Login to MyEpiPen^®

Anaphylaxis is a severe allergic reaction which can be potentially life-threatening. It should always be treated as a medical emergency, requiring immediate treatment.¹

Anaphylaxis is both preventable and treatable. Knowing your triggers and avoiding them is the best way to help prevent an anaphylactic event.^2,3

To treat anaphylaxis, give adrenaline (epinephrine) as the first line of treatment. For more information on the steps to treat anaphylaxis, including Action Plans and First Aid Plans for Anaphylaxis, visit the Australasian Society of Clinical Immunology and Allergy (ASCIA) website here.²

The following are symptoms of anaphylaxis:^4,5

• Difficult/noisy breathing
• Swelling of the tongue
• Swelling/tightness in the throat
• Difficulty talking and/or hoarse voice
• Wheeze or persistent cough
• Persistent dizziness or collapse
• Loss of consciousness and/or collapse or becoming pale and floppy (in young children)

Symptoms may also include:⁶

• Swelling of the lips, face and eyes
• Hives or welts
• Tingling mouth
• Abdominal pain, vomiting

Anaphylaxis is not always accompanied by skin symptoms. Some anaphylactic reactions can occur without any skin symptoms.⁷

Skin symptoms are usually a sign of a mild to moderate allergic reaction and may include:⁸

• Hives
• Welts
• Body redness
• Swelling of the face, lips and/or eyes.

However, the symptoms and severity of a reaction can be different each time and can start with mild symptoms that get worse quickly.⁷

Anaphylaxis usually occurs within minutes of exposure to an allergen. However, in some cases, anaphylaxis can happen 30 minutes or longer after exposure. In very rare cases, anaphylaxis may be delayed for hours.⁹

For food allergies, anaphylaxis typically happens within one to two hours, with the start of symptoms occurring more rapidly – within 30 minutes.¹⁰

Anaphylaxis to stings and injected medications usually happens within 5-30 minutes but can be delayed.¹⁰

Anaphylactic shock is the severe, rapid progression of anaphylaxis that results in a life-threatening drop in blood pressure.¹¹

It’s possible to have a mild to moderate allergic reaction to a certain trigger or triggers. Symptoms of a mild to moderate allergic reaction may include:¹²

• Swelling of the lips, face and eyes
• Hives or welts
• Tingling mouth
• Abdominal pain, vomiting

Sometimes, (but not always) before an anaphylactic reaction occurs, a person experiences milder symptoms. These may include tingling of the skin or abdominal pain and vomiting. These early symptoms can be a useful warning that exposure to a trigger has occurred, and that treatment may be needed.⁴

Anaphylaxis is a form of allergy.¹³

An allergic reaction occurs when our immune system reacts to something that is usually considered harmless, such as a certain food, pollen, dust mites, insect bites or latex.¹

Anaphylaxis is the most severe form of allergic reaction, can be life-threatening and should always be treated as an emergency.^13,14

The best way to manage allergies is to identify and avoid your allergy triggers and treat your allergy, depending on the severity.¹⁵

To treat anaphylaxis, the most severe type of allergy, adrenaline (epinephrine) should be used as the first line of treatment.²

For mild allergies, medications can help. These include prescription and non-prescription medications. For allergies that are not completely relieved by other treatment, immunotherapy may be an option.¹⁵

Anaphylaxis can occur in people who are exposed to an allergen to which they are allergic.¹²

In people with anaphylaxis, the immune system 'overreacts' to the allergen. Contact with, or ingestion of this allergen sets off a chain reaction in the immune system that may lead to anaphylaxis.¹⁶

The most common triggers for anaphylaxis include:

• Foods (e.g. peanuts and eggs)¹⁷
• Insect bites and stings (e.g. bees and wasps)^17,18
• Latex allergy (e.g. gloves and balloons)¹⁹
• Medicines (e.g. penicillin and chemotherapy drugs)^17,20,21

Sometimes anaphylaxis can occur without a cause. This is called idiopathic anaphylaxis.

While deaths from anaphylaxis are rare, there are several factors that increase the risk of fatal anaphylaxis. These include:²²

• Delaying the use of or not using adrenaline
• Upright posture during anaphylaxis
• Age
  • Teenagers and young adults (from food allergy)
  • Adults (from insect and drug allergy)
• Asthma
• People who are allergic to foods and are eating away from their home
• People who have been initially misdiagnosed
• People with systemic mastocytosis

It’s important to know that a previous mild or moderate reaction does not rule out the possibility of a severe or fatal reaction during a subsequent exposure to a trigger.²²

Without immediate treatment, anaphylaxis can quickly worsen and lead to death within 15 minutes.²³

Swelling of the face, lips or eyes can be a sign of an allergic reaction.¹²

If you experience any of these symptoms or other common symptoms of allergy and/anaphylaxis after eating nuts, you may have an allergy to nuts.

It’s important that you seek immediate advice from your doctor.

People with an allergy to peanuts can react to as little as 1/2000^th of a single peanut, with a range of one tiny fragment to two peanuts. As time goes by, it can take less and less to cause a reaction. This is because repeated exposure to the allergen boosts the immune response, and the IgE antibody levels rise.²⁴

In people who have an initial mild reaction to peanuts, up to half may go on to have a severe reaction after a subsequent exposure.²⁴

Most life-threatening reactions are triggered by ingesting peanuts. However, serious reactions can also occur from skin or eye contact and inhalation of food particles.²⁴

Difficulty breathing can be a sign of anaphylaxis.^4,6

If you experience chest tightness, difficulty breathing, or other common symptoms of anaphylaxis after a bee or insect sting, you may have an allergy.

It’s important that you seek immediate advice from your doctor.

Anaphylaxis to insect bites and stings usually happens within 5-30 minutes but can be delayed.¹⁰

In Australia, allergies to venoms from stinging insects, such as bees, wasps and ants, are one of the most common causes of anaphylaxis.²⁵

Symptoms of a severe allergic reaction to an insect bite or sting include: an all over rash, swelling of the tongue or throat, trouble breathing, abdominal pain, diarrhoea, vomiting and shock.²⁵

Anaphylaxis following vaccination is rare but does happen. Anaphylaxis to vaccines is caused by the vaccine antigen itself or an ingredient in the vaccine.

Severe anaphylactic reactions typically happen within 15 minutes of vaccination.²⁶

Before receiving a vaccination of any kind, you will usually be asked to complete a questionnaire to determine whether you are at risk.²⁶

If you have concerns about anaphylaxis from receiving vaccines, speak with your doctor, nurse or pharmacist.

Penicillin allergy can be determined by an allergist/immunologist taking a full medical history and performing a skin prick test.²⁷

Approximately 10% of people report an allergy to penicillin, but in fact most of these people may not truly be allergic. Most people with penicillin allergy lose their reaction over time, even those with a history of anaphylaxis.²⁷

Reactions to penicillin typically appear less than an hour after receiving a dose of the medication. Symptoms frequently involve skin reactions such as hives and swelling. In more serious cases that suggest anaphylaxis, symptoms can include:²⁷

• Swelling of the tongue, throat and lips
• Difficulty breathing, coughing, chest tightness, wheezing
• Light-headedness, loss of consciousness

Living with, and managing, a severe allergy can sometimes have a negative impact on quality of life. Understanding your triggers and being prepared for a severe allergic reaction are ways that you can help lessen your fears.

However, if you feel that your fear of anaphylaxis is getting in the way of living your day-to-day life and stopping you from doing things you enjoy, you may want to reach out for help. Allergy & Anaphylaxis Australia have a range of resources for dealing with anxiety.²⁸ To find out more, click here.