Prognosis andManagement outgrow them.outgrow people with seafood allergies eventually to 4%of than other foodallergies.outgrown Only about 3.5 allergies develop later inlife andare less likely to be seafood Typically, allergy. their outgrow will child It is difficult to determine whether ornot yourIt isdifficult to determine For about foodallergies, morevisit: detailed information RESOURCES disorders.eosinophilic gastrointestinal IgE-mediated food allergy, gastrointestinal foodallergies, including awide variety of food of management allergy, and Center provides comprehensive services in the evaluationThe Food Allergy and Program at Children’s NationalFOOD ALLERGY PROGRAM Medical • The Food Initiative• The Allergy (www.faiusa.org) (www.foodallergy.org) Food andAnaphylaxis• The Network Allergy Children’s NationalMedical Center www.childrensnational.org Children’s National Medical Center Supported by a grant from the from bya grant Supported 111 Michigan Avenue,111 Michigan NW Washington, DC20010 Food Program Allergy Phone: 202-476-3016 or fVisitors Board of Fax: 202-476-2280

ALLabout FISH & SHELLFISH ALLERGIES Overview of Fish and Shellfish Allergies Shellfish How to avoid a seafood allergic reaction It is very important to be able to identify sources of Fish and shellfish allergies occur in only about There are two families of shellfish: fish and/or shellfish in order to help your child avoid 0.1% of young children in the United States. • Crustacea - shrimp, crab, crawfish, prawns, them. Any packaged food containing fish and/or It is more common for these allergies to and lobster shellfish is required to clearly state that on its label. develop in adulthood: 40% of people • Mollusks - clams, scallops, oysters, mussels, Some Sources of Fish/Shellfish: with fish allergy and 60% of those abalone, cockle, octopus, squid, and snail • Fish sticks with shellfish allergy acquire the (escargot) The most common shellfish allergies are to • Anchovies allergy as adults. Shellfish If • Asian dishes – many use fish allergy is in fact the most my child crustacea, specifically shrimp, crab and lobster. is allergic to Usually it is recommended that people with a sauce as a flavoring base common food allergy in fish, should he/ • Salad dressings, particularly Can iodine adults. Reactions to she also avoid shellfish allergy avoid all shellfish. Some people shellfish?? Caesar cause an adverse fish and shellfish with an allergy to one shellfish group may be able • Worcestershire sauce reaction in someone are often severe, Despite both being to tolerate the other group. However, you should “seafood,” fish and shellfish – often contains with a fish/shellfish and shellfish are actually in two different consult with your child’s allergist before exposing food families. That means that if anchovies allergy? in particular your child to other types of shellfish. someone is allergic to fish, but testing • Surimi is imitation is one of to shellfish is negative, he/she may be able to eat shellfish. Of course, crabmeat made No, allergy to iodine and the most cross-contamination is always a risk from fish allergy to fish/shellfish are not frequent triggers because fish and shellfish are often handled and displayed • Eating out related. Iodine is used in many of anaphylaxis. together at stores, and radiographic procedures. Often the cooked or fried together – When at restaurants. Be sure eating radiologist will ask if the patient is Fish to talk with your out, be allergic to shellfish or fish. In reality, There are a number of allergist to come up with a plan aware of it is not necessary to worry about different kinds of fish that can for your child. the possibility cross-reactions with iodine cause a fish-allergic reaction. Salmon, of cross- if your child has a fish or tuna, and halibut are responsible for a contamination. It shellfish allergy. majority of fish allergies. If your child has is important to make a fish allergy, it is generally recommended that sure the food your child he/she stay away from all fish. This is because orders is not cooked in most people who are allergic to one fish are usually the same pan or the same allergic to other types of fish as well. You may have oil used to cook fish and/or heard that some people with a fish allergy are able shellfish. to tolerate canned tuna or salmon. However, it is In general, it is advised that fish and/ usually recommended to avoid canned fish and it is or shellfish-allergic individuals avoid seafood imperative to consult with your child’s allergist on restaurants. There is a high risk of cross- this issue. contamination. Also, there is a possibility that allergen can become airborne while fish and/or shellfish are being cooked and potentially cause an allergic reaction.