DOCSLIB.ORG

Influenza Vaccination of People with a History of Egg Allergy

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Influenza Vaccination of People with a History of Egg Allergy InfluenzaV accination of People with a History of Egg Allergy • Most influenza vaccines, with the exception of recombi- Recommendations regarding influenza vaccination nant influenza vaccine (RIV4) and cell culture-based of persons who report allergy to eggs – Advisory influenza vaccine (ccIIV4), are cultured in eggs and Committee on Immunization Practices, United States, might contain trace amounts of egg protein (e.g., 2020–21 influenza season ovalbumin). • People with a history of egg allergy who have experi- Administer any recom- enced only urticaria (hives) after exposure to egg should After eating eggs or mended, and age-appro- egg-containing foods, receive influenza vaccine. Any recommended and age- yes priate IIV, RIV4, or LAIV4 does the person appropriate influenza vaccine (i.e., any IIV, RIV4, or that is otherwise appro- experience only hives? priate for the persons’s LAIV4) that is otherwise appropriate for their health sta- health status tus may be used. no • People who report having had reactions to egg involving symptoms other than urticaria (hives), such as angio- After eating eggs or edema or swelling, respiratory distress, lightheadedness, egg-containing foods, or recurrent vomiting, or who required epinephrine or does the person experi- Administer any IIV, RIV4, ence other symptoms or LAIV4 that is other- another emergency medical intervention, may similarly such as wise appropriate for the receive any recommended, and age-appropriate influ- • Angioedema? person’s age and health enza vaccine (i.e., any IIV, RIV4, or LAIV4) that is other- status in a medical set- wise appropriate for their age and health status. If a vac- • Respiratory distress ting (e.g., health depart- (e.g., wheezing)? cine other than ccIIV4 or RIV4 is used, the selected ment, physician office). yes vaccine should be administered in a medical setting (e.g., • Lightheadedness? If a vaccine other than ccIIV4 or RIV4 is used, clinic, health department, physician office) and super- • Recurrent emesis vaccination should be vised by a healthcare provider who is able to recognize (e.g., nausea/vomit- ing)? supervised by a health- and manage severe allergic conditions. care provider with experi- • Reaction requiring ence in the recognition • A previous severe allergic reaction to influenza vaccine, epinephrine? and management of regardless of the component suspected of being respon- • Reaction requiring severe allergic condi- sible for the reaction, is a contraindication to future emergency medical tions. receipt of the vaccine. attention? • Regardless of allergy history, all vaccines should be administered in settings in which personnel and equip- ment for rapid recognition and treatment of anaphylaxis are available.* abbreviations references = IIV Inactivated Influenza Vaccine (Afluria Quadrivalent, Fluad, * CDC. Best practices guidance of the Advisory Committee on Immu- Fluad Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, nization Practices Committee (ACIP). Access at Fluzone Quadrivalent) www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html ccIIV4 = Cell-cultured inactivated influenza vaccine (Flucelvax Adapted from CDC. “Prevention and Control of Seasonal Influenza Quadrivalent) with Vaccines: Recommendations of the Advisory Committee on Immu- RIV4 = Recombinant Influenza Vaccine (Flublok Quadrivalent) nization Practices – United States, . Access links to current recom- mendations at www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html LAIV4 = Live Attenuated Influenza Vaccine (FluMist Quadrivalent) Saint Paul, Minnesota • 651-647-9009 • www.immunize.org • www.vaccineinformation.org www.immunize.org/catg.d/p3094.pdf • Item #P3094 (9/20).
Load more

Recommended publications
  • Food Allergy Outline
    Allergy Evaluation-What it all Means & Role of Allergist Sai R. Nimmagadda, M.D.. Associated Allergists and Asthma Specialists Ltd. Clinical Assistant Professor Of Pediatrics Northwestern University Chicago, Illinois Objectives of Presentation • Discuss the different options for allergy evaluation. – Skin tests – Immunocap Testing • Understand the results of Allergy testing in various allergic diseases. • Briefly Understand what an Allergist Does Common Allergic Diseases Seen in the Primary Care Office • Atopic Dermatitis/Eczema • Food Allergy • Allergic Rhinitis • Allergic Asthma • Allergic GI Diseases Factors that Influence Allergies Development and Expression Host Factors Environmental Factors . Genetic Indoor allergens - Atopy Outdoor allergens - Airway hyper Occupational sensitizers responsiveness Tobacco smoke . Gender Air Pollution . Obesity Respiratory Infections Diet © Global Initiative for Asthma Why Perform Allergy Testing? – Confirm Allergens and answer specific questions. • Am I allergic to my dog? • Do I have a milk allergy? • Have I outgrown my allergy? • Do I need medications? • Am I penicillin allergic? • Do I have a bee sting allergy Tests Performed in the Diagnostic Allergy Laboratory • Allergen-specific IgE (over 200 allergen extracts) – Pollen (weeds, grasses, trees), – Epidermal, dust mites, molds, – Foods, – Venoms, – Drugs, – Occupational allergens (e.g., natural rubber latex) • Total Serum IgE (anti-IgE; ABPA) • Multi-allergen screen for IgE antibody Diagnostic Allergy Testing Serological Confirmation of Sensitization History of RAST Testing • RAST (radioallergosorbent test) invented and marketed in 1974 • The suspected allergen is bound to an insoluble material and the patient's serum is added • If the serum contains antibodies to the allergen, those antibodies will bind to the allergen • Radiolabeled anti-human IgE antibody is added where it binds to those IgE antibodies already bound to the insoluble material • The unbound anti-human IgE antibodies are washed away.
    [Show full text]
  • Egg Allergy: the Facts
    Egg Allergy: The Facts Egg is a common cause of allergic reactions in infants and young children. It often begins in the child’s first year of life and in some cases lasts into the teenage years – or even into adulthood for a few people. Children who develop allergy to foods such as egg often have other allergic conditions. Eczema and food allergy often occur in early infancy and later on there may be hay-fever, asthma or both. This Factsheet aims to answer some of the questions which you and your family may have about living with egg allergy. Our aim is to provide information that will help you to understand and minimise risks. Even severe cases can be well managed with the right guidance. Many cases of egg allergy are mild, but more severe symptoms are a possibility for some people. If you believe you or your child is allergic to egg, the most important message is to visit your GP and ask for allergy tests and expert advice on management. Throughout this Factsheet you will see brief medical references given in brackets. If you wish to see the full references, please email us at [email protected]. Symptoms triggered by egg The symptoms of a food allergy, including egg allergy, may occur within seconds or minutes of contact with the culprit food. On occasions there may be a delay of more than an hour. Mild symptoms include nettle rash (otherwise known as hives or urticaria) or a tingling or itchy feeling in the mouth. More serious symptoms are uncommon but remain a possibility for some people, including children.
    [Show full text]
  • What You Need to Know
    WhatWhat YouYou NeedNeed ToTo KnowKnow 11 inin 1313 childrenchildren That’sThat’s roughlyroughly inin thethe U.S.U.S. hashas 66 millionmillion aa foodfood allergy...allergy... children.children. That'sThat's aboutabout 22 kidskids inin everyevery classroom.classroom. MoreMore thanthan 15%15% ofof schoolschool agedaged childrenchildren withwith foodfood allergiesallergies havehave hadhad aa reactionreaction inin school.school. A food allergy occurs when Food allergy is an IgE-mediated immune the immune system targets a reaction and is not the same as a food food protein and sets off a intolerance or sensitivity. It occurs quickly reaction throughout the body. and can be life-threatening. IgE, or Immunoglobulin E, are antibodies produced by the immune system. IgE antibodies fight allergenic food by releasing chemicals like histamine that trigger symptoms of an allergic reaction. ANTIBODY HISTAMINE Mild Symptoms Severe Symptoms Redness around Swelling of lips, Difficulty Hives mouth or eyes tongue and/or throat swallowing Shortness of Low blood Itchy mouth, Stomach pain breath, wheezing pressure nose or ears or cramps Loss of Chest pain consciousness Nausea or Sneezing Repetitive coughing vomiting AccordingAccording toto thethe CDC,CDC, foodfood allergiesallergies resultresult inin moremore thanthan 300,000300,000 doctordoctor visitsvisits eacheach yearyear amongamong childrenchildren underunder thethe ageage ofof 18.18. Risk Factors Family history Children are at Having asthma or an of asthma or greater risk allergic condition such allergies than adults as hay fever or eczema WhatWhat CanCan YouYou BeBe AllergicAllergic To?To? Up to 4,145,700 people in the U.S. are PEANUTSPEANUTS allergic to peanuts. That’s more than the entire country population 25-40% of Panama! of people who are allergic to peanuts also have reactions to at least one tree nut.
    [Show full text]
  • Early Exposure to Egg: Egg Allergy Prevention
    Early exposure to egg: egg allergy prevention Intervention Introduction of egg to the diet of infants aged 4–6 months. Indication Infants, particularly those at higher risk of food allergy, with the aim of reducing the risk of developing egg allergy. (See Precautions.) [Hen’s egg allergy is the second most common food allergy Infants who started eating egg between 4 and 6 months of age show a 40% relative in infants and young children risk reduction of egg allergy compared with children who started egg later in life. (cow’s milk is the most common). In terms of absolute risk reduction, in a population where 5.4% of people have egg Most children outgrow egg allergy (ie reported UK prevalence rate), early egg introduction could prevent allergy by adolescence.] 24 cases of egg allergy per 1000 people. The Australasian Society of Clinical Immunology and Allergy recommends introduction of solids (including egg and peanut) for all infants between 4 and 6 months of age. Precautions Infants with a personal history of atopy (particularly moderate-severe eczema) or with a family history of atopy are at high risk of developing allergic disease, including food allergies. These infants may benefit from evaluation by an allergist or a general practitioner trained in management of allergic diseases in this age group to diagnose food allergy and assist in early egg introduction if appropriate. Adverse effects There were no deaths in the studies (which included children at higher risk) and no significant differences in rates of serious adverse events in egg consumption groups and egg avoidance groups.
    [Show full text]
  • BSACI Egg Allergy (PDF)
    Egg allergy What is egg allergy? How is egg allergy diagnosed? Egg allergy is caused by an allergic reaction to The diagnosis of egg allergy is based on the egg protein. This protein is found mostly in the history of previous reactions, and can be egg white but also on the yolk. It is common in confirmed by skin tests or blood tests. children under 5 years and usually first noticed in infancy when egg is introduced into the diet What is the treatment? for the first time. It is rare for egg allergy to The best current treatment is to avoid all food develop in adulthood. Those who develop egg containing egg for 1-2 years, allowing the allergy as adults may also be allergic to birds or allergy time to resolve. Egg may be found in a feathers which contain a protein which is similar wide range of foods, including: cakes, pastries, to that found in egg yolk. desserts, meat products, salad dressings, glazes, pasta, battered and bread crumbed What are the symptoms? foods, ice cream, chocolates and sweets. It Most reactions are mild. Commonly infants may also be referred to by unusual terms refuse the egg-containing food, develop especially on imported foods e.g. egg lecithin or redness and sometimes swelling around the albumen (=egg white). The proteins in eggs mouth soon after skin contact and then vomit from other birds are very similar to those in after eating. Stomach ache or diarrhoea may hens’ eggs and should be avoided too. This list also occur. Rarely, some children also develop is not exhaustive and because ingredients can a more severe reaction with cough, an asthma- change food labels must be read carefully type wheeze or even anaphylaxis.
    [Show full text]
  • What You Need to Know About the New Guidelines for the Diagnosis and Management of Food Allergy in the U.S
    Allergy guidelines insert_Layout 1 9/26/11 1:36 PM Page 1 What you need to know about the new guidelines for the diagnosis and management of food allergy in the U.S. V OLUME 126, N O . 6 D ECEMBER 2010 • Tests for food-specific IgE are recom- Overview www.jacionline.org • The Guidelines, sponsored by the NIH Supplement to mended to assist in diagnosis, but should (NIAID), are based upon expert opinion THE JOURNAL OF not be relied upon as a sole means to di- Allergy ANDClinical and a comprehensive literature review. Immunology agnose food allergy. The medical history/ AAP had input on the document.1,2 exam are recommended to aid in diag- nosis. A medically monitored feeding Guidelines for the Diagnosis and Management Definitions of Food Allergy in the United States: Report of the (food challenge) is considered the most NIAID-Sponsored Expert Panel • Food allergy was defined as an adverse definitive test for food allergy. health effect arising from a specific im- • Food-specific IgE testing has numerous mune response. limitations; positive tests are not intrin- • Food allergies result in IgE-mediated sically diagnostic and reactions some- immediate reactions (e.g., anaphylaxis) OFFICIAL JOURNAL OF times occur with negative tests. These and several chronic diseases (e.g., ente- Supported by the Food Allergy Initiative issues are also reviewed in an AAP Clini - rocolitis syndromes, eosinophilic esopha - cal Report.3 Testing “food panels” with- gitis, etc), in which IgE may not play an important role. out considering history is often mis - leading. Tests selected to evaluate food allergy should be Epidemiology and Natural History based on the patient’s medical history and not comprise • Food allergy is more common in children than adults, large general panels of food allergens.
    [Show full text]
  • Egg Allergy: Diagnosis and Immunotherapy
    International Journal of Molecular Sciences Review Egg Allergy: Diagnosis and Immunotherapy Dulashi Withanage Dona and Cenk Suphioglu * NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, 75 Pigdons Road, Geelong 3216 VIC, Australia; [email protected] * Correspondence: [email protected]; Tel.: +61-3-5227-2886 Received: 1 May 2020; Accepted: 14 July 2020; Published: 16 July 2020 Abstract: Hypersensitivity or an allergy to chicken egg proteins is a predominant symptomatic condition affecting 1 in 20 children in Australia; however, an effective form of therapy has not yet been found. This occurs as the immune system of the allergic individual overreacts when in contact with egg allergens (egg proteins), triggering a complex immune response. The subsequent instantaneous inflammatory immune response is characterized by the excessive production of immunoglobulin E (IgE) antibody against the allergen, T-cell mediators and inflammation. Current allergen-specific approaches to egg allergy diagnosis and treatment lack consistency and therefore pose safety concerns among anaphylactic patients. Immunotherapy has thus far been found to be the most efficient way to treat and relieve symptoms, this includes oral immunotherapy (OIT) and sublingual immunotherapy (SLIT). A major limitation in immunotherapy, however, is the difficulty in preparing effective and safe extracts from natural allergen sources. Advances in molecular techniques allow for the production of safe and standardized recombinant and hypoallergenic egg variants by targeting the IgE-binding epitopes responsible for clinical allergic symptoms. Site-directed mutagenesis can be performed to create such safe hypoallergens for their potential use in future methods of immunotherapy, providing a feasible standardized therapeutic approach to target egg allergies safely.
    [Show full text]
  • ASCIA Health Professional Information Paper
    ASCIA Health Professional Information Paper Nutritional Management of Food Allergy September 2013 This health professional information paper complements ASCIA food allergy e-training for dietitians and other health professionals. The primary purpose of this document is to provide an evidence based, ‘quick reference guide’ to assist dietitians in the management of patients with IgE and non-IgE mediated food allergy. ASCIA has received a grant from WA Department of Health to produce this health professional information paper. 1 ASCIA HP Information Paper: Food allergy | ©ASCIA 2013 Contents Page 1. Adverse food reactions - definitions 3 1.1 Overview 3 1.2 Food allergy 1.2.1 IgE mediated food allergy 3 1.2.2 Non-IgE mediated food allergy 4 1.2.3 Mixed IgE and non-IgE mediated food allergy 4 1.3 Food intolerance 4 2. Diagnosis of food allergy 5 3. Nutrition assessment of food allergic individuals 6 3.1 Initial dietary assessment – adults and children 3.2 Initial dietary assessment – infants and children 6 3.3 Assessing growth 6 3.4 Identifying nutrients at risk with exclusion diets 7 4. Comprehensive management of food allergy 8 4.1 Role of dietitian 8 4.2 Breastfeeding and infant formulas 4.3 Complementary foods/introducing solids 10 4.4 Education 11 Appendices A. Diagnosis and emergency treatment of food allergy 13 B. Nutrition assessment – infants and children with food allergy 15 C. Food labels and food allergy 16 D. Non-IgE mediated and mixed IgE/non-IgE mediated conditions associated 17 with food allergy E. Sources of information about food allergy for dietitians and patients 22 F.
    [Show full text]
  • Egg Allergen Component Testing Brochure
    Egg allergen component testing Gal d2 Egg Gal allergen d1 by the numbers Detect sensitizations to the whole egg protein to create personalized management plans for your patients. High levels of egg white IgE may predict the likelihood of sensitivity, but may not be solely predictive of reactions to baked egg or allergy duration.1 Egg allergen component testing Measurement of specific IgE by blood test that Determine provides objective assessment of sensitization to egg white is the first step in discovering your patient’s which proteins allergy. Egg allergen component tests can help you your patient is determine the likelihood of reaction to products baked with egg, such as muffins or cookies, as well as the sensitized to. likelihood of allergy persistence. % of children with egg allergy 70 do not react to baked egg.9 Gal Gal d2 d1 Ovalbumin Ovomucoid F232 F233 • Susceptible to heat • Resistant to heat denaturation2 denaturation2 • HIGHER RISK of reaction • HIGHER RISK of reaction to uncooked egg1,3 to all forms of egg1 • LOWER RISK of reaction • Patient unlikely to to baked egg1,3a outgrow egg allergy with • Patient likely to outgrow high levels of specific IgE egg allergy4 to ovomucoid5,6,7,8 Knowing which protein your patient is sensitized to can help you develop a management plan.1,2,9,10 Ovalbumin Ovomucoid Test interpretations and next steps • Avoid uncooked eggs • Likely to tolerate baked egg • Baked egg oral food challenge with a specialist may be appropriate • Consider repeating IgE component test biennially + - during childhood
    [Show full text]
  • Hodgkin's Lymphoma and Late Onset Egg Allergy
    +Model ALLER-218; No. of Pages 3 ARTICLE IN PRESS Allergol Immunopathol (Madr). 2011;xxx(xx):xxx—xxx View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Repositório Institucional dos Hospitais da Universidade de Coimbra www.elsevier.es/ai RESEARCH LETTER Hodgkin’s lymphoma and late onset egg history of birds or egg proteins exposition. Her personal his- allergy: is there a causal relationship? tory included pollinic rhinoconjuntivitis since she was 14. She denied a clinical history of atopic eczema, asthma, To the Editor: drug allergy or insect bite allergy. She also denied any regu- lar medication (namely acid suppression treatment) besides Hen’s egg is responsible for one of the most frequent chemotherapy until she was 17. food allergies in childhood. About two-thirds of children will The immunoallergic study revealed normal cell counts, outgrow their egg allergy by early school age (1). The per- serum immunoglobulins, complement fractions, immuno- sistence of egg allergy or its late onset has usually a less electrophoresis, lung function and chest X-ray. The study favourable prognosis. of autoimmunity, celiac disease and viral serologies were Hen’s egg is composed by a non-allergic shell (10% of all negatives. The paranasal sinus X-ray showed maxillary the egg), egg white (60%) and egg yolk (30%). Egg white sinusitis. Skin prick tests (prick method) were performed is 10% protein and 88% water, being more allergenic than with a battery of common aeroallergens (ALK Abelló, Madrid, egg yolk. The former contains more than 20 proteins, four Spain), epithelia (ALK Abelló, Madrid, Spain), food commer- of them being major allergens.
    [Show full text]
  • New Onset Egg Allergy in an Adult
    CASE REPORT New Onset Egg Allergy in an Adult M Ünsel, AZ Sin, Ö Ardeniz, N Erdem, R Ersoy, O Gulbahar, N Mete, A Kokuluda˘g Ege University Medical Faculty, Department of Internal Medicine, Division of Allergy and Clinical Immunology, Bornova-Izmir, Turkey ■ Abstract We report newly presenting systemic and local allergic reactions to egg in a 55-year-old woman. The patient did not have a history of egg allergy in childhood or occupational exposure to egg proteins; nor did she report any disease that is known to be related to food allergy. A skin prick test with commercial extracts, prick-to-prick test, CAP radioallergosorbent assay, and a double-blind, placebo-controlled food challenge test were used to prove egg allergy. Because egg allergy mainly affects children and symptoms frequently disappear with age, the late onset in this patient is rare. Key Words: Egg allergy. Adult age. Double-blind placebo-controlled food challenge. ■ Resumen Informamos de nuevas reacciones alérgicas locales y sistémicas al huevo en una mujer de 55 años de edad. La paciente no había tenido reacciones alérgicas al huevo en la infancia, no había estado expuesta por motivos laborales a proteínas del huevo ni informó de que tuviera ninguna enfermedad relacionada con alergia alimentaria. Para confi rmar la alergia al huevo se empleó una prueba cutánea con extractos comerciales, una prueba de radioalergoadsorción CAP y una prueba de provocación alimentaria a doble ciego, controlada con placebo. Debido a que la alergia al huevo afecta principalmente a los niños y a que los síntomas desaparecen con la edad, el inicio tardío de la alergia en esta paciente es infrecuente.
    [Show full text]
  • (ASCIA): Infant Feeding and Allergy Prevention Clinical Update
    Infant Feeding and Allergy Prevention Clinical Update Background ASCIA Guidelines for infant feeding and allergy prevention were developed in 2016 to outline practices that may help reduce the risk of infants developing allergies, particularly early onset allergic diseases such as eczema and food allergy1. The reasons for the continued rise in allergic diseases such as food allergy and eczema are complex and not well understood. Although infants with a family history of allergic disease are at increased risk of developing allergies, infants with no family history can also develop allergies. Therefore, ASCIA guidelines are relevant for all families, including those in which siblings or parents already have food allergies or other allergic conditions. Risk factors for food allergy development An infant with severe eczema or immediate family history (first degree relative) of allergies, is considered at increased risk of developing food allergy. Severe eczema is defined as persistent or frequently recurring eczema with typical morphology and distribution, assessed as severe by a healthcare professional and requiring frequent prescription-strength topical corticosteroids, calcineurin inhibitors or other anti-inflammatory agents, despite appropriate use of emollients2. Infants with severe eczema and/or egg allergy are at increased risk of developing peanut allergy. Introduction of peanut before 12 months of age in these infants significantly reduces the risk of developing peanut allergy3,4. Implementing ASCIA Guidelines in clinical practice 1. Breastfeeding and infant formula • Breastfeeding is recommended for at least 6 months and for as long as mother and infant wish to continue, for the many benefits it provides to the mother and infant.
    [Show full text]