/vasculitis-disorders)\n  - [Drug allergy](https:\/\/www.allergy.org.au\/patients\/drug-allergy)\n    - [Drug allergy overview](https:\/\/www.allergy.org.au\/patients\/drug-allergy)\n    - [Adverse Reactions to Complementary and Alternative Medicines](https:\/\/www.allergy.org.au\/patients\/drug-allergy\/adverse-reactions-to-alternative-medicines)\n    - [Allergic reactions to aspirin and other pain killers](https:\/\/www.allergy.org.au\/patients\/drug-allergy\/allergic-reactions-to-aspirin-and-other-pain-killers)\n    - [Antibiotic Allergy Challenges](https:\/\/www.allergy.org.au\/patients\/drug-allergy\/antibiotic-allergy-challenges)\n    - [Chlorhexidine allergy](https:\/\/www.allergy.org.au\/patients\/drug-allergy\/chlorhexidine-allergy)\n    - [Penicillin Allergy](https:\/\/www.allergy.org.au\/patients\/drug-allergy\/penicillin)\n    - [Sulfonamide Antibiotic Allergy](https:\/\/www.allergy.org.au\/patients\/drug-allergy\/sulfonamide-antibiotic-allergy)\n  - [Food allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy)\n    - [Food allergy overview](https:\/\/www.allergy.org.au\/patients\/food-allergy)\n    - [ASCIA Dietary avoidance for food allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy)\n      - [Cow's milk protein (dairy)](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/cows-milk-dairy)\n      - [Cow's milk protein (dairy) and soy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/cows-milk-protein-dairy-and-soy)\n      - [Egg](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/egg)\n      - [Fish](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/fish)\n      - [Peanut](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/peanut)\n      - [Sesame](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/sesame)\n      - [Shellfish](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/shellfish)\n      - [Soy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/soy)\n      - [Treenut](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/treenut)\n      - [Wheat](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/wheat)\n    - [ASCIA Dietary avoidance for food allergy FAQ](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy-faq)\n    - [Allergic and toxic reactions to seafood](https:\/\/www.allergy.org.au\/patients\/food-allergy\/allergic-and-toxic-reactions-to-seafood)\n    - [Coconut allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/coconut-allergy)\n    - [Cow\\`s milk (dairy) allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/cows-milk-dairy-allergy)\n    - [Egg allergy flu vaccine](https:\/\/www.allergy.org.au\/patients\/food-allergy\/egg-allergy-flu-vaccine)\n    - [Food Allergy FAQ](https:\/\/www.allergy.org.au\/patients\/food-allergy\/faqs)\n    - [Food allergen challenges](https:\/\/www.allergy.org.au\/patients\/food-allergy\/food-allergen-challenges)\n    - [Lupin food allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/lupin-food-allergy)\n    - [Mammalian meat and tick allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/mammalian-meat-tick-faq)\n    - [Peanut, tree nut and seed allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/peanut-tree-nut-and-seed-allergy)\n    - [Wheat Dependant Exercise Induced Anaphylaxis](https:\/\/www.allergy.org.au\/patients\/food-allergy\/wheat-dependant-exercise-induced-anaphylaxis)\n  - [Food other adverse reactions](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions)\n    - [Food other adverse reactions overview](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions)\n    - [Food intolerance](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/food-intolerance)\n    - [Lactose Intolerance](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/lactose-intolerance)\n    - [Milk, mucus and cough](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/milk-mucus-and-cough)\n    - [Oral Allergy Syndrome](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/oral-allergy-syndrome)\n    - [Eosinophilic Oesophagitis (EoE)](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/eosinophilic-oesophagitis)\n    - [Two Food Elimination Diet (2FED) for EoE](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/eoe-2fed)\n    - [Four Food Elimination Diet (4FED) for EoE](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/eoe-4fed)\n    - [Action Plan for Eosinophilic Oesophagitis (EoE)](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/eoe-action-plan)\n    - [Management Plan for Eosinophilic Oesophagitis (EoE)](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/eoe-management-plan)\n    - [Food Protein Induced Enterocolitis Syndrome (FPIES)](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/food-protein-induced-enterocolitis-syndrome-fpies)\n    - [FPIES Action Plan](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/fpies-action-plan)\n    - [Food Protein-Induced Allergic Proctocolitis (FPIAP)](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/proctocolitis-fpiap)\n    - [Management Plan for Delayed Allergic Reactions to Foods](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions\/delayed-reactions-management-plan)\n  - [Immune system](https:\/\/www.allergy.org.au\/patients\/immune-system)\n    - [Immune System Overview](https:\/\/www.allergy.org.au\/patients\/immune-system)\n    - [Immune System - Fast Facts](https:\/\/www.allergy.org.au\/patients\/fast-facts\/immune-system)\n  - [Immunisation](https:\/\/www.allergy.org.au\/patients\/immunisation)\n  - [Immunodeficiencies](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies)\n    - [Immunodeficiencies overview](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies)\n    - [Subcutaneous immunoglobulin (SCIg) therapy - general information](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/scig-therapy-general-information)\n    - [Subcutaneous immunoglobulin (SCIg) therapy - equipment checklist](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/scig-therapy-equipment-checklist)\n    - [Subcutaneous immunoglobulin (SCIg) infusion checklist](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/scig-infusion-checklist)\n    - [Immunoglobulin replacement therapy](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/immunoglobulin-replacement-therapy)\n    - [Primary Immunodeficiency (PID)](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/primary-immunodeficiency)\n    - [Severe combined immunodeficiency](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/severe-combined-immunodeficiency)\n    - [Primary Immunodeficiencies and the Immune System](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/pid-immune-system)\n    - [Preventing Infections](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/preventing-infections)\n    - [Newborn Screening for Severe Combined Immune Deficiency (SCID)](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/nbs-scid)\n    - [Common variable immune deficiency (CVID)](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/common-variable-immune-deficiency-cvid)\n    - [Hereditary Angioedema (HAE)](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies\/hae)\n  - [Insect and tick allergy](https:\/\/www.allergy.org.au\/patients\/insect-allergy-bites-and-stings)\n    - [Insect and tick allergy overview](https:\/\/www.allergy.org.au\/patients\/insect-allergy-bites-and-stings)\n    - [Allergic reactions to bites and stings](https:\/\/www.allergy.org.au\/patients\/insect-allergy-bites-and-stings\/allergic-reactions-to-bites-and-stings)\n    - [Jack Jumper Ant Allergy](https:\/\/www.allergy.org.au\/patients\/insect-allergy-bites-and-stings\/jack-jumper-ant-allergy)\n    - [Large Local Reactions to Insect Stings](https:\/\/www.allergy.org.au\/patients\/insect-allergy-bites-and-stings\/large-local-reactions)\n    - [Mammalian meat and tick allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/mammalian-meat-tick-faq)\n    - [Tick Allergy](https:\/\/www.allergy.org.au\/patients\/insect-allergy-bites-and-stings\/tick-allergy)\n    - [Venom Immunotherapy](https:\/\/www.allergy.org.au\/patients\/allergy-treatments\/venom-immunotherapy-faqs)\n  - [Other allergies](https:\/\/www.allergy.org.au\/patients\/other-allergy)\n    - [Other allergies overview](https:\/\/www.allergy.org.au\/patients\/other-allergy)\n    - [Alcohol allergy](https:\/\/www.allergy.org.au\/patients\/other-allergy\/alcohol-allergy)\n    - [Latex allergy](https:\/\/www.allergy.org.au\/patients\/other-allergy\/latex-allergy)\n    - [Pet allergy](https:\/\/www.allergy.org.au\/patients\/other-allergy\/pet-allergy)\n    - [Sulfite Sensitivity](https:\/\/www.allergy.org.au\/patients\/other-allergy\/sulfite-sensitivity)\n- [Schools](https:\/\/www.allergy.org.au\/schools-childcare)\n- [Meetings](https:\/\/www.allergy.org.au\/conferences)\n  - [Advanced Trainees](https:\/\/www.allergy.org.au\/conferences\/advanced-trainees)\n    - [APID](https:\/\/www.allergy.org.au\/conferences\/advanced-trainees\/apid)\n  - [ASCIA Annual Conference](https:\/\/www.allergy.org.au\/conferences\/ascia-annual-conference)\n    - [Annual ASCIA Conference Reports](https:\/\/www.allergy.org.au\/conferences\/ascia-annual-conference\/reports)\n    - [Annual ASCIA Basten Oration](https:\/\/www.allergy.org.au\/conferences\/ascia-annual-conference\/annual-ascia-basten-oration)\n    - [Schedule for ASCIA Annual Conferences](https:\/\/www.allergy.org.au\/conferences\/ascia-annual-conference\/schedule-for-ascia-acs)\n    - [Published Abstracts ASCIA](https:\/\/www.allergy.org.au\/conferences\/ascia-annual-conference\/published-abstracts-ascia)\n    - [Annual Conferences (1990 onwards)](https:\/\/www.allergy.org.au\/conferences\/ascia-annual-conference\/ascia-ac-1990-onwards)\n  - [ASCIA Education Meetings](https:\/\/www.allergy.org.au\/conferences\/education)\n  - [ASCIA Online Meetings](https:\/\/www.allergy.org.au\/conferences\/online-meetings)\n  - [Calendar: Conferences, Meetings, Events](https:\/\/www.allergy.org.au\/conferences\/calendar)\n  - [Immunopathology](https:\/\/www.allergy.org.au\/conferences\/immunopathology)\n- [Reports](https:\/\/www.allergy.org.au\/ascia-reports)\n  - [ASCIA Annual Highlights, Reports and AGM Minutes](https:\/\/www.allergy.org.au\/ascia-reports#s2)\n  - [ASCIA Scope of Practice documents](https:\/\/www.allergy.org.au\/ascia-reports#s3)\n  - [Cost of allergic disease in Australia](https:\/\/www.allergy.org.au\/ascia-reports-economic)\n  - [National Allergy Strategy](https:\/\/www.allergy.org.au\/ascia-reports#s4)\n  - [NPS Choosing Wisely and RACP Evolve](https:\/\/www.allergy.org.au\/ascia-reports#s5)\n  - [Allergy in Australia 2014](https:\/\/www.allergy.org.au\/ascia-reports#s6)\n  - [Allergy and Immune Diseases in Australia (AIDA) Report 2013](https:\/\/www.allergy.org.au\/ascia-reports#s7)\n  - [ASCIA Education Resources Report 2013](https:\/\/www.allergy.org.au\/ascia-reports#s8)\n  - [Economic Impact of Allergies Report 2007](https:\/\/www.allergy.org.au\/ascia-reports#s9)\n- [Submissions](https:\/\/www.allergy.org.au\/ascia-submissions)\n  - [All ASCIA Submissions](https:\/\/www.allergy.org.au\/ascia-submissions)\n  - [Submissions 2025](https:\/\/www.allergy.org.au\/ascia-submissions\/2025)\n  - [Submissions 2024](https:\/\/www.allergy.org.au\/ascia-submissions\/2024)\n  - [Submissions 2023](https:\/\/www.allergy.org.au\/ascia-submissions\/2023)\n  - [Submissions 2022](https:\/\/www.allergy.org.au\/ascia-submissions\/2022)\n  - [Submissions 2021](https:\/\/www.allergy.org.au\/ascia-submissions\/2021)\n  - [Submissions 2020](https:\/\/www.allergy.org.au\/ascia-submissions\/2020)\n  - [Submissions 2019](https:\/\/www.allergy.org.au\/ascia-submissions\/2019)\n- [Telehealth](https:\/\/www.allergy.org.au\/ascia-telehealth)\n  - [Resources](https:\/\/www.allergy.org.au\/ascia-telehealth)\n  - [ASCIA plans and guides](https:\/\/www.allergy.org.au\/ascia-telehealth#plans)\n  - [ASCIA checklists and forms](https:\/\/www.allergy.org.au\/ascia-telehealth#checklists)\n  - [Adrenaline injector instructions](https:\/\/www.allergy.org.au\/ascia-telehealth#aai)\n  - [ASCIA information for patients, carers and community](https:\/\/www.allergy.org.au\/ascia-telehealth#pcc)\n  - [National Allergy Council Resources](https:\/\/www.allergy.org.au\/ascia-telehealth#nas)\n- [Quicklinks](https:\/\/www.allergy.org.au\/about-ascia\/quick-links)\n- [Referrals](https:\/\/www.allergy.org.au\/patients\/allergy-and-clinical-immunology-services)\n- [Videos](https:\/\/www.allergy.org.au\/ascia-videos)\n\n[Contact Us](https:\/\/www.allergy.org.au\/contact-us \"Contact Us\") \\| [Locate a Specialist](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist \"Locate a Specialist\") \\| [Sitemap](https:\/\/www.allergy.org.au\/about-ascia\/sitemap \"Sitemap\")\n\n[![ASCIA](https:\/\/www.allergy.org.au\/templates\/yootheme\/cache\/a5\/ascia-logo-white-275-a5b6954f.png)](https:\/\/www.allergy.org.au\/)\n\n- [Home](https:\/\/www.allergy.org.au\/)\n- [About Us](https:\/\/www.allergy.org.au\/about-ascia)\n  - 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[Venom Allergy](https:\/\/www.allergy.org.au\/hp\/venom-allergy)\n  - [Other Allergy](https:\/\/www.allergy.org.au\/hp\/other-allergy)\n  - [Allergen Immunotherapy](https:\/\/www.allergy.org.au\/hp\/immunotherapy)\n  \n  - [Allergy Prevention](https:\/\/www.allergy.org.au\/hp\/prevention)\n  - [Allergy Testing](https:\/\/www.allergy.org.au\/hp\/tests)\n  - [Skin](https:\/\/www.allergy.org.au\/hp\/skin)\n  - [Autoimmunity](https:\/\/www.allergy.org.au\/hp\/autoimmunity)\n  - [Laboratory Tests for Autoimmune Diseases](https:\/\/www.allergy.org.au\/hp\/autoimmunity-laboratory-testing)\n  - [Immunisation](https:\/\/www.allergy.org.au\/hp\/immunisation)\n  - [External Links](https:\/\/www.allergy.org.au\/hp\/external-links)\n  - [ASCIA Action, First Aid, Management, Transfer, Travel and Treatment Plans](https:\/\/www.allergy.org.au\/hp\/ascia-plans-action-and-treatment)\n  - [Health Professionals e-training](https:\/\/www.allergy.org.au\/hp\/hp-e-training)\n  \n  - [Podcast - Antibiotics and Allergy](https:\/\/www.allergy.org.au\/hp\/podcasts)\n  - [Webinar - Immunodeficiency](https:\/\/www.allergy.org.au\/hp\/immunodeficiency-webinar)\n  - [A career in Clinical Immunology and Allergy](https:\/\/www.allergy.org.au\/hp\/a-career-in-clinical-immunology-and-allergy)\n  - [Awards\/Grants](https:\/\/www.allergy.org.au\/hp\/awards-grants)\n  - [Research Studies](https:\/\/www.allergy.org.au\/hp\/research-studies)\n  - [ASCIA ID Register](https:\/\/idregister.ascia.org.au\/)\n  - [Resources for Health Professionals](https:\/\/www.allergy.org.au\/hp\/resources-for-health-professionals)\n  - [ASCIA Position Paper - IFNAR1 Deficiency](https:\/\/www.allergy.org.au\/hp\/ifnar1-deficiency)\n  - [Drug (Medication) Allergy Challenges Position Paper](https:\/\/www.allergy.org.au\/hp\/challenges)\n- [Patients](https:\/\/www.allergy.org.au\/patients)\n  - [Patients and Carers](https:\/\/www.allergy.org.au\/patients)\n  - [Allergy and Clinical Immunology Services](https:\/\/www.allergy.org.au\/patients\/allergy-and-clinical-immunology-services)\n  - [Locate a specialist](https:\/\/www.allergy.org.au\/patients\/locate-a-specialist)\n  - [Patient support organisations](https:\/\/www.allergy.org.au\/patients\/patient-support-organisations)\n  - [Anaphylaxis e-training](https:\/\/www.allergy.org.au\/patients\/anaphylaxis-e-training-schools-and-childcare)\n  - [Anaphylaxis e-training first aid (community)](https:\/\/www.allergy.org.au\/patients\/anaphylaxis-e-training-first-aid-community)\n  - [Fast Facts](https:\/\/www.allergy.org.au\/patients\/fast-facts)\n  - [Allergy and anaphylaxis](https:\/\/www.allergy.org.au\/patients\/about-allergy)\n  \n  - [Allergic rhinitis (hay fever) and sinusitis](https:\/\/www.allergy.org.au\/patients\/allergic-rhinitis-hay-fever-and-sinusitis)\n  - [Allergy and the skin](https:\/\/www.allergy.org.au\/patients\/skin-allergy)\n  - [Allergy prevention](https:\/\/www.allergy.org.au\/patients\/allergy-prevention)\n  - [Allergy testing](https:\/\/www.allergy.org.au\/patients\/allergy-testing)\n  - [Allergy treatments](https:\/\/www.allergy.org.au\/patients\/allergy-treatments)\n  - [Asthma and allergy](https:\/\/www.allergy.org.au\/patients\/asthma-and-allergy)\n  - [Autoimmunity](https:\/\/www.allergy.org.au\/patients\/autoimmunity)\n  - [Drug allergy](https:\/\/www.allergy.org.au\/patients\/drug-allergy)\n  \n  - [Food allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy)\n  - [Food other adverse reactions](https:\/\/www.allergy.org.au\/patients\/food-other-adverse-reactions)\n  - [Immune system](https:\/\/www.allergy.org.au\/patients\/immune-system)\n  - [Immunisation](https:\/\/www.allergy.org.au\/patients\/immunisation)\n  - [Immunodeficiencies](https:\/\/www.allergy.org.au\/patients\/immunodeficiencies)\n  - [Insect and tick allergy](https:\/\/www.allergy.org.au\/patients\/insect-allergy-bites-and-stings)\n  - [Other allergies](https:\/\/www.allergy.org.au\/patients\/other-allergy)\n- [Schools](https:\/\/www.allergy.org.au\/schools-childcare)\n- [Meetings](https:\/\/www.allergy.org.au\/conferences)\n  - [Advanced Trainees](https:\/\/www.allergy.org.au\/conferences\/advanced-trainees)\n  - [ASCIA Annual Conference](https:\/\/www.allergy.org.au\/conferences\/ascia-annual-conference)\n  \n  - [ASCIA Education Meetings](https:\/\/www.allergy.org.au\/conferences\/education)\n  - [ASCIA Online Meetings](https:\/\/www.allergy.org.au\/conferences\/online-meetings)\n  \n  - [Calendar: Conferences, Meetings, Events](https:\/\/www.allergy.org.au\/conferences\/calendar)\n  - [Immunopathology](https:\/\/www.allergy.org.au\/conferences\/immunopathology)\n- [Reports](https:\/\/www.allergy.org.au\/ascia-reports)\n  - [ASCIA Annual Highlights, Reports and AGM Minutes](https:\/\/www.allergy.org.au\/ascia-reports#s2)\n  - [ASCIA Scope of Practice documents](https:\/\/www.allergy.org.au\/ascia-reports#s3)\n  - [Cost of allergic disease in Australia](https:\/\/www.allergy.org.au\/ascia-reports-economic)\n  \n  - [National Allergy Strategy](https:\/\/www.allergy.org.au\/ascia-reports#s4)\n  - [NPS Choosing Wisely and RACP Evolve](https:\/\/www.allergy.org.au\/ascia-reports#s5)\n  - [Allergy in Australia 2014](https:\/\/www.allergy.org.au\/ascia-reports#s6)\n  \n  - [Allergy and Immune Diseases in Australia (AIDA) Report 2013](https:\/\/www.allergy.org.au\/ascia-reports#s7)\n  - [ASCIA Education Resources Report 2013](https:\/\/www.allergy.org.au\/ascia-reports#s8)\n  - [Economic Impact of Allergies Report 2007](https:\/\/www.allergy.org.au\/ascia-reports#s9)\n- [Submissions](https:\/\/www.allergy.org.au\/ascia-submissions)\n  - [All ASCIA Submissions](https:\/\/www.allergy.org.au\/ascia-submissions)\n  - [Submissions 2025](https:\/\/www.allergy.org.au\/ascia-submissions\/2025)\n  - [Submissions 2024](https:\/\/www.allergy.org.au\/ascia-submissions\/2024)\n  - [Submissions 2023](https:\/\/www.allergy.org.au\/ascia-submissions\/2023)\n  - [Submissions 2022](https:\/\/www.allergy.org.au\/ascia-submissions\/2022)\n  - [Submissions 2021](https:\/\/www.allergy.org.au\/ascia-submissions\/2021)\n  - [Submissions 2020](https:\/\/www.allergy.org.au\/ascia-submissions\/2020)\n  - [Submissions 2019](https:\/\/www.allergy.org.au\/ascia-submissions\/2019)\n- [Telehealth](https:\/\/www.allergy.org.au\/ascia-telehealth)\n  - [Resources](https:\/\/www.allergy.org.au\/ascia-telehealth)\n  - [ASCIA plans and guides](https:\/\/www.allergy.org.au\/ascia-telehealth#plans)\n  - [ASCIA checklists and forms](https:\/\/www.allergy.org.au\/ascia-telehealth#checklists)\n  - [Adrenaline injector instructions](https:\/\/www.allergy.org.au\/ascia-telehealth#aai)\n  - [ASCIA information for patients, carers and community](https:\/\/www.allergy.org.au\/ascia-telehealth#pcc)\n  - [National Allergy Council Resources](https:\/\/www.allergy.org.au\/ascia-telehealth#nas)\n- [Quicklinks](https:\/\/www.allergy.org.au\/about-ascia\/quick-links)\n- [Referrals](https:\/\/www.allergy.org.au\/patients\/allergy-and-clinical-immunology-services)\n- [Videos](https:\/\/www.allergy.org.au\/ascia-videos)\n\n- [Home](https:\/\/www.allergy.org.au\/)\n- [Patients](https:\/\/www.allergy.org.au\/patients)\n- [Food allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy)\n- Allergic and toxic reactions to seafood\n\n[Listen](https:\/\/app-eu.readspeaker.com\/cgi-bin\/rsent?customerid=12404&lang=en_au&readid=rs_read_this2&audiofilename=Allergic_and_Toxic_Reactions_to_Seafood___Australasian_Society_of_Clinical_Immunology_and_Allergy__ASCIA_&url=https%3A%2F%2Fwww.allergy.org.au%2Fpatients%2Ffood-allergy%2Fallergic-and-toxic-reactions-to-seafood \"Listen\")\n\n# Allergic and Toxic Reactions to Seafood\n[Email](https:\/\/www.allergy.org.au\/#email)\n\n[Print](https:\/\/www.allergy.org.au\/#print)\n### Frequently Asked Questions\nThis document has been developed by [ASCIA](https:\/\/www.allergy.org.au\/), the peak professional body of clinical immunology\/allergy specialists in Australia and New Zealand. ASCIA information is based on published literature and expert review, is not influenced by commercial organisations and is not intended to replace medical advice.\n\nFor patient or carer support contact [Allergy & Anaphylaxis Australia](https:\/\/allergyfacts.org.au\/) or [Allergy New Zealand](https:\/\/www.allergy.org.nz\/).\n\n[![pdf](https:\/\/www.allergy.org.au\/media\/jce\/icons\/pdf.png)ASCIA PC Seafood Allergy FAQ 2024 187\\.78 KB](https:\/\/www.allergy.org.au\/images\/pc\/ASCIA_PC_Seafood_Allergy_FAQ_2024.pdf \"ASCIA PC Seafood Allergy FAQ 2024 \")\n\n#### Q 1: Is seafood allergy common?\nSeafood allergy occurs most commonly where seafood is an important part of the diet, such as in Asia and Scandinavia. Approximately 1% of the population is estimated to have a seafood allergy. It is more common in teenage and adult life than very early childhood. About 20% of people will grow out of their seafood allergy with time.\n\n#### Q 2: What types of seafood cause allergic reactions?\nThe major groups of seafood that can trigger allergic reactions:\n\n**Fish** (vertebrates - with a backbone)\n\n- Including salmon, cod, mackerel, sardines, herring, anchovies, tuna, trout, haddock, eels and rays.\n\n**Shellfish** (invertebrates – without a backbone)\n\n- Crustaceans including prawns\/shrimps, lobster, crab, crayfish, and yabbies.\n- Molluscs including oysters, mussels, clams, octopus, squid (calamari), abalone, and sea slugs.\n\nThe protein allergens present in one seafood group can be very different to those in other seafood groups. This means that a person can be allergic to fish only, shellfish only, or members of both groups. People who are allergic to one fish are usually (but not always) allergic to most other fish.\n\n#### Q 3: What is cross reactivity?\nCross reactivity means that a similar protein is present in a range of different foods. If the same protein is present in several foods, then that person may have allergic reactions to any food containing that protein. Examples of cross reactivity include people allergic to similar proteins present in one fish that are also present in other fish, or those allergic to proteins present in prawn, crab and lobster.\n\nAllergy to one crustacean usually means that all must be avoided. People with allergy to seafood from one group (such as crustaceans) may tolerate seafood from another group (such as molluscs). This can only be confirmed with allergy testing and guidance from a clinical immunology\/allergy specialist.\n\n#### Q 4: How are people exposed to the seafood allergen?\nEating seafood is the major trigger for allergic reactions.\n\nSensitive people may sometimes have breathing difficulties from inhaling fumes when seafood is being cooked, and in seafood processing factories. They may also have symptoms from touching seafood, such as when cleaning and handling fish.\n\nSymptoms caused by allergic reactions to seafood usually appear within minutes. Delayed reactions and exercise-induced anaphylaxis can occur, particularly after eating shellfish such as oyster, abalone, squid, and shrimp.\n\n#### Q 5: What are the signs and symptoms of allergic reactions to seafood?\nSigns and symptoms of **mild to moderate allergic reactions** to foods include:\n\n- Swelling of the lips, face, eyes\n- Hives or welts on the skin\n- Abdominal pain, vomiting\n\nSigns of **anaphylaxis** to foods include any one of the following:\n\n- Difficult or noisy breathing\n- Swelling of the tongue\n- Swelling or tightness in the throat\n- Wheeze or persistent cough\n- Difficulty talking or hoarse voice\n- Persistent dizziness or collapse\n- Pale and floppy (in young children)\n\nAnaphylaxis is the most severe type of allergic reaction and should always be treated as a medical emergency. Anaphylaxis requires immediate treatment with adrenaline (epinephrine), which is injected into the outer mid-thigh muscle. Delayed treatment can result in fatal anaphylaxis.\n\n#### Q 6: How is a food allergy diagnosed?\nAccurate diagnosis of food allergy is important. A doctor (GP) will ask questions that may help to narrow down the list of likely causes of allergy such as foods or medicines consumed that day, or exposure to stinging insects. This approach will also help to exclude conditions that can sometimes be confused with food allergy. A referral to a clinical immunology\/allergy specialist may be given.\n\nSkin or blood allergen specific IgE allergy tests help confirm or exclude potential triggers. While the results of allergy testing by a specialist are a guide to whether the person is allergic, results will not be able to tell you whether your reaction will be mild or severe.\n\nIt may not be possible to test for all seafood species using commercial skin prick or blood allergy testing, since these are not available for all seafood species. For this reason, some allergy clinics will recommend that you bring samples of fresh food for testing.\n\n#### Q 7: Are there ‘allergy testing’ methods which are unproven and not recommended?\nSome unorthodox\/alternative practitioners offer unproven, non-evidence-based allergy ‘tests’ and ‘treatments’ that are not recommended by ASCIA.\n\nThese include cytotoxic food testing, kinesiology, hair analysis, vega testing, electrodermal testing, pulse testing, reflexology, bioresonance, Bryan’s or Alcat tests, VoiceBio, allergy elimination techniques and immunoglobulin G (IgG) to foods. These tests can result in misdiagnosis, ineffective treatments, costly and often dangerous dietary restrictions.\n\n#### Q 8: How is seafood allergy managed?\nPeople can learn to manage their seafood allergy with the guidance of their clinical immunology\/allergy specialist. It is important for people with confirmed food allergy to:\n\n- Avoid confirmed food allergens.\n- Know the signs and symptoms of allergic reactions and know what to do when a reaction occurs.\n- Carry their adrenaline injector (if prescribed) and ASCIA Action Plan at all times.\n#### Q 9: How can seafood be avoided?\nAvoidance of one or more groups of seafood is often advised to manage confirmed seafood allergy. Accidental exposure is more likely to happen when eating away from home.\n\nOther potential sources of accidental exposure and cross-contamination include:\n\n- Seafood platters and buffets.\n- Asian foods often contain shellfish as a common ingredient or contaminant such as prawns in fried rice or soups, and seafood extender.\n- Takeaway food which may be rolled in the same batter or cooked in the same oil as seafood.\n- Commercial pizzas where contamination may happen during preparation.\n- Anchovies in Caesar salads, and as an ingredient in Worcestershire sauce.\n- Contaminated barbeques where seafood has been cooked.\n\nIsinglass is sometimes used as a fining agent to remove cloudiness from beer and wine. Made from the swim bladder of certain types of fish, it consists almost entirely of collagen, and is considered unlikely to cause allergic reactions. Use of isinglass in beer and wine has been exempted from mandatory labelling regulations in Australia.\n\nWhile the risk of allergic reactions to fish oils is low in those allergic to fish due to the method of purification, people with fish allergy are advised to seek medical advice before consuming. Other sources of omega-3 fatty acids include evening primrose oil and flaxseed oil.\n\n#### Q 10: Does cooking seafood affect tolerance?\nSeafood allergens are usually heat stable and cannot easily be destroyed through cooking. Some people can tolerate tinned fish (intensely heat treated) yet are unable to tolerate the same fish when freshly cooked.\n\n#### Q 11: Are seafood allergy and iodine allergy related?\nPeople with seafood allergy react to proteins in the seafood, not to iodine in the fish or shellfish. People who are allergic to seafood are not at an increased risk of allergic reactions to iodine in topical antiseptics such as Betadine or Povidine, or intravenous x-ray radio-contrast agents.   \n People with iodine allergy are not at increased risk of seafood allergy.\n\n#### Q 12: Is allergy to glucosamine common?\nAllergic reactions to glucosamine are not common. Glucosamine is a popular complementary medicine used to treat osteoarthritis. It is derived from the outer coatings of shellfish such as crustaceans. Sometimes chondroitin sulfate is added, usually derived from shark cartilage.\n\nProducts containing glucosamine registered in Australia and New Zealand carry labels warning against their use in people allergic to shellfish\/crustaceans. Vegetarian glucosamine is available which does not contain seafood allergen as it is produced in bacteria cultures.\n\n#### Q 13: What toxic reactions look like seafood allergy?\nSome conditions caused by toxins or parasites in seafood can resemble allergic reactions to seafood.\n\n**Scombroid Fish Poisoning**\n\nAn allergy-like reaction that occurs after eating fish that has high levels of histamine because it has not been properly stored or processed. This is more common in fish which turns brown upon cooking. This including mackerel, tuna, king fish, herring, sardines, marlin, anchovies and bluefish. Affected fish often have a metallic or peppery taste.\n\nScombroid poisoning symptoms usually start within 30 minutes of eating. These include flushing, itch, hives (urticaria), nausea, vomiting, stomach cramps, dizziness, palpitations and headache. Severe reactions may result in wheezing and dizziness or a drop in blood pressure. Urgent medical assistance is required. Treatment usually involves taking antihistamines, and sometimes adrenaline is given in a hospital setting. Scombroid poisoning can be identified by the pattern of symptoms and the absence of reactions with skin or blood allergy testing.\n\n**Anisakis Simplex**\n\nThis is a nematode (worm) that is a fish parasite found in most parts of the world, including Australia. The parasite is killed when cooked at temperatures above 60oC or if stored in industrial freezers for two days. Anisakis can cause two major problems in people:\n\n- Anisakis *infection* (anisakiasis) can result from eating raw or undercooked seafood. Infection may cause nausea, vomiting, stomach pain, and sometimes appendicitis, bowel blockage or bleeding. Symptoms occur due to inflammation in the gut. Diagnosis requires an endoscopy where a specialist doctor uses a tube to observe the inside of the stomach and bowel. The parasite usually gets destroyed by our immune system after three weeks, but surgery may be required.\n- Anisakis *allergy* resembles other allergic reactions to food. In this case, the allergy is to the fish parasite, not to the fish itself. Reactions occur sometimes after eating seafood, rather than on every occasion. The allergens of Anisakis simplex are not destroyed by heat or cooking and so allergic reactions may be triggered by dead parasites in fish that have been well cooked. Blood allergy testing is available to confirm suspected sensitivity to this parasite.\n\n**Ciguatera Poisoning, Paralytic Shellfish Poisoning** **and Diarrhoetic Shellfish Poisoning**\n\nCiguatera poisoning is caused by eating seafood that has been contaminated by algae-derived toxins. Ciguatera toxins are only present in fish, particularly large reef fish in the tropics. Paralytic shellfish poisoning and diarrhoetic shellfish poisoning is caused by shellfish contaminated with microorganisms (i.e. algae producing toxins), in particular mussels and oysters. These toxins or poisons interfere with the function of nerve endings.\n\nSymptoms occur within two to three hours of eating contaminated food, and consist of tingling of the lips, tongue and throat, often followed by stomach upset, headache, fever, muscle aches and pains and in the case of ciguatera poisoning, sometimes changes in blood pressure and heart rhythm. Numbness, collapse, coma and confusion have also been described. Most people recover within a few days or weeks with supportive treatment.\n\n**Metabisulfite** **Reactions**\n\nMetabisulfite preservative can sometimes be used to stop crustaceans (such as prawns) from discolouring. This preservative is also used in wine, beer and some dried fruit as a preservative. Adverse reactions include wheezing\/tight chest (more common in those with asthma), stomach irritation (such as nausea and pain), and rarely itch\/rashes.\n\nToxic and other adverse reactions to seafood are outlined in the table below.\n\n**Table: Toxic and other adverse reactions to seafood**\n\n|   |   |   |   |   |\n|---|---|---|---|---|\n| **Cause** | **Seafood** **implicated** | **Clinical symptoms** | **Time of** **onset** | **Allergy test** |\n| **Bacterial infection** Salmonella, Vibrio, Aeromonas, Listeria | Crustacean, Mollusc, Fish | Dermatological Gastrointestinal Neurological Respiratory | Minutes to several hours | Negative |\n| **Viral infection** Hepatitis A, Rota-  Astrovirus, Small round Viruses etc. | Crustacean, Mollusc | Negative |   |   |\n| **Seafood parasites** Anisakis Diphyllobothrium | All fish and some molluscs | Negative |   |   |\n| **Toxins** **1\\)** Scombrotoxin **Marine Toxins** **2\\)** Ciguatera toxin **3\\)** Algae toxins | 1\\) Fish, particularly with dark meat  2\\) Reef fish 3\\) All Mollusc species | Negative |   |   |\n| **Allergens** Shellfish | Crustacean Mollusc Fish | Positive |   |   |\n\n**© ASCIA 2024**\n\nContent updated April 2024\n\nFor more information go to [www.allergy.org.au\/patients\/food-allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/)\n\nTo support allergy and immunology research go to [www.allergyimmunology.org.au\/donate](https:\/\/www.allergyimmunology.org.au\/donate)\n\n### Food allergy\n- [Food allergy overview](https:\/\/www.allergy.org.au\/patients\/food-allergy)\n- [ASCIA Dietary avoidance for food allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy)\n  - [Cow's milk protein (dairy)](https:\/\/www.allergy.org.au\/patients\/food-allergy\/ascia-dietary-avoidance-for-food-allergy\/cows-milk-dairy)\n  - [Cow's milk protein (dairy) and 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ASCIA information is based on published literature and expert review, is not influenced by commercial organisations and is not intended to replace medical advice.\n\nFor patient or carer support contact [Allergy & Anaphylaxis Australia](https:\/\/allergyfacts.org.au\/) or [Allergy New Zealand](https:\/\/www.allergy.org.nz\/).\n\n[![pdf](https:\/\/www.allergy.org.au\/media\/jce\/icons\/pdf.png)ASCIA PC Seafood Allergy FAQ 2024 187\\.78 KB](https:\/\/www.allergy.org.au\/images\/pc\/ASCIA_PC_Seafood_Allergy_FAQ_2024.pdf \"ASCIA PC Seafood Allergy FAQ 2024 \")\n\n#### Q 1: Is seafood allergy common?\nSeafood allergy occurs most commonly where seafood is an important part of the diet, such as in Asia and Scandinavia. Approximately 1% of the population is estimated to have a seafood allergy. It is more common in teenage and adult life than very early childhood. About 20% of people will grow out of their seafood allergy with time.\n\n#### Q 2: What types of seafood cause allergic reactions?\nThe major groups of seafood that can trigger allergic reactions:\n\n**Fish** (vertebrates - with a backbone)\n\n- Including salmon, cod, mackerel, sardines, herring, anchovies, tuna, trout, haddock, eels and rays.\n\n**Shellfish** (invertebrates – without a backbone)\n\n- Crustaceans including prawns\/shrimps, lobster, crab, crayfish, and yabbies.\n- Molluscs including oysters, mussels, clams, octopus, squid (calamari), abalone, and sea slugs.\n\nThe protein allergens present in one seafood group can be very different to those in other seafood groups. This means that a person can be allergic to fish only, shellfish only, or members of both groups. People who are allergic to one fish are usually (but not always) allergic to most other fish.\n\n#### Q 3: What is cross reactivity?\nCross reactivity means that a similar protein is present in a range of different foods. If the same protein is present in several foods, then that person may have allergic reactions to any food containing that protein. Examples of cross reactivity include people allergic to similar proteins present in one fish that are also present in other fish, or those allergic to proteins present in prawn, crab and lobster.\n\nAllergy to one crustacean usually means that all must be avoided. People with allergy to seafood from one group (such as crustaceans) may tolerate seafood from another group (such as molluscs). This can only be confirmed with allergy testing and guidance from a clinical immunology\/allergy specialist.\n\n#### Q 4: How are people exposed to the seafood allergen?\nEating seafood is the major trigger for allergic reactions.\n\nSensitive people may sometimes have breathing difficulties from inhaling fumes when seafood is being cooked, and in seafood processing factories. They may also have symptoms from touching seafood, such as when cleaning and handling fish.\n\nSymptoms caused by allergic reactions to seafood usually appear within minutes. Delayed reactions and exercise-induced anaphylaxis can occur, particularly after eating shellfish such as oyster, abalone, squid, and shrimp.\n\n#### Q 5: What are the signs and symptoms of allergic reactions to seafood?\nSigns and symptoms of **mild to moderate allergic reactions** to foods include:\n\n- Swelling of the lips, face, eyes\n- Hives or welts on the skin\n- Abdominal pain, vomiting\n\nSigns of **anaphylaxis** to foods include any one of the following:\n\n- Difficult or noisy breathing\n- Swelling of the tongue\n- Swelling or tightness in the throat\n- Wheeze or persistent cough\n- Difficulty talking or hoarse voice\n- Persistent dizziness or collapse\n- Pale and floppy (in young children)\n\nAnaphylaxis is the most severe type of allergic reaction and should always be treated as a medical emergency. Anaphylaxis requires immediate treatment with adrenaline (epinephrine), which is injected into the outer mid-thigh muscle. Delayed treatment can result in fatal anaphylaxis.\n\n#### Q 6: How is a food allergy diagnosed?\nAccurate diagnosis of food allergy is important. A doctor (GP) will ask questions that may help to narrow down the list of likely causes of allergy such as foods or medicines consumed that day, or exposure to stinging insects. This approach will also help to exclude conditions that can sometimes be confused with food allergy. A referral to a clinical immunology\/allergy specialist may be given.\n\nSkin or blood allergen specific IgE allergy tests help confirm or exclude potential triggers. While the results of allergy testing by a specialist are a guide to whether the person is allergic, results will not be able to tell you whether your reaction will be mild or severe.\n\nIt may not be possible to test for all seafood species using commercial skin prick or blood allergy testing, since these are not available for all seafood species. For this reason, some allergy clinics will recommend that you bring samples of fresh food for testing.\n\n#### Q 7: Are there ‘allergy testing’ methods which are unproven and not recommended?\nSome unorthodox\/alternative practitioners offer unproven, non-evidence-based allergy ‘tests’ and ‘treatments’ that are not recommended by ASCIA.\n\nThese include cytotoxic food testing, kinesiology, hair analysis, vega testing, electrodermal testing, pulse testing, reflexology, bioresonance, Bryan’s or Alcat tests, VoiceBio, allergy elimination techniques and immunoglobulin G (IgG) to foods. These tests can result in misdiagnosis, ineffective treatments, costly and often dangerous dietary restrictions.\n\n#### Q 8: How is seafood allergy managed?\nPeople can learn to manage their seafood allergy with the guidance of their clinical immunology\/allergy specialist. It is important for people with confirmed food allergy to:\n\n- Avoid confirmed food allergens.\n- Know the signs and symptoms of allergic reactions and know what to do when a reaction occurs.\n- Carry their adrenaline injector (if prescribed) and ASCIA Action Plan at all times.\n#### Q 9: How can seafood be avoided?\nAvoidance of one or more groups of seafood is often advised to manage confirmed seafood allergy. Accidental exposure is more likely to happen when eating away from home.\n\nOther potential sources of accidental exposure and cross-contamination include:\n\n- Seafood platters and buffets.\n- Asian foods often contain shellfish as a common ingredient or contaminant such as prawns in fried rice or soups, and seafood extender.\n- Takeaway food which may be rolled in the same batter or cooked in the same oil as seafood.\n- Commercial pizzas where contamination may happen during preparation.\n- Anchovies in Caesar salads, and as an ingredient in Worcestershire sauce.\n- Contaminated barbeques where seafood has been cooked.\n\nIsinglass is sometimes used as a fining agent to remove cloudiness from beer and wine. Made from the swim bladder of certain types of fish, it consists almost entirely of collagen, and is considered unlikely to cause allergic reactions. Use of isinglass in beer and wine has been exempted from mandatory labelling regulations in Australia.\n\nWhile the risk of allergic reactions to fish oils is low in those allergic to fish due to the method of purification, people with fish allergy are advised to seek medical advice before consuming. Other sources of omega-3 fatty acids include evening primrose oil and flaxseed oil.\n\n#### Q 10: Does cooking seafood affect tolerance?\nSeafood allergens are usually heat stable and cannot easily be destroyed through cooking. Some people can tolerate tinned fish (intensely heat treated) yet are unable to tolerate the same fish when freshly cooked.\n\n#### Q 11: Are seafood allergy and iodine allergy related?\nPeople with seafood allergy react to proteins in the seafood, not to iodine in the fish or shellfish. People who are allergic to seafood are not at an increased risk of allergic reactions to iodine in topical antiseptics such as Betadine or Povidine, or intravenous x-ray radio-contrast agents.   \n People with iodine allergy are not at increased risk of seafood allergy.\n\n#### Q 12: Is allergy to glucosamine common?\nAllergic reactions to glucosamine are not common. Glucosamine is a popular complementary medicine used to treat osteoarthritis. It is derived from the outer coatings of shellfish such as crustaceans. Sometimes chondroitin sulfate is added, usually derived from shark cartilage.\n\nProducts containing glucosamine registered in Australia and New Zealand carry labels warning against their use in people allergic to shellfish\/crustaceans. Vegetarian glucosamine is available which does not contain seafood allergen as it is produced in bacteria cultures.\n\n#### Q 13: What toxic reactions look like seafood allergy?\nSome conditions caused by toxins or parasites in seafood can resemble allergic reactions to seafood.\n\n**Scombroid Fish Poisoning**\n\nAn allergy-like reaction that occurs after eating fish that has high levels of histamine because it has not been properly stored or processed. This is more common in fish which turns brown upon cooking. This including mackerel, tuna, king fish, herring, sardines, marlin, anchovies and bluefish. Affected fish often have a metallic or peppery taste.\n\nScombroid poisoning symptoms usually start within 30 minutes of eating. These include flushing, itch, hives (urticaria), nausea, vomiting, stomach cramps, dizziness, palpitations and headache. Severe reactions may result in wheezing and dizziness or a drop in blood pressure. Urgent medical assistance is required. Treatment usually involves taking antihistamines, and sometimes adrenaline is given in a hospital setting. Scombroid poisoning can be identified by the pattern of symptoms and the absence of reactions with skin or blood allergy testing.\n\n**Anisakis Simplex**\n\nThis is a nematode (worm) that is a fish parasite found in most parts of the world, including Australia. The parasite is killed when cooked at temperatures above 60oC or if stored in industrial freezers for two days. Anisakis can cause two major problems in people:\n\n- Anisakis *infection* (anisakiasis) can result from eating raw or undercooked seafood. Infection may cause nausea, vomiting, stomach pain, and sometimes appendicitis, bowel blockage or bleeding. Symptoms occur due to inflammation in the gut. Diagnosis requires an endoscopy where a specialist doctor uses a tube to observe the inside of the stomach and bowel. The parasite usually gets destroyed by our immune system after three weeks, but surgery may be required.\n- Anisakis *allergy* resembles other allergic reactions to food. In this case, the allergy is to the fish parasite, not to the fish itself. Reactions occur sometimes after eating seafood, rather than on every occasion. The allergens of Anisakis simplex are not destroyed by heat or cooking and so allergic reactions may be triggered by dead parasites in fish that have been well cooked. Blood allergy testing is available to confirm suspected sensitivity to this parasite.\n\n**Ciguatera Poisoning, Paralytic Shellfish Poisoning** **and Diarrhoetic Shellfish Poisoning**\n\nCiguatera poisoning is caused by eating seafood that has been contaminated by algae-derived toxins. Ciguatera toxins are only present in fish, particularly large reef fish in the tropics. Paralytic shellfish poisoning and diarrhoetic shellfish poisoning is caused by shellfish contaminated with microorganisms (i.e. algae producing toxins), in particular mussels and oysters. These toxins or poisons interfere with the function of nerve endings.\n\nSymptoms occur within two to three hours of eating contaminated food, and consist of tingling of the lips, tongue and throat, often followed by stomach upset, headache, fever, muscle aches and pains and in the case of ciguatera poisoning, sometimes changes in blood pressure and heart rhythm. Numbness, collapse, coma and confusion have also been described. Most people recover within a few days or weeks with supportive treatment.\n\n**Metabisulfite** **Reactions**\n\nMetabisulfite preservative can sometimes be used to stop crustaceans (such as prawns) from discolouring. This preservative is also used in wine, beer and some dried fruit as a preservative. Adverse reactions include wheezing\/tight chest (more common in those with asthma), stomach irritation (such as nausea and pain), and rarely itch\/rashes.\n\nToxic and other adverse reactions to seafood are outlined in the table below.\n\n**Table: Toxic and other adverse reactions to seafood**\n\n|   |   |   |   |   |\n|---|---|---|---|---|\n| **Cause** | **Seafood** **implicated** | **Clinical symptoms** | **Time of** **onset** | **Allergy test** |\n| **Bacterial infection** Salmonella, Vibrio, Aeromonas, Listeria | Crustacean, Mollusc, Fish | Dermatological Gastrointestinal Neurological Respiratory | Minutes to several hours | Negative |\n| **Viral infection** Hepatitis A, Rota-  Astrovirus, Small round Viruses etc. | Crustacean, Mollusc | Negative |   |   |\n| **Seafood parasites** Anisakis Diphyllobothrium | All fish and some molluscs | Negative |   |   |\n| **Toxins** **1\\)** Scombrotoxin **Marine Toxins** **2\\)** Ciguatera toxin **3\\)** Algae toxins | 1\\) Fish, particularly with dark meat  2\\) Reef fish 3\\) All Mollusc species | Negative |   |   |\n| **Allergens** Shellfish | Crustacean Mollusc Fish | Positive |   |   |\n\n**© ASCIA 2024**\n\nContent updated April 2024\n\nFor more information go to [www.allergy.org.au\/patients\/food-allergy](https:\/\/www.allergy.org.au\/patients\/food-allergy\/)\n\nTo support allergy and immunology research go to [www.allergyimmunology.org.au\/donate](https:\/\/www.allergyimmunology.org.au\/donate)","meta_canonical":null}

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Boilerpipe Text	Frequently Asked Questions This document has been developed by ASCIA , the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand. ASCIA information is based on published literature and expert review, is not influenced by commercial organisations and is not intended to replace medical advice. For patient or carer support contact Allergy & Anaphylaxis Australia or Allergy New Zealand . ASCIA PC Seafood Allergy FAQ 2024 187.78 KB Q 1: Is seafood allergy common? Seafood allergy occurs most commonly where seafood is an important part of the diet, such as in Asia and Scandinavia. Approximately 1% of the population is estimated to have a seafood allergy. It is more common in teenage and adult life than very early childhood. About 20% of people will grow out of their seafood allergy with time. Q 2: What types of seafood cause allergic reactions? The major groups of seafood that can trigger allergic reactions: Fish (vertebrates - with a backbone) Including salmon, cod, mackerel, sardines, herring, anchovies, tuna, trout, haddock, eels and rays. Shellfish (invertebrates – without a backbone) Crustaceans including prawns/shrimps, lobster, crab, crayfish, and yabbies. Molluscs including oysters, mussels, clams, octopus, squid (calamari), abalone, and sea slugs. The protein allergens present in one seafood group can be very different to those in other seafood groups. This means that a person can be allergic to fish only, shellfish only, or members of both groups. People who are allergic to one fish are usually (but not always) allergic to most other fish. Q 3: What is cross reactivity? Cross reactivity means that a similar protein is present in a range of different foods. If the same protein is present in several foods, then that person may have allergic reactions to any food containing that protein. Examples of cross reactivity include people allergic to similar proteins present in one fish that are also present in other fish, or those allergic to proteins present in prawn, crab and lobster. Allergy to one crustacean usually means that all must be avoided. People with allergy to seafood from one group (such as crustaceans) may tolerate seafood from another group (such as molluscs). This can only be confirmed with allergy testing and guidance from a clinical immunology/allergy specialist. Q 4: How are people exposed to the seafood allergen? Eating seafood is the major trigger for allergic reactions. Sensitive people may sometimes have breathing difficulties from inhaling fumes when seafood is being cooked, and in seafood processing factories. They may also have symptoms from touching seafood, such as when cleaning and handling fish. Symptoms caused by allergic reactions to seafood usually appear within minutes. Delayed reactions and exercise-induced anaphylaxis can occur, particularly after eating shellfish such as oyster, abalone, squid, and shrimp. Q 5: What are the signs and symptoms of allergic reactions to seafood? Signs and symptoms of mild to moderate allergic reactions to foods include: Swelling of the lips, face, eyes Hives or welts on the skin Abdominal pain, vomiting Signs of anaphylaxis to foods include any one of the following: Difficult or noisy breathing Swelling of the tongue Swelling or tightness in the throat Wheeze or persistent cough Difficulty talking or hoarse voice Persistent dizziness or collapse Pale and floppy (in young children) Anaphylaxis is the most severe type of allergic reaction and should always be treated as a medical emergency. Anaphylaxis requires immediate treatment with adrenaline (epinephrine), which is injected into the outer mid-thigh muscle. Delayed treatment can result in fatal anaphylaxis. Q 6: How is a food allergy diagnosed? Accurate diagnosis of food allergy is important. A doctor (GP) will ask questions that may help to narrow down the list of likely causes of allergy such as foods or medicines consumed that day, or exposure to stinging insects. This approach will also help to exclude conditions that can sometimes be confused with food allergy. A referral to a clinical immunology/allergy specialist may be given. Skin or blood allergen specific IgE allergy tests help confirm or exclude potential triggers. While the results of allergy testing by a specialist are a guide to whether the person is allergic, results will not be able to tell you whether your reaction will be mild or severe. It may not be possible to test for all seafood species using commercial skin prick or blood allergy testing, since these are not available for all seafood species. For this reason, some allergy clinics will recommend that you bring samples of fresh food for testing. Q 7: Are there ‘allergy testing’ methods which are unproven and not recommended? Some unorthodox/alternative practitioners offer unproven, non-evidence-based allergy ‘tests’ and ‘treatments’ that are not recommended by ASCIA. These include cytotoxic food testing, kinesiology, hair analysis, vega testing, electrodermal testing, pulse testing, reflexology, bioresonance, Bryan’s or Alcat tests, VoiceBio, allergy elimination techniques and immunoglobulin G (IgG) to foods. These tests can result in misdiagnosis, ineffective treatments, costly and often dangerous dietary restrictions. Q 8: How is seafood allergy managed? People can learn to manage their seafood allergy with the guidance of their clinical immunology/allergy specialist. It is important for people with confirmed food allergy to: Avoid confirmed food allergens. Know the signs and symptoms of allergic reactions and know what to do when a reaction occurs. Carry their adrenaline injector (if prescribed) and ASCIA Action Plan at all times. Q 9: How can seafood be avoided? Avoidance of one or more groups of seafood is often advised to manage confirmed seafood allergy. Accidental exposure is more likely to happen when eating away from home. Other potential sources of accidental exposure and cross-contamination include: Seafood platters and buffets. Asian foods often contain shellfish as a common ingredient or contaminant such as prawns in fried rice or soups, and seafood extender. Takeaway food which may be rolled in the same batter or cooked in the same oil as seafood. Commercial pizzas where contamination may happen during preparation. Anchovies in Caesar salads, and as an ingredient in Worcestershire sauce. Contaminated barbeques where seafood has been cooked. Isinglass is sometimes used as a fining agent to remove cloudiness from beer and wine. Made from the swim bladder of certain types of fish, it consists almost entirely of collagen, and is considered unlikely to cause allergic reactions. Use of isinglass in beer and wine has been exempted from mandatory labelling regulations in Australia. While the risk of allergic reactions to fish oils is low in those allergic to fish due to the method of purification, people with fish allergy are advised to seek medical advice before consuming. Other sources of omega-3 fatty acids include evening primrose oil and flaxseed oil. Q 10: Does cooking seafood affect tolerance? Seafood allergens are usually heat stable and cannot easily be destroyed through cooking. Some people can tolerate tinned fish (intensely heat treated) yet are unable to tolerate the same fish when freshly cooked. Q 11: Are seafood allergy and iodine allergy related? People with seafood allergy react to proteins in the seafood, not to iodine in the fish or shellfish. People who are allergic to seafood are not at an increased risk of allergic reactions to iodine in topical antiseptics such as Betadine or Povidine, or intravenous x-ray radio-contrast agents. People with iodine allergy are not at increased risk of seafood allergy. Q 12: Is allergy to glucosamine common? Allergic reactions to glucosamine are not common. Glucosamine is a popular complementary medicine used to treat osteoarthritis. It is derived from the outer coatings of shellfish such as crustaceans. Sometimes chondroitin sulfate is added, usually derived from shark cartilage. Products containing glucosamine registered in Australia and New Zealand carry labels warning against their use in people allergic to shellfish/crustaceans. Vegetarian glucosamine is available which does not contain seafood allergen as it is produced in bacteria cultures. Q 13: What toxic reactions look like seafood allergy? Some conditions caused by toxins or parasites in seafood can resemble allergic reactions to seafood. Scombroid Fish Poisoning An allergy-like reaction that occurs after eating fish that has high levels of histamine because it has not been properly stored or processed. This is more common in fish which turns brown upon cooking. This including mackerel, tuna, king fish, herring, sardines, marlin, anchovies and bluefish. Affected fish often have a metallic or peppery taste. Scombroid poisoning symptoms usually start within 30 minutes of eating. These include flushing, itch, hives (urticaria), nausea, vomiting, stomach cramps, dizziness, palpitations and headache. Severe reactions may result in wheezing and dizziness or a drop in blood pressure. Urgent medical assistance is required. Treatment usually involves taking antihistamines, and sometimes adrenaline is given in a hospital setting. Scombroid poisoning can be identified by the pattern of symptoms and the absence of reactions with skin or blood allergy testing. Anisakis Simplex This is a nematode (worm) that is a fish parasite found in most parts of the world, including Australia. The parasite is killed when cooked at temperatures above 60 o C or if stored in industrial freezers for two days. Anisakis can cause two major problems in people: Anisakis infection (anisakiasis) can result from eating raw or undercooked seafood. Infection may cause nausea, vomiting, stomach pain, and sometimes appendicitis, bowel blockage or bleeding. Symptoms occur due to inflammation in the gut. Diagnosis requires an endoscopy where a specialist doctor uses a tube to observe the inside of the stomach and bowel. The parasite usually gets destroyed by our immune system after three weeks, but surgery may be required. Anisakis allergy resembles other allergic reactions to food. In this case, the allergy is to the fish parasite, not to the fish itself. Reactions occur sometimes after eating seafood, rather than on every occasion. The allergens of Anisakis simplex are not destroyed by heat or cooking and so allergic reactions may be triggered by dead parasites in fish that have been well cooked. Blood allergy testing is available to confirm suspected sensitivity to this parasite. Ciguatera Poisoning, Paralytic Shellfish Poisoning and Diarrhoetic Shellfish Poisoning Ciguatera poisoning is caused by eating seafood that has been contaminated by algae-derived toxins. Ciguatera toxins are only present in fish, particularly large reef fish in the tropics. Paralytic shellfish poisoning and diarrhoetic shellfish poisoning is caused by shellfish contaminated with microorganisms (i.e. algae producing toxins), in particular mussels and oysters. These toxins or poisons interfere with the function of nerve endings. Symptoms occur within two to three hours of eating contaminated food, and consist of tingling of the lips, tongue and throat, often followed by stomach upset, headache, fever, muscle aches and pains and in the case of ciguatera poisoning, sometimes changes in blood pressure and heart rhythm. Numbness, collapse, coma and confusion have also been described. Most people recover within a few days or weeks with supportive treatment. Metabisulfite Reactions Metabisulfite preservative can sometimes be used to stop crustaceans (such as prawns) from discolouring. This preservative is also used in wine, beer and some dried fruit as a preservative. Adverse reactions include wheezing/tight chest (more common in those with asthma), stomach irritation (such as nausea and pain), and rarely itch/rashes. Toxic and other adverse reactions to seafood are outlined in the table below. Table: Toxic and other adverse reactions to seafood Cause Seafood implicated Clinical symptoms Time of onset Allergy test Bacterial infection Salmonella, Vibrio, Aeromonas, Listeria Crustacean, Mollusc, Fish Dermatological Gastrointestinal Neurological Respiratory Minutes to several hours Negative Viral infection Hepatitis A, Rota- Astrovirus, Small round Viruses etc. Crustacean, Mollusc Negative Seafood parasites Anisakis Diphyllobothrium All fish and some molluscs Negative Toxins 1) Scombrotoxin Marine Toxins 2) Ciguatera toxin 3) Algae toxins 1) Fish, particularly with dark meat 2) Reef fish 3) All Mollusc species Negative Allergens Shellfish Crustacean Mollusc Fish Positive © ASCIA 2024 Content updated April 2024 For more information go to www.allergy.org.au/patients/food-allergy To support allergy and immunology research go to www.allergyimmunology.org.au/donate
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[ASCIA Member allergen immunotherapy information](https://www.allergy.org.au/members/allergen-immunotherapy-information) - [ASCIA Member donations to AIFA](https://www.allergy.org.au/about-ascia/aifa) - [ASCIA Member feedback](https://www.allergy.org.au/members/member-feedback) - [ASCIA Membership applications](https://www.allergy.org.au/members/apply) - [Medical Product Supply Updates](https://www.allergy.org.au/members/medical-product-updates) - [Positions](https://www.allergy.org.au/members/positions) - [ASCIA Website - member access](https://www.allergy.org.au/members/members-access) - [ASCIA Medical Associates](https://www.allergy.org.au/members/medical-associates) - [Dietitians](https://www.allergy.org.au/members/dietitians) - [Nurses](https://www.allergy.org.au/members/nurses) - [Scientists](https://www.allergy.org.au/members/scientists) - [Adrenaline device availability](https://www.allergy.org.au/members/adrenaline-device-availability) - [ASCIA Annual Reports](https://www.allergy.org.au/members/ascia-annual-reports) - [ASCIA Penicillin allergy guidelines](https://www.allergy.org.au/members/ascia-penicillin-allergy-guidelines) - [ASCIA FAC Register](https://facregister.ascia.org.au/) - [ASCIA ID Register](https://idregister.ascia.org.au/) - [ASCIA ID Register Access Film](https://www.allergy.org.au/hp/papers/id-register-access-film) - [ASCIA Member Publications](https://www.allergy.org.au/members/publications) - [ASCIA 2016 Conference Photographs](https://www.allergy.org.au/members/ascia-2016-conference-photographs) - [ASCIA 2015 Conference Photographs](https://www.allergy.org.au/members/ascia-2015-conference-photographs) - [ASCIA 2012 Conference Photographs](https://www.allergy.org.au/members/photographs-taken-at-ascia-2012) - [ASCIA 2011 Conference Photographs](https://www.allergy.org.au/members/photographs-taken-at-ascia-2011) - [Health Professionals](https://www.allergy.org.au/hp) - [Health Professionals](https://www.allergy.org.au/hp) - [Anaphylaxis Resources](https://www.allergy.org.au/hp/anaphylaxis) - [ASCIA Action Plan: Anaphylaxis](https://www.allergy.org.au/hp/anaphylaxis/ascia-action-plan-for-anaphylaxis) - [ASCIA Travel Plan: Anaphylaxis](https://www.allergy.org.au/hp/anaphylaxis/ascia-travel-plan-anaphylaxis) - [ASCIA Action Plans Frequently Asked Questions](https://www.allergy.org.au/hp/anaphylaxis/action-plans-for-allergic-reactions-faq) - [Anaphylaxis Checklist for GPs](https://www.allergy.org.au/hp/anaphylaxis/anaphylaxis-checklist) - [Anaphylaxis Checklist for Pharmacists](https://www.allergy.org.au/hp/anaphylaxis/anaphylaxis-checklist-for-pharmacists) - [ASCIA Management Summary for Allergic Conditions](https://www.allergy.org.au/hp/anaphylaxis/ascia-management-summary-allergic-conditions) - [Anaphylaxis Guidelines](https://www.allergy.org.au/hp/anaphylaxis/anaphylaxis-guidelines-for-schools-and-childrens-services) - [Anaphylaxis Event Record](https://www.allergy.org.au/hp/anaphylaxis/anaphylaxis-event-record) - [Signs and Symptoms of Allergic Reactions](https://www.allergy.org.au/hp/anaphylaxis/signs-and-symptoms-of-allergic-reactions) - [How to position a person having anaphylaxis](https://www.allergy.org.au/hp/anaphylaxis/positioning) - [Clinical History Form - allergic reactions](https://www.allergy.org.au/hp/anaphylaxis/clinical-history-form-allergic-reactions) - [First Aid for Anaphylaxis](https://www.allergy.org.au/hp/anaphylaxis/first-aid-for-anaphylaxis) - [First Aid Other Languages](https://www.allergy.org.au/hp/anaphylaxis/first-aid-for-anaphylaxis-other-languages) - [First Aid Languages - New Zealand](https://www.allergy.org.au/hp/anaphylaxis/first-aid-for-anaphylaxis-languages-nz) - [Fact Sheet for Parents Anaphylaxis - New Zealand](https://www.allergy.org.au/hp/anaphylaxis/fact-sheet-for-parents-anaphylaxis-nz) - [ASCIA Adrenaline Device Authority Form](https://www.allergy.org.au/hp/anaphylaxis/adrenaline-authority-form) - [ASCIA Guidelines for adrenaline device prescription](https://www.allergy.org.au/hp/anaphylaxis/adrenaline-device-prescription) - [Adrenaline devices\\|\\|General use](https://www.allergy.org.au/hp/anaphylaxis/adrenaline-devices-for-general-use) - [Adrenaline devices\\|\\|Storage, expiry, disposal](https://www.allergy.org.au/hp/anaphylaxis/adrenaline-devices-storage-expiry-and-disposal) - [Adrenaline devices](https://www.allergy.org.au/hp/anaphylaxis/adrenaline-devices) - [EpiPen® Jr Out of Stock](https://www.allergy.org.au/hp/anaphylaxis/epipen-jr-out-of-stock) - [How to give Epipen](https://www.allergy.org.au/hp/anaphylaxis/how-to-give-epipen) - [How to give Anapen](https://www.allergy.org.au/hp/anaphylaxis/how-to-give-anapen) - [How to give devices](https://www.allergy.org.au/hp/anaphylaxis/how-to-give-devices) - [How to give Epipen\\|\\|Languages New Zealand](https://www.allergy.org.au/hp/anaphylaxis/how-to-give-epipen-languages-nz) - [How to give Epipen\\|\\|Other Languages](https://www.allergy.org.au/hp/anaphylaxis/how-to-give-epipen-in-english-and-other-languages) - [Translations of anaphylaxis information](https://www.allergy.org.au/hp/anaphylaxis/translations-of-anaphylaxis-information) - [Drug allergy](https://www.allergy.org.au/hp/drug-allergy) - [Drug Allergy (Medication)](https://www.allergy.org.au/drug-allergy) - [ASCIA Antibiotic Allergy Challenges Consent Form](https://www.allergy.org.au/hp/drug-allergy/ascia-consent-form-antibiotic-allergy-challenges) - [ASCIA Action Plan Drug (Medication) Allergy](https://www.allergy.org.au/hp/drug-allergy/ascia-action-plan-drug-medication-allergy) - [ASCIA Radiocontrast Media Hypersensitivity](https://www.allergy.org.au/hp/drug-allergy/radiocontrast-media) - [ASCIA Record for Drug (Medication) Allergy](https://www.allergy.org.au/hp/drug-allergy/ascia-record-for-drug-medication-allergy) - [ASCIA Drug (Medication) Allergy Terms](https://www.allergy.org.au/hp/drug-allergy/ascia-drug-medication-allergy-terms) - [ASCIA Drug (Medication) Allergy Checklist - Patient and Carers](https://www.allergy.org.au/hp/drug-allergy/checklist-testing) - [Food Allergy](https://www.allergy.org.au/hp/food-allergy) - [Food – Other Adverse Reactions](https://www.allergy.org.au/hp/food-other-adverse-reactions) - [Respiratory Allergy - Allergic Rhinitis (Hay Fever), Asthma and Sinusitis](https://www.allergy.org.au/hp/allergic-rhinitis) - [Checklist: Non-Allergic Rhinitis, Allergic Rhinitis and Chronic Rhinosinusitis with Nasal Polyps](https://www.allergy.org.au/hp/allergic-rhinitis/nar-ar-crwnp) - [Venom Allergy](https://www.allergy.org.au/hp/venom-allergy) - [Other Allergy](https://www.allergy.org.au/hp/other-allergy) - [Allergen Immunotherapy](https://www.allergy.org.au/hp/immunotherapy) - [Allergy Prevention](https://www.allergy.org.au/hp/prevention) - [Allergy Testing](https://www.allergy.org.au/hp/tests) - [Skin](https://www.allergy.org.au/hp/skin) - [Checklist: Acute Urticaria and Chronic Urticaria](https://www.allergy.org.au/hp/skin/acute-chronic-urticaria) - [Autoimmunity](https://www.allergy.org.au/hp/autoimmunity) - [Laboratory Tests for Autoimmune Diseases](https://www.allergy.org.au/hp/autoimmunity-laboratory-testing) - [Immunisation](https://www.allergy.org.au/hp/immunisation) - [External Links](https://www.allergy.org.au/hp/external-links) - [ASCIA Action, First Aid, Management, Transfer, Travel and Treatment Plans](https://www.allergy.org.au/hp/ascia-plans-action-and-treatment) - [Health Professionals e-training](https://www.allergy.org.au/hp/hp-e-training) - [Anaphylaxis - short film](https://www.allergy.org.au/hp/hp-e-training/anaphylaxis-short-film) - [HP e-training feedback](https://www.allergy.org.au/hp/hp-e-training/hp-e-training-feedback) - [Podcast - Antibiotics and Allergy](https://www.allergy.org.au/hp/podcasts) - [Antibiotics and Allergy in our Community](https://www.allergy.org.au/hp/podcasts/antibiotics-and-allergy) - [Webinar - Immunodeficiency](https://www.allergy.org.au/hp/immunodeficiency-webinar) - [A career in Clinical Immunology and Allergy](https://www.allergy.org.au/hp/a-career-in-clinical-immunology-and-allergy) - [Awards/Grants](https://www.allergy.org.au/hp/awards-grants) - [ASCIA Grants for Medical Students](https://www.allergy.org.au/hp/awards-grants/ascia-grants-for-medical-students) - [ASCIA Grants for Members](https://www.allergy.org.au/hp/awards-grants/ascia-grants-for-members) - [ASCIA Media Awards](https://www.allergy.org.au/hp/awards-grants/ascia-media-awards) - [ASCIA Award, Grant & Scholarship Recipients](https://www.allergy.org.au/hp/awards-grants/ascia-award-grant-scholarship-recipients) - [Research Studies](https://www.allergy.org.au/hp/research-studies) - [ASCIA ID Register](https://idregister.ascia.org.au/) - [Resources for Health Professionals](https://www.allergy.org.au/hp/resources-for-health-professionals) - [ASCIA Position Paper - IFNAR1 Deficiency](https://www.allergy.org.au/hp/ifnar1-deficiency) - [Drug (Medication) Allergy Challenges Position Paper](https://www.allergy.org.au/hp/challenges) - [Patients](https://www.allergy.org.au/patients) - [Patients and Carers](https://www.allergy.org.au/patients) - [Allergy and Clinical Immunology Services](https://www.allergy.org.au/patients/allergy-and-clinical-immunology-services) - [What is a Clinical Immunology/Allergy Specialist](https://www.allergy.org.au/patients/allergy-and-clinical-immunology-services/clinical-immunologist-allergy-specialist) - [Locate a specialist](https://www.allergy.org.au/patients/locate-a-specialist) - [ACT](https://www.allergy.org.au/patients/locate-a-specialist/act) - [NSW](https://www.allergy.org.au/patients/locate-a-specialist/nsw) - [NT](https://www.allergy.org.au/patients/locate-a-specialist/nt) - [QLD](https://www.allergy.org.au/patients/locate-a-specialist/qld) - [SA](https://www.allergy.org.au/patients/locate-a-specialist/sa) - [TAS](https://www.allergy.org.au/patients/locate-a-specialist/tas) - [VIC](https://www.allergy.org.au/patients/locate-a-specialist/vic) - [WA](https://www.allergy.org.au/patients/locate-a-specialist/wa) - [New Zealand](https://www.allergy.org.au/patients/locate-a-specialist/new-zealand) - [Patient support organisations](https://www.allergy.org.au/patients/patient-support-organisations) - [Anaphylaxis e-training](https://www.allergy.org.au/patients/anaphylaxis-e-training-schools-and-childcare) - [Resources](https://www.allergy.org.au/patients/anaphylaxis-e-training-schools-and-childcare/etraining-resources) - [Anaphylaxis e-training feedback](https://www.allergy.org.au/patients/anaphylaxis-e-training-schools-and-childcare/anaphylaxis-e-training-feedback) - [Anaphylaxis e-training first aid (community)](https://www.allergy.org.au/patients/anaphylaxis-e-training-first-aid-community) - [Anaphylaxis e-training first aid feedback](https://www.allergy.org.au/patients/anaphylaxis-e-training-first-aid-community/anaphylaxis-e-training-first-aid-feedback) - [Fast Facts](https://www.allergy.org.au/patients/fast-facts) - [Fast Facts Home](https://www.allergy.org.au/patients/fast-facts) - [Adrenaline (Epinephrine) Devices](https://www.allergy.org.au/patients/fast-facts/adrenaline-devices) - [Allergic Rhinitis (Hay Fever )](https://www.allergy.org.au/patients/fast-facts/hay-fever-allergic-rhinitis) - [Allergy Testing](https://www.allergy.org.au/patients/fast-facts/allergy-testing) - [Allergy Treatments](https://www.allergy.org.au/patients/fast-facts/allergy-treatments) - [Anaphylaxis](https://www.allergy.org.au/patients/fast-facts/anaphylaxis) - [Asthma and Allergy](https://www.allergy.org.au/patients/fast-facts/asthma-and-allergy) - [Autoimmune Diseases](https://www.allergy.org.au/patients/fast-facts/autoimmune-diseases) - [Cow’s Milk (Dairy) Allergy](https://www.allergy.org.au/patients/fast-facts/cows-milk-dairy-allergy) - [Drug (Medication) Allergy](https://www.allergy.org.au/patients/fast-facts/drug-allergy) - [Eczema (Atopic Dermatitis)](https://www.allergy.org.au/patients/fast-facts/eczema-atopic-dermatitis) - [Eczema and Food Allergy](https://www.allergy.org.au/patients/fast-facts/eczema-and-food-allergy) - [Evidence-based Allergy Tests and Treatments](https://www.allergy.org.au/patients/fast-facts/evidence-based-allergy-tests-and-treatments) - [Food Allergy](https://www.allergy.org.au/patients/fast-facts/food-allergy) - [Immune System](https://www.allergy.org.au/patients/fast-facts/immune-system) - [Immunodeficiencies](https://www.allergy.org.au/patients/fast-facts/immunodeficiencies) - [Infant Feeding and Allergy Prevention](https://www.allergy.org.au/patients/fast-facts/infant-feeding-and-allergy-prevention) - [Insect and Tick Allergy](https://www.allergy.org.au/patients/fast-facts/insect-and-tick-allergy) - [Peanut Allergy](https://www.allergy.org.au/patients/fast-facts/peanut-allergy) - [Seed Allergy](https://www.allergy.org.au/patients/fast-facts/seed-allergy) - [Tree Nut Allergy](https://www.allergy.org.au/patients/fast-facts/tree-nut-allergy) - [Allergy and anaphylaxis](https://www.allergy.org.au/patients/about-allergy) - [Allergy and anaphylaxis](https://www.allergy.org.au/patients/about-allergy) - [What is allergy?](https://www.allergy.org.au/patients/about-allergy/what-is-allergy) - [Allergy glossary of terms](https://www.allergy.org.au/patients/about-allergy/glossary-of-allergy-terms) - [Idiopathic Anaphylaxis](https://www.allergy.org.au/patients/about-allergy/idiopathic-anaphylaxis) - [Anaphylaxis](https://www.allergy.org.au/patients/about-allergy/anaphylaxis) - [Checklist - Anaphylaxis](https://www.allergy.org.au/patients/about-allergy/checklist-anaphylaxis) - [Anaphylaxis translations](https://www.allergy.org.au/patients/about-allergy/anaphylaxis-translations) - [Anaphylaxis translations - New Zealand](https://www.allergy.org.au/patients/about-allergy/anaphylaxis-translations-nz) - [Common myths about allergy and asthma](https://www.allergy.org.au/patients/about-allergy/common-myths-about-allergy-and-asthma) - [Fact Sheet for Parents - Anaphylaxis](https://www.allergy.org.au/patients/about-allergy/facts-parents-anaphylaxis) - [Allergic rhinitis (hay fever) and sinusitis](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis) - [Allergic rhinitis (hay fever) and sinusitis](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis) - [Allergic rhinitis (hay fever)](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/allergic-rhinitis-or-hay-fever) - [Allergic Rhinitis Treatment Plan](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/allergic-rhinitis-treatment-plan) - [Allergic conjunctivitis](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/allergic-conjunctivitis) - [Nasal polyps](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/nasal-polyps) - [Non-Allergic Rhinitis](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/non-allergic-rhinitis) - [Pollen allergy](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/pollen-allergy) - [Pollen calendar - guide to common allergenic pollen](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/guide-to-common-allergenic-pollen) - [Sinusitis and allergy](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/sinusitis-and-allergy) - [Vocal Cord Dysfunction](https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/vocal-cord-dysfunction) - [Allergy and the skin](https://www.allergy.org.au/patients/skin-allergy) - [Allergy and the skin](https://www.allergy.org.au/patients/skin-allergy) - [Angioedema](https://www.allergy.org.au/patients/skin-allergy/angioedema) - [Chronic Spontaneous Urticaria](https://www.allergy.org.au/patients/skin-allergy/urticaria-hives-chronic) - [Contact dermatitis](https://www.allergy.org.au/patients/skin-allergy/contact-dermatitis) - [Eczema (Atopic Dermatitis)](https://www.allergy.org.au/patients/skin-allergy/eczema) - [ASCIA Eczema Action Plan](https://www.allergy.org.au/patients/skin-allergy/eczema-action-plan) - [Hives (urticaria)](https://www.allergy.org.au/patients/skin-allergy/urticaria-hives) - [Orofacial granulomatosis](https://www.allergy.org.au/patients/skin-allergy/orofacial-granulomatosis) - [Allergy prevention](https://www.allergy.org.au/patients/allergy-prevention) - [Allergy prevention](https://www.allergy.org.au/patients/allergy-prevention) - [ASCIA Information on how to introduce solid foods to babies for allergy prevention](https://www.allergy.org.au/patients/allergy-prevention/ascia-how-to-introduce-solid-foods-to-babies) - [Allergy prevention](https://www.allergy.org.au/patients/allergy-prevention/allergy-prevention) - [Food Allergen Starter Packs for Babies that Contain Common Allergy Causing Foods](https://www.allergy.org.au/patients/allergy-prevention/infant-feeding-products) - [Checklist: Introducing Solid Foods to Babies for Food Allergy Prevention](https://www.allergy.org.au/patients/allergy-prevention/infant-feeding-checklist) - [Allergy testing](https://www.allergy.org.au/patients/allergy-testing) - [Allergy testing overview](https://www.allergy.org.au/patients/allergy-testing) - [Allergy testing](https://www.allergy.org.au/patients/allergy-testing/allergy-testing) - [Food allergen challenges](https://www.allergy.org.au/patients/food-allergy/food-allergen-challenges) - [Food Allergy Testing](https://www.allergy.org.au/patients/allergy-testing/food-allergy) - [Mastocytosis](https://www.allergy.org.au/patients/allergy-testing/mastocytosis) - [Evidence-Based Versus Non Evidence-Based Tests and Treatments](https://www.allergy.org.au/patients/allergy-testing/evidence-based-versus-non-evidence-based-tests-and-treatments) - [What is causing your allergy](https://www.allergy.org.au/patients/allergy-testing/causes-of-allergy) - [Allergy treatments](https://www.allergy.org.au/patients/allergy-treatments) - [Allergy treatments](https://www.allergy.org.au/patients/allergy-treatments) - [SCIT Treatment Plan](https://www.allergy.org.au/patients/allergy-treatments/scit-treatment-plan) - [Allergen Immunotherapy](https://www.allergy.org.au/patients/allergy-treatments/allergen-immunotherapy) - [Allergen minimisation](https://www.allergy.org.au/patients/allergy-treatments/allergen-minimisation) - [Venom Immunotherapy FAQs](https://www.allergy.org.au/patients/allergy-treatments/venom-immunotherapy-faqs) - [Adrenaline for severe allergies](https://www.allergy.org.au/patients/allergy-treatments/adrenaline-for-severe-allergies) - [Transitioning from paediatric to adult care](https://www.allergy.org.au/patients/allergy-treatments/transitioning-from-paediatric-to-adult-care) - [Oral immunotherapy (OIT) for food allergy](https://www.allergy.org.au/patients/allergy-treatments/oral-immunotherapy-for-food-allergy) - [Asthma and allergy](https://www.allergy.org.au/patients/asthma-and-allergy) - [Asthma and allergy](https://www.allergy.org.au/patients/asthma-and-allergy) - [About asthma and allergy](https://www.allergy.org.au/patients/asthma-and-allergy/about-asthma-and-allergy) - [Asthma and anaphylaxis](https://www.allergy.org.au/patients/asthma-and-allergy/asthma-and-anaphylaxis) - [Asthma Issues: sport, travel, and pregnancy](https://www.allergy.org.au/patients/asthma-and-allergy/asthma-issues-sport-travel-and-pregnancy) - [Thunderstorm asthma](https://www.allergy.org.au/patients/asthma-and-allergy/thunderstorm-asthma) - [Autoimmunity](https://www.allergy.org.au/patients/autoimmunity) - [Autoimmunity overview](https://www.allergy.org.au/patients/autoimmunity) - [Autoimmune diseases](https://www.allergy.org.au/patients/autoimmunity/autoimmune-diseases) - [Systemic Lupus Erythematosus (SLE)](https://www.allergy.org.au/patients/autoimmunity/systemic-lupus-erythematosus-sle) - [Sjögren’s Disease](https://www.allergy.org.au/patients/autoimmunity/sjoegrens-disease) - [Vasculitis disorders](https://www.allergy.org.au/patients/autoimmunity/vasculitis-disorders) - [Drug allergy](https://www.allergy.org.au/patients/drug-allergy) - [Drug allergy overview](https://www.allergy.org.au/patients/drug-allergy) - [Adverse Reactions to Complementary and Alternative Medicines](https://www.allergy.org.au/patients/drug-allergy/adverse-reactions-to-alternative-medicines) - [Allergic reactions to aspirin and other pain killers](https://www.allergy.org.au/patients/drug-allergy/allergic-reactions-to-aspirin-and-other-pain-killers) - [Antibiotic Allergy Challenges](https://www.allergy.org.au/patients/drug-allergy/antibiotic-allergy-challenges) - [Chlorhexidine allergy](https://www.allergy.org.au/patients/drug-allergy/chlorhexidine-allergy) - [Penicillin Allergy](https://www.allergy.org.au/patients/drug-allergy/penicillin) - [Sulfonamide Antibiotic Allergy](https://www.allergy.org.au/patients/drug-allergy/sulfonamide-antibiotic-allergy) - [Food allergy](https://www.allergy.org.au/patients/food-allergy) - [Food allergy overview](https://www.allergy.org.au/patients/food-allergy) - [ASCIA Dietary avoidance for food allergy](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy) - [Cow's milk protein (dairy)](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy/cows-milk-dairy) - [Cow's milk protein (dairy) and soy](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy/cows-milk-protein-dairy-and-soy) - [Egg](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy/egg) - [Fish](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy/fish) - [Peanut](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy/peanut) - [Sesame](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy/sesame) - [Shellfish](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy/shellfish) - [Soy](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy/soy) - [Treenut](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy/treenut) - [Wheat](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy/wheat) - [ASCIA Dietary avoidance for food allergy FAQ](https://www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy-faq) - [Allergic and toxic reactions to seafood](https://www.allergy.org.au/patients/food-allergy/allergic-and-toxic-reactions-to-seafood) - [Coconut allergy](https://www.allergy.org.au/patients/food-allergy/coconut-allergy) - [Cow\`s milk (dairy) allergy](https://www.allergy.org.au/patients/food-allergy/cows-milk-dairy-allergy) - [Egg allergy flu vaccine](https://www.allergy.org.au/patients/food-allergy/egg-allergy-flu-vaccine) - [Food Allergy FAQ](https://www.allergy.org.au/patients/food-allergy/faqs) - [Food allergen challenges](https://www.allergy.org.au/patients/food-allergy/food-allergen-challenges) - [Lupin food allergy](https://www.allergy.org.au/patients/food-allergy/lupin-food-allergy) - [Mammalian meat and tick allergy](https://www.allergy.org.au/patients/food-allergy/mammalian-meat-tick-faq) - [Peanut, tree nut and seed allergy](https://www.allergy.org.au/patients/food-allergy/peanut-tree-nut-and-seed-allergy) - [Wheat Dependant Exercise Induced Anaphylaxis](https://www.allergy.org.au/patients/food-allergy/wheat-dependant-exercise-induced-anaphylaxis) - [Food other adverse reactions](https://www.allergy.org.au/patients/food-other-adverse-reactions) - [Food other adverse reactions overview](https://www.allergy.org.au/patients/food-other-adverse-reactions) - [Food intolerance](https://www.allergy.org.au/patients/food-other-adverse-reactions/food-intolerance) - [Lactose Intolerance](https://www.allergy.org.au/patients/food-other-adverse-reactions/lactose-intolerance) - [Milk, mucus and cough](https://www.allergy.org.au/patients/food-other-adverse-reactions/milk-mucus-and-cough) - [Oral Allergy Syndrome](https://www.allergy.org.au/patients/food-other-adverse-reactions/oral-allergy-syndrome) - [Eosinophilic Oesophagitis (EoE)](https://www.allergy.org.au/patients/food-other-adverse-reactions/eosinophilic-oesophagitis) - [Two Food Elimination Diet (2FED) for EoE](https://www.allergy.org.au/patients/food-other-adverse-reactions/eoe-2fed) - [Four Food Elimination Diet (4FED) for EoE](https://www.allergy.org.au/patients/food-other-adverse-reactions/eoe-4fed) - [Action Plan for Eosinophilic Oesophagitis (EoE)](https://www.allergy.org.au/patients/food-other-adverse-reactions/eoe-action-plan) - [Management Plan for Eosinophilic Oesophagitis (EoE)](https://www.allergy.org.au/patients/food-other-adverse-reactions/eoe-management-plan) - [Food Protein Induced Enterocolitis Syndrome (FPIES)](https://www.allergy.org.au/patients/food-other-adverse-reactions/food-protein-induced-enterocolitis-syndrome-fpies) - [FPIES Action Plan](https://www.allergy.org.au/patients/food-other-adverse-reactions/fpies-action-plan) - [Food Protein-Induced Allergic Proctocolitis (FPIAP)](https://www.allergy.org.au/patients/food-other-adverse-reactions/proctocolitis-fpiap) - [Management Plan for Delayed Allergic Reactions to Foods](https://www.allergy.org.au/patients/food-other-adverse-reactions/delayed-reactions-management-plan) - [Immune system](https://www.allergy.org.au/patients/immune-system) - [Immune System Overview](https://www.allergy.org.au/patients/immune-system) - [Immune System - Fast Facts](https://www.allergy.org.au/patients/fast-facts/immune-system) - [Immunisation](https://www.allergy.org.au/patients/immunisation) - [Immunodeficiencies](https://www.allergy.org.au/patients/immunodeficiencies) - [Immunodeficiencies overview](https://www.allergy.org.au/patients/immunodeficiencies) - [Subcutaneous immunoglobulin (SCIg) therapy - general information](https://www.allergy.org.au/patients/immunodeficiencies/scig-therapy-general-information) - [Subcutaneous immunoglobulin (SCIg) therapy - equipment checklist](https://www.allergy.org.au/patients/immunodeficiencies/scig-therapy-equipment-checklist) - [Subcutaneous immunoglobulin (SCIg) infusion checklist](https://www.allergy.org.au/patients/immunodeficiencies/scig-infusion-checklist) - [Immunoglobulin replacement therapy](https://www.allergy.org.au/patients/immunodeficiencies/immunoglobulin-replacement-therapy) - [Primary Immunodeficiency (PID)](https://www.allergy.org.au/patients/immunodeficiencies/primary-immunodeficiency) - [Severe combined immunodeficiency](https://www.allergy.org.au/patients/immunodeficiencies/severe-combined-immunodeficiency) - [Primary Immunodeficiencies and the Immune System](https://www.allergy.org.au/patients/immunodeficiencies/pid-immune-system) - [Preventing Infections](https://www.allergy.org.au/patients/immunodeficiencies/preventing-infections) - [Newborn Screening for Severe Combined Immune Deficiency (SCID)](https://www.allergy.org.au/patients/immunodeficiencies/nbs-scid) - [Common variable immune deficiency (CVID)](https://www.allergy.org.au/patients/immunodeficiencies/common-variable-immune-deficiency-cvid) - [Hereditary Angioedema (HAE)](https://www.allergy.org.au/patients/immunodeficiencies/hae) - [Insect and tick allergy](https://www.allergy.org.au/patients/insect-allergy-bites-and-stings) - [Insect and tick allergy overview](https://www.allergy.org.au/patients/insect-allergy-bites-and-stings) - [Allergic reactions to bites and stings](https://www.allergy.org.au/patients/insect-allergy-bites-and-stings/allergic-reactions-to-bites-and-stings) - [Jack Jumper Ant Allergy](https://www.allergy.org.au/patients/insect-allergy-bites-and-stings/jack-jumper-ant-allergy) - [Large Local Reactions to Insect Stings](https://www.allergy.org.au/patients/insect-allergy-bites-and-stings/large-local-reactions) - [Mammalian meat and tick allergy](https://www.allergy.org.au/patients/food-allergy/mammalian-meat-tick-faq) - [Tick Allergy](https://www.allergy.org.au/patients/insect-allergy-bites-and-stings/tick-allergy) - [Venom Immunotherapy](https://www.allergy.org.au/patients/allergy-treatments/venom-immunotherapy-faqs) - [Other allergies](https://www.allergy.org.au/patients/other-allergy) - [Other allergies overview](https://www.allergy.org.au/patients/other-allergy) - [Alcohol allergy](https://www.allergy.org.au/patients/other-allergy/alcohol-allergy) - [Latex allergy](https://www.allergy.org.au/patients/other-allergy/latex-allergy) - [Pet allergy](https://www.allergy.org.au/patients/other-allergy/pet-allergy) - [Sulfite Sensitivity](https://www.allergy.org.au/patients/other-allergy/sulfite-sensitivity) - [Schools](https://www.allergy.org.au/schools-childcare) - [Meetings](https://www.allergy.org.au/conferences) - [Advanced Trainees](https://www.allergy.org.au/conferences/advanced-trainees) - [APID](https://www.allergy.org.au/conferences/advanced-trainees/apid) - [ASCIA Annual Conference](https://www.allergy.org.au/conferences/ascia-annual-conference) - [Annual ASCIA Conference Reports](https://www.allergy.org.au/conferences/ascia-annual-conference/reports) - [Annual ASCIA Basten Oration](https://www.allergy.org.au/conferences/ascia-annual-conference/annual-ascia-basten-oration) - [Schedule for ASCIA Annual Conferences](https://www.allergy.org.au/conferences/ascia-annual-conference/schedule-for-ascia-acs) - [Published Abstracts ASCIA](https://www.allergy.org.au/conferences/ascia-annual-conference/published-abstracts-ascia) - [Annual Conferences (1990 onwards)](https://www.allergy.org.au/conferences/ascia-annual-conference/ascia-ac-1990-onwards) - [ASCIA Education Meetings](https://www.allergy.org.au/conferences/education) - [ASCIA Online Meetings](https://www.allergy.org.au/conferences/online-meetings) - [Calendar: Conferences, Meetings, Events](https://www.allergy.org.au/conferences/calendar) - [Immunopathology](https://www.allergy.org.au/conferences/immunopathology) - [Reports](https://www.allergy.org.au/ascia-reports) - [ASCIA Annual Highlights, Reports and AGM Minutes](https://www.allergy.org.au/ascia-reports#s2) - [ASCIA Scope of Practice documents](https://www.allergy.org.au/ascia-reports#s3) - [Cost of allergic disease in Australia](https://www.allergy.org.au/ascia-reports-economic) - [National Allergy Strategy](https://www.allergy.org.au/ascia-reports#s4) - [NPS Choosing Wisely and RACP Evolve](https://www.allergy.org.au/ascia-reports#s5) - [Allergy in Australia 2014](https://www.allergy.org.au/ascia-reports#s6) - [Allergy and Immune Diseases in Australia (AIDA) Report 2013](https://www.allergy.org.au/ascia-reports#s7) - [ASCIA Education Resources Report 2013](https://www.allergy.org.au/ascia-reports#s8) - [Economic Impact of Allergies Report 2007](https://www.allergy.org.au/ascia-reports#s9) - [Submissions](https://www.allergy.org.au/ascia-submissions) - [All ASCIA Submissions](https://www.allergy.org.au/ascia-submissions) - [Submissions 2025](https://www.allergy.org.au/ascia-submissions/2025) - [Submissions 2024](https://www.allergy.org.au/ascia-submissions/2024) - [Submissions 2023](https://www.allergy.org.au/ascia-submissions/2023) - [Submissions 2022](https://www.allergy.org.au/ascia-submissions/2022) - [Submissions 2021](https://www.allergy.org.au/ascia-submissions/2021) - 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Allergic and toxic reactions to seafood [Listen](https://app-eu.readspeaker.com/cgi-bin/rsent?customerid=12404&lang=en_au&readid=rs_read_this2&audiofilename=Allergic_and_Toxic_Reactions_to_Seafood___Australasian_Society_of_Clinical_Immunology_and_Allergy__ASCIA_&url=https%3A%2F%2Fwww.allergy.org.au%2Fpatients%2Ffood-allergy%2Fallergic-and-toxic-reactions-to-seafood "Listen") # Allergic and Toxic Reactions to Seafood [Email](https://www.allergy.org.au/#email) [Print](https://www.allergy.org.au/#print) ### Frequently Asked Questions This document has been developed by [ASCIA](https://www.allergy.org.au/), the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand. ASCIA information is based on published literature and expert review, is not influenced by commercial organisations and is not intended to replace medical advice. For patient or carer support contact [Allergy & Anaphylaxis Australia](https://allergyfacts.org.au/) or [Allergy New Zealand](https://www.allergy.org.nz/). [![pdf](https://www.allergy.org.au/media/jce/icons/pdf.png)ASCIA PC Seafood Allergy FAQ 2024 187\.78 KB](https://www.allergy.org.au/images/pc/ASCIA_PC_Seafood_Allergy_FAQ_2024.pdf "ASCIA PC Seafood Allergy FAQ 2024 ") #### Q 1: Is seafood allergy common? Seafood allergy occurs most commonly where seafood is an important part of the diet, such as in Asia and Scandinavia. Approximately 1% of the population is estimated to have a seafood allergy. It is more common in teenage and adult life than very early childhood. About 20% of people will grow out of their seafood allergy with time. #### Q 2: What types of seafood cause allergic reactions? The major groups of seafood that can trigger allergic reactions: Fish (vertebrates - with a backbone) - Including salmon, cod, mackerel, sardines, herring, anchovies, tuna, trout, haddock, eels and rays. Shellfish (invertebrates – without a backbone) - Crustaceans including prawns/shrimps, lobster, crab, crayfish, and yabbies. - Molluscs including oysters, mussels, clams, octopus, squid (calamari), abalone, and sea slugs. The protein allergens present in one seafood group can be very different to those in other seafood groups. This means that a person can be allergic to fish only, shellfish only, or members of both groups. People who are allergic to one fish are usually (but not always) allergic to most other fish. #### Q 3: What is cross reactivity? Cross reactivity means that a similar protein is present in a range of different foods. If the same protein is present in several foods, then that person may have allergic reactions to any food containing that protein. Examples of cross reactivity include people allergic to similar proteins present in one fish that are also present in other fish, or those allergic to proteins present in prawn, crab and lobster. Allergy to one crustacean usually means that all must be avoided. People with allergy to seafood from one group (such as crustaceans) may tolerate seafood from another group (such as molluscs). This can only be confirmed with allergy testing and guidance from a clinical immunology/allergy specialist. #### Q 4: How are people exposed to the seafood allergen? Eating seafood is the major trigger for allergic reactions. Sensitive people may sometimes have breathing difficulties from inhaling fumes when seafood is being cooked, and in seafood processing factories. They may also have symptoms from touching seafood, such as when cleaning and handling fish. Symptoms caused by allergic reactions to seafood usually appear within minutes. Delayed reactions and exercise-induced anaphylaxis can occur, particularly after eating shellfish such as oyster, abalone, squid, and shrimp. #### Q 5: What are the signs and symptoms of allergic reactions to seafood? Signs and symptoms of mild to moderate allergic reactions to foods include: - Swelling of the lips, face, eyes - Hives or welts on the skin - Abdominal pain, vomiting Signs of anaphylaxis to foods include any one of the following: - Difficult or noisy breathing - Swelling of the tongue - Swelling or tightness in the throat - Wheeze or persistent cough - Difficulty talking or hoarse voice - Persistent dizziness or collapse - Pale and floppy (in young children) Anaphylaxis is the most severe type of allergic reaction and should always be treated as a medical emergency. Anaphylaxis requires immediate treatment with adrenaline (epinephrine), which is injected into the outer mid-thigh muscle. Delayed treatment can result in fatal anaphylaxis. #### Q 6: How is a food allergy diagnosed? Accurate diagnosis of food allergy is important. A doctor (GP) will ask questions that may help to narrow down the list of likely causes of allergy such as foods or medicines consumed that day, or exposure to stinging insects. This approach will also help to exclude conditions that can sometimes be confused with food allergy. A referral to a clinical immunology/allergy specialist may be given. Skin or blood allergen specific IgE allergy tests help confirm or exclude potential triggers. While the results of allergy testing by a specialist are a guide to whether the person is allergic, results will not be able to tell you whether your reaction will be mild or severe. It may not be possible to test for all seafood species using commercial skin prick or blood allergy testing, since these are not available for all seafood species. For this reason, some allergy clinics will recommend that you bring samples of fresh food for testing. #### Q 7: Are there ‘allergy testing’ methods which are unproven and not recommended? Some unorthodox/alternative practitioners offer unproven, non-evidence-based allergy ‘tests’ and ‘treatments’ that are not recommended by ASCIA. These include cytotoxic food testing, kinesiology, hair analysis, vega testing, electrodermal testing, pulse testing, reflexology, bioresonance, Bryan’s or Alcat tests, VoiceBio, allergy elimination techniques and immunoglobulin G (IgG) to foods. These tests can result in misdiagnosis, ineffective treatments, costly and often dangerous dietary restrictions. #### Q 8: How is seafood allergy managed? People can learn to manage their seafood allergy with the guidance of their clinical immunology/allergy specialist. It is important for people with confirmed food allergy to: - Avoid confirmed food allergens. - Know the signs and symptoms of allergic reactions and know what to do when a reaction occurs. - Carry their adrenaline injector (if prescribed) and ASCIA Action Plan at all times. #### Q 9: How can seafood be avoided? Avoidance of one or more groups of seafood is often advised to manage confirmed seafood allergy. Accidental exposure is more likely to happen when eating away from home. Other potential sources of accidental exposure and cross-contamination include: - Seafood platters and buffets. - Asian foods often contain shellfish as a common ingredient or contaminant such as prawns in fried rice or soups, and seafood extender. - Takeaway food which may be rolled in the same batter or cooked in the same oil as seafood. - Commercial pizzas where contamination may happen during preparation. - Anchovies in Caesar salads, and as an ingredient in Worcestershire sauce. - Contaminated barbeques where seafood has been cooked. Isinglass is sometimes used as a fining agent to remove cloudiness from beer and wine. Made from the swim bladder of certain types of fish, it consists almost entirely of collagen, and is considered unlikely to cause allergic reactions. Use of isinglass in beer and wine has been exempted from mandatory labelling regulations in Australia. While the risk of allergic reactions to fish oils is low in those allergic to fish due to the method of purification, people with fish allergy are advised to seek medical advice before consuming. Other sources of omega-3 fatty acids include evening primrose oil and flaxseed oil. #### Q 10: Does cooking seafood affect tolerance? Seafood allergens are usually heat stable and cannot easily be destroyed through cooking. Some people can tolerate tinned fish (intensely heat treated) yet are unable to tolerate the same fish when freshly cooked. #### Q 11: Are seafood allergy and iodine allergy related? People with seafood allergy react to proteins in the seafood, not to iodine in the fish or shellfish. People who are allergic to seafood are not at an increased risk of allergic reactions to iodine in topical antiseptics such as Betadine or Povidine, or intravenous x-ray radio-contrast agents. People with iodine allergy are not at increased risk of seafood allergy. #### Q 12: Is allergy to glucosamine common? Allergic reactions to glucosamine are not common. Glucosamine is a popular complementary medicine used to treat osteoarthritis. It is derived from the outer coatings of shellfish such as crustaceans. Sometimes chondroitin sulfate is added, usually derived from shark cartilage. Products containing glucosamine registered in Australia and New Zealand carry labels warning against their use in people allergic to shellfish/crustaceans. Vegetarian glucosamine is available which does not contain seafood allergen as it is produced in bacteria cultures. #### Q 13: What toxic reactions look like seafood allergy? Some conditions caused by toxins or parasites in seafood can resemble allergic reactions to seafood. Scombroid Fish Poisoning An allergy-like reaction that occurs after eating fish that has high levels of histamine because it has not been properly stored or processed. This is more common in fish which turns brown upon cooking. This including mackerel, tuna, king fish, herring, sardines, marlin, anchovies and bluefish. Affected fish often have a metallic or peppery taste. Scombroid poisoning symptoms usually start within 30 minutes of eating. These include flushing, itch, hives (urticaria), nausea, vomiting, stomach cramps, dizziness, palpitations and headache. Severe reactions may result in wheezing and dizziness or a drop in blood pressure. Urgent medical assistance is required. Treatment usually involves taking antihistamines, and sometimes adrenaline is given in a hospital setting. Scombroid poisoning can be identified by the pattern of symptoms and the absence of reactions with skin or blood allergy testing. Anisakis Simplex This is a nematode (worm) that is a fish parasite found in most parts of the world, including Australia. The parasite is killed when cooked at temperatures above 60oC or if stored in industrial freezers for two days. Anisakis can cause two major problems in people: - Anisakis infection (anisakiasis) can result from eating raw or undercooked seafood. Infection may cause nausea, vomiting, stomach pain, and sometimes appendicitis, bowel blockage or bleeding. Symptoms occur due to inflammation in the gut. Diagnosis requires an endoscopy where a specialist doctor uses a tube to observe the inside of the stomach and bowel. The parasite usually gets destroyed by our immune system after three weeks, but surgery may be required. - Anisakis allergy resembles other allergic reactions to food. In this case, the allergy is to the fish parasite, not to the fish itself. Reactions occur sometimes after eating seafood, rather than on every occasion. The allergens of Anisakis simplex are not destroyed by heat or cooking and so allergic reactions may be triggered by dead parasites in fish that have been well cooked. Blood allergy testing is available to confirm suspected sensitivity to this parasite. Ciguatera Poisoning, Paralytic Shellfish Poisoning and Diarrhoetic Shellfish Poisoning Ciguatera poisoning is caused by eating seafood that has been contaminated by algae-derived toxins. Ciguatera toxins are only present in fish, particularly large reef fish in the tropics. Paralytic shellfish poisoning and diarrhoetic shellfish poisoning is caused by shellfish contaminated with microorganisms (i.e. algae producing toxins), in particular mussels and oysters. These toxins or poisons interfere with the function of nerve endings. Symptoms occur within two to three hours of eating contaminated food, and consist of tingling of the lips, tongue and throat, often followed by stomach upset, headache, fever, muscle aches and pains and in the case of ciguatera poisoning, sometimes changes in blood pressure and heart rhythm. Numbness, collapse, coma and confusion have also been described. Most people recover within a few days or weeks with supportive treatment. Metabisulfite Reactions Metabisulfite preservative can sometimes be used to stop crustaceans (such as prawns) from discolouring. This preservative is also used in wine, beer and some dried fruit as a preservative. Adverse reactions include wheezing/tight chest (more common in those with asthma), stomach irritation (such as nausea and pain), and rarely itch/rashes. Toxic and other adverse reactions to seafood are outlined in the table below. Table: Toxic and other adverse reactions to seafood \| \| \| \| \| \| \|---\|---\|---\|---\|---\| \| Cause \| Seafood implicated \| Clinical symptoms \| Time of onset \| Allergy test \| \| Bacterial infection Salmonella, Vibrio, Aeromonas, Listeria \| Crustacean, Mollusc, Fish \| Dermatological Gastrointestinal Neurological Respiratory \| Minutes to several hours \| Negative \| \| Viral infection Hepatitis A, Rota- Astrovirus, Small round Viruses etc. \| Crustacean, Mollusc \| Negative \| \| \| \| Seafood parasites Anisakis Diphyllobothrium \| All fish and some molluscs \| Negative \| \| \| \| Toxins 1\) Scombrotoxin Marine Toxins 2\) Ciguatera toxin 3\) Algae toxins \| 1\) Fish, particularly with dark meat 2\) Reef fish 3\) All Mollusc species \| Negative \| \| \| \| Allergens Shellfish \| Crustacean Mollusc Fish \| Positive \| \| \| © ASCIA 2024 Content updated April 2024 For more information go to [www.allergy.org.au/patients/food-allergy](https://www.allergy.org.au/patients/food-allergy/) To support allergy and immunology research go to [www.allergyimmunology.org.au/donate](https://www.allergyimmunology.org.au/donate) ### Food allergy - 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Readable Markdown	### Frequently Asked Questions This document has been developed by [ASCIA](https://www.allergy.org.au/), the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand. ASCIA information is based on published literature and expert review, is not influenced by commercial organisations and is not intended to replace medical advice. For patient or carer support contact [Allergy & Anaphylaxis Australia](https://allergyfacts.org.au/) or [Allergy New Zealand](https://www.allergy.org.nz/). [![pdf](https://www.allergy.org.au/media/jce/icons/pdf.png)ASCIA PC Seafood Allergy FAQ 2024 187\.78 KB](https://www.allergy.org.au/images/pc/ASCIA_PC_Seafood_Allergy_FAQ_2024.pdf "ASCIA PC Seafood Allergy FAQ 2024 ") #### Q 1: Is seafood allergy common? Seafood allergy occurs most commonly where seafood is an important part of the diet, such as in Asia and Scandinavia. Approximately 1% of the population is estimated to have a seafood allergy. It is more common in teenage and adult life than very early childhood. About 20% of people will grow out of their seafood allergy with time. #### Q 2: What types of seafood cause allergic reactions? The major groups of seafood that can trigger allergic reactions: Fish (vertebrates - with a backbone) - Including salmon, cod, mackerel, sardines, herring, anchovies, tuna, trout, haddock, eels and rays. Shellfish (invertebrates – without a backbone) - Crustaceans including prawns/shrimps, lobster, crab, crayfish, and yabbies. - Molluscs including oysters, mussels, clams, octopus, squid (calamari), abalone, and sea slugs. The protein allergens present in one seafood group can be very different to those in other seafood groups. This means that a person can be allergic to fish only, shellfish only, or members of both groups. People who are allergic to one fish are usually (but not always) allergic to most other fish. #### Q 3: What is cross reactivity? Cross reactivity means that a similar protein is present in a range of different foods. If the same protein is present in several foods, then that person may have allergic reactions to any food containing that protein. Examples of cross reactivity include people allergic to similar proteins present in one fish that are also present in other fish, or those allergic to proteins present in prawn, crab and lobster. Allergy to one crustacean usually means that all must be avoided. People with allergy to seafood from one group (such as crustaceans) may tolerate seafood from another group (such as molluscs). This can only be confirmed with allergy testing and guidance from a clinical immunology/allergy specialist. #### Q 4: How are people exposed to the seafood allergen? Eating seafood is the major trigger for allergic reactions. Sensitive people may sometimes have breathing difficulties from inhaling fumes when seafood is being cooked, and in seafood processing factories. They may also have symptoms from touching seafood, such as when cleaning and handling fish. Symptoms caused by allergic reactions to seafood usually appear within minutes. Delayed reactions and exercise-induced anaphylaxis can occur, particularly after eating shellfish such as oyster, abalone, squid, and shrimp. #### Q 5: What are the signs and symptoms of allergic reactions to seafood? Signs and symptoms of mild to moderate allergic reactions to foods include: - Swelling of the lips, face, eyes - Hives or welts on the skin - Abdominal pain, vomiting Signs of anaphylaxis to foods include any one of the following: - Difficult or noisy breathing - Swelling of the tongue - Swelling or tightness in the throat - Wheeze or persistent cough - Difficulty talking or hoarse voice - Persistent dizziness or collapse - Pale and floppy (in young children) Anaphylaxis is the most severe type of allergic reaction and should always be treated as a medical emergency. Anaphylaxis requires immediate treatment with adrenaline (epinephrine), which is injected into the outer mid-thigh muscle. Delayed treatment can result in fatal anaphylaxis. #### Q 6: How is a food allergy diagnosed? Accurate diagnosis of food allergy is important. A doctor (GP) will ask questions that may help to narrow down the list of likely causes of allergy such as foods or medicines consumed that day, or exposure to stinging insects. This approach will also help to exclude conditions that can sometimes be confused with food allergy. A referral to a clinical immunology/allergy specialist may be given. Skin or blood allergen specific IgE allergy tests help confirm or exclude potential triggers. While the results of allergy testing by a specialist are a guide to whether the person is allergic, results will not be able to tell you whether your reaction will be mild or severe. It may not be possible to test for all seafood species using commercial skin prick or blood allergy testing, since these are not available for all seafood species. For this reason, some allergy clinics will recommend that you bring samples of fresh food for testing. #### Q 7: Are there ‘allergy testing’ methods which are unproven and not recommended? Some unorthodox/alternative practitioners offer unproven, non-evidence-based allergy ‘tests’ and ‘treatments’ that are not recommended by ASCIA. These include cytotoxic food testing, kinesiology, hair analysis, vega testing, electrodermal testing, pulse testing, reflexology, bioresonance, Bryan’s or Alcat tests, VoiceBio, allergy elimination techniques and immunoglobulin G (IgG) to foods. These tests can result in misdiagnosis, ineffective treatments, costly and often dangerous dietary restrictions. #### Q 8: How is seafood allergy managed? People can learn to manage their seafood allergy with the guidance of their clinical immunology/allergy specialist. It is important for people with confirmed food allergy to: - Avoid confirmed food allergens. - Know the signs and symptoms of allergic reactions and know what to do when a reaction occurs. - Carry their adrenaline injector (if prescribed) and ASCIA Action Plan at all times. #### Q 9: How can seafood be avoided? Avoidance of one or more groups of seafood is often advised to manage confirmed seafood allergy. Accidental exposure is more likely to happen when eating away from home. Other potential sources of accidental exposure and cross-contamination include: - Seafood platters and buffets. - Asian foods often contain shellfish as a common ingredient or contaminant such as prawns in fried rice or soups, and seafood extender. - Takeaway food which may be rolled in the same batter or cooked in the same oil as seafood. - Commercial pizzas where contamination may happen during preparation. - Anchovies in Caesar salads, and as an ingredient in Worcestershire sauce. - Contaminated barbeques where seafood has been cooked. Isinglass is sometimes used as a fining agent to remove cloudiness from beer and wine. Made from the swim bladder of certain types of fish, it consists almost entirely of collagen, and is considered unlikely to cause allergic reactions. Use of isinglass in beer and wine has been exempted from mandatory labelling regulations in Australia. While the risk of allergic reactions to fish oils is low in those allergic to fish due to the method of purification, people with fish allergy are advised to seek medical advice before consuming. Other sources of omega-3 fatty acids include evening primrose oil and flaxseed oil. #### Q 10: Does cooking seafood affect tolerance? Seafood allergens are usually heat stable and cannot easily be destroyed through cooking. Some people can tolerate tinned fish (intensely heat treated) yet are unable to tolerate the same fish when freshly cooked. #### Q 11: Are seafood allergy and iodine allergy related? People with seafood allergy react to proteins in the seafood, not to iodine in the fish or shellfish. People who are allergic to seafood are not at an increased risk of allergic reactions to iodine in topical antiseptics such as Betadine or Povidine, or intravenous x-ray radio-contrast agents. People with iodine allergy are not at increased risk of seafood allergy. #### Q 12: Is allergy to glucosamine common? Allergic reactions to glucosamine are not common. Glucosamine is a popular complementary medicine used to treat osteoarthritis. It is derived from the outer coatings of shellfish such as crustaceans. Sometimes chondroitin sulfate is added, usually derived from shark cartilage. Products containing glucosamine registered in Australia and New Zealand carry labels warning against their use in people allergic to shellfish/crustaceans. Vegetarian glucosamine is available which does not contain seafood allergen as it is produced in bacteria cultures. #### Q 13: What toxic reactions look like seafood allergy? Some conditions caused by toxins or parasites in seafood can resemble allergic reactions to seafood. Scombroid Fish Poisoning An allergy-like reaction that occurs after eating fish that has high levels of histamine because it has not been properly stored or processed. This is more common in fish which turns brown upon cooking. This including mackerel, tuna, king fish, herring, sardines, marlin, anchovies and bluefish. Affected fish often have a metallic or peppery taste. Scombroid poisoning symptoms usually start within 30 minutes of eating. These include flushing, itch, hives (urticaria), nausea, vomiting, stomach cramps, dizziness, palpitations and headache. Severe reactions may result in wheezing and dizziness or a drop in blood pressure. Urgent medical assistance is required. Treatment usually involves taking antihistamines, and sometimes adrenaline is given in a hospital setting. Scombroid poisoning can be identified by the pattern of symptoms and the absence of reactions with skin or blood allergy testing. Anisakis Simplex This is a nematode (worm) that is a fish parasite found in most parts of the world, including Australia. The parasite is killed when cooked at temperatures above 60oC or if stored in industrial freezers for two days. Anisakis can cause two major problems in people: - Anisakis infection (anisakiasis) can result from eating raw or undercooked seafood. Infection may cause nausea, vomiting, stomach pain, and sometimes appendicitis, bowel blockage or bleeding. Symptoms occur due to inflammation in the gut. Diagnosis requires an endoscopy where a specialist doctor uses a tube to observe the inside of the stomach and bowel. The parasite usually gets destroyed by our immune system after three weeks, but surgery may be required. - Anisakis allergy resembles other allergic reactions to food. In this case, the allergy is to the fish parasite, not to the fish itself. Reactions occur sometimes after eating seafood, rather than on every occasion. The allergens of Anisakis simplex are not destroyed by heat or cooking and so allergic reactions may be triggered by dead parasites in fish that have been well cooked. Blood allergy testing is available to confirm suspected sensitivity to this parasite. Ciguatera Poisoning, Paralytic Shellfish Poisoning and Diarrhoetic Shellfish Poisoning Ciguatera poisoning is caused by eating seafood that has been contaminated by algae-derived toxins. Ciguatera toxins are only present in fish, particularly large reef fish in the tropics. Paralytic shellfish poisoning and diarrhoetic shellfish poisoning is caused by shellfish contaminated with microorganisms (i.e. algae producing toxins), in particular mussels and oysters. These toxins or poisons interfere with the function of nerve endings. Symptoms occur within two to three hours of eating contaminated food, and consist of tingling of the lips, tongue and throat, often followed by stomach upset, headache, fever, muscle aches and pains and in the case of ciguatera poisoning, sometimes changes in blood pressure and heart rhythm. Numbness, collapse, coma and confusion have also been described. Most people recover within a few days or weeks with supportive treatment. Metabisulfite Reactions Metabisulfite preservative can sometimes be used to stop crustaceans (such as prawns) from discolouring. This preservative is also used in wine, beer and some dried fruit as a preservative. Adverse reactions include wheezing/tight chest (more common in those with asthma), stomach irritation (such as nausea and pain), and rarely itch/rashes. Toxic and other adverse reactions to seafood are outlined in the table below. Table: Toxic and other adverse reactions to seafood \| \| \| \| \| \| \|---\|---\|---\|---\|---\| \| Cause \| Seafood implicated \| Clinical symptoms \| Time of onset \| Allergy test \| \| Bacterial infection Salmonella, Vibrio, Aeromonas, Listeria \| Crustacean, Mollusc, Fish \| Dermatological Gastrointestinal Neurological Respiratory \| Minutes to several hours \| Negative \| \| Viral infection Hepatitis A, Rota- Astrovirus, Small round Viruses etc. \| Crustacean, Mollusc \| Negative \| \| \| \| Seafood parasites Anisakis Diphyllobothrium \| All fish and some molluscs \| Negative \| \| \| \| Toxins 1\) Scombrotoxin Marine Toxins 2\) Ciguatera toxin 3\) Algae toxins \| 1\) Fish, particularly with dark meat 2\) Reef fish 3\) All Mollusc species \| Negative \| \| \| \| Allergens Shellfish \| Crustacean Mollusc Fish \| Positive \| \| \| © ASCIA 2024 Content updated April 2024 For more information go to [www.allergy.org.au/patients/food-allergy](https://www.allergy.org.au/patients/food-allergy/) To support allergy and immunology research go to [www.allergyimmunology.org.au/donate](https://www.allergyimmunology.org.au/donate)
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