When allergies can kill you – what you need to know about anaphylaxis

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Anaphylaxis is a severe, life-threatening allergic reaction that needs to be treated quickly.
Anaphylaxis is a severe, life-threatening allergic reaction that needs to be treated quickly.
Enrique Díaz/7cero/Getty Images

Sniffing, snuffling and sneezing? If it’s not a cold, you could be suffering from an allergy.

An allergic reaction occurs when a person’s immune system becomes hypersensitive to certain substances. Common ones include pollen, certain foods, medication, and bee stings.

Many people suffer from allergies of one sort or another and the symptoms can vary from mild to severe.

Anaphylaxis is the severest form of allergic reaction and this is why it is the focus of this year’s World Allergy Week.

It is a very dangerous condition, as its onset is often sudden and deterioration can be rapid, says CEO of the Allergy Foundation of South Africa, Professor Mike Levin.

“The quicker anaphylaxis is treated, the better. We can save lives if everyone learns the early signs of anaphylaxis and is able to recognise it and respond fast.

“That is why it is essential that people at risk, as well as the parents of children who suffer from this condition, must know how to reduce the risk, recognise the symptoms, and administer emergency treatment if required,” he says.

Read more | 10 people in the US had bad allergic reactions to Moderna’s vaccine – after 4 million doses

What causes anaphylaxis?

For many people, foods such as egg, milk, peanuts, nuts, fish, shellfish, sesame, soya and wheat are the trigger for anaphylaxis, Prof Levin says.

In others, medications may be the cause, including antibiotics, aspirin and other over-the-counter pain relievers.

Also air-borne or occupational allergens, such as dust mites, pollen, and animal skin or saliva or an allergy to natural rubber latex.

Anaphylaxis can also be caused by an allergy to insect stings, like bees or wasps, or even to physical factors such as extreme cold.

The symptoms

Anaphylaxis usually occurs soon after exposure to an allergen, within 15 minutes to one hour. It can include the following symptoms

  • Skin reactions, including hives and itching and flushed or pale skin
  • Low blood pressure (hypotension)
  • Constriction of your airways and a swollen tongue or throat, which can cause wheezing and trouble breathing
  • A weak and rapid pulse
  • Nausea, vomiting or diarrhoea
  • Dizziness or fainting.

Read more | Flu season might coincide with a rise in Covid-19 cases, warns NICD

Treatment

If someone with anaphylaxis realises they are having an attack and treats it speedily, it can usually be controlled quickly, says allergist and executive committee member of Allergy Society of South Africa, Professor Claudia Gray.

But if it’s allowed to progress untreated, it becomes more difficult to control, with possible serious results. 

“People at risk from anaphylaxis must be taught to immediately recognise the earliest signs so they can react swiftly. Sufferers should wear a medical emergency disc or band (bracelet or necklace) and must ensure they always carry emergency adrenaline treatment (for example, an adrenaline auto-injector), and know how to inject themselves. 

“The auto-injectors generally come in two strengths – one for children between 8 and 25kg and another for people weighing more than 25kg.  Large adults may need two doses,” she adds.

The best strategy for someone who knows they have a severe allergy is to avoid the trigger they are allergic to. So, people with food allergies must learn to read food labels carefully and those who have a reaction for the first time must try to identify the trigger and have tests done to confirm the cause. 

Covid-19 vaccine induced anaphylaxis

There have been reported cases of people experiencing anaphylaxis after receiving the Covid-19 vaccine.

Professors Gray and Levin agree the instances are extremely rare, with the occurrence of estimated at 1.31 in 1 million doses given.

“Although the specific vaccine component causing the anaphylaxis has not been identified, people who have a history of a severe allergic reaction to any prior vaccine should be referred to an allergist for further evaluation prior to getting the Covid-19 vaccination,” Prof Gray says. 

“Anyone who has a reaction of any severity within four hours of receiving the first Covid-19 shot should not get the second shot. 

“People with food allergies and environmental allergies and asthma can safely be given the Covid-19 vaccine without any additional risk. It is administered in a healthcare setting where anaphylaxis can be treated speedily should it occur. But again, I reiterate that instances are rare,” she adds.

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