Egg

Symptoms

• Vomiting
• Stomach cramps
• Indigestion
• Diarrhea
• Wheezing
• Shortness of breath, difficulty breathing
• Repetitive cough
• Tightness in throat, hoarse voice
• Weak pulse
• Pale or blue coloring of the skin
• Hives
• Swelling, can affect the tongue and/or lips
• Dizziness
• Confusion

If you or your child experiences any of these symptoms, see an allergist.

Diagnosis

Eggs are one of the most common food allergens. People with an allergy to chicken eggs may also be allergic to other types of eggs, such as goose, duck, turkey or quail.

Within a short period of time after eating (or even touching) eggs, you may experience the following symptoms:

• Skin reactions, such as swelling, a rash, hives or eczema
• Wheezing or difficulty breathing
• Runny nose and sneezing
• Red or watery eyes
• Stomach pain, nausea, vomiting or diarrhea
• Anaphylaxis (less common)

If you or your child experiences any of these symptoms, see an allergist. Your allergist may diagnose an egg allergy through a skin-prick test and/or a blood test.

In the skin-prick test, a small amount of a liquid containing egg protein is placed on the back or forearm, which is then pricked with a small, sterile probe to allow the liquid to seep into the skin. If a raised, reddish spot forms within 15 to 20 minutes, that can indicate an allergy. Depending on the protein in the liquid, skin-prick tests can determine whether your allergy is to egg white proteins or egg yolk proteins. Allergy to egg white proteins is most common.

In the blood test, a blood sample is sent to a laboratory to test for the presence of immunoglobulin E antibodies to egg protein.

If these tests aren’t definitive, your allergist may order an oral food challenge. Under medical supervision, you’ll eat small amounts of egg to see if a reaction develops. Because of the possibility that a reaction could be severe, this test is conducted in your allergists office or at a food challenge center with trained staff, emergency equipment and medication on hand.

A food elimination diet also may be used to determine if an allergy is present. If symptoms disappear when eggs are removed from the diet and reappear when eggs are again eaten, an egg allergy is likely.

Management and Treatment

The best way to manage an egg allergy is to avoid eating eggs.

Unfortunately, eggs are a hidden ingredient in many foods, including canned soups, salad dressings, ice cream and many meat-based dishes, such as meatballs and meatloaf. Even some commercial egg substitutes contain egg protein. As a result, people with an egg allergy must be vigilant about reading labels and asking about the ingredients of foods prepared by others.

Egg is one of eight allergens with specific labeling requirements under the Food Allergen Labeling and Consumer Protection Act of 2004. That law requires manufacturers of packaged food products sold in the U.S. and containing egg as an ingredient to include the presence of egg or egg products, in clear language, on the ingredient label.

Anyone diagnosed with an allergy to either egg whites or egg yolks should avoid eggs altogether; it is not possible to completely separate the white from the yolk.

People with an egg allergy can sometimes tolerate baked goods and other foods containing eggs that have been heated for a prolonged period at a high temperature. Still, there is no way to predict when, or whether, an egg-allergic individual can safely tolerate any product containing eggs. If you’re allergic to eggs, or your child is, ask an allergist which foods must be avoided.

Antihistamines may help to relieve mild symptoms of egg allergy, such as itching.

In addition, your allergist may prescribe epinephrine (adrenaline) in an auto-injector, to be taken in the event you develop symptoms of anaphylaxis a potentially fatal reaction that includes shortness of breath, swelling of the throat, and dizziness from a sudden drop in blood pressure. Your allergist will teach you how to use the auto-injector, which should be kept with you at all times and used as soon as symptoms start to appear. You or someone near you should also call for an ambulance, even if epinephrine provides relief, as the symptoms may recur.

Eggs in vaccines

In the past, the seasonal influenza (flu) vaccine has contained a small amount of egg protein. In today’s vaccines, this is no longer the case. The Centers for Disease Control and Prevention (CDC) no longer recommends that egg-allergic individuals avoid the flu vaccine or receive any special testing prior to administration. It is recommended that all individuals receive this vaccine annually.

The yellow fever vaccine also contains egg protein. Both the World Health Organization and CDC state that a severe egg allergy is a contraindication for that vaccine. Yellow fever is most commonly found in parts of Africa and South America; the vaccine may be required for travel to countries where the disease is found. If needed, your doctor can provide a waiver letter for the vaccine requirement.

Egg-free cooking

A registered dietitian or a nutritionist can help you plan your meals to ensure that you get adequate protein in the absence of eggs.

Many recipes can be modified to avoid the need for eggs. When recipes call for three or fewer eggs, substitute each egg with a mixture of 1 tablespoons of water, 1 tablespoons of oil and 1 teaspoon of baking powder. Alternative substitutes are 1 packet of unflavored gelatin dissolved in 2 tablespoons of warm water (mixed when ready to use), or 1 teaspoon of yeast dissolved in cup of warm water.

Don’t let an egg allergy hold you back from the things you love. Find expert care with an allergist.