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Shellfish Allergy Avoidance

The Asthma Center, Allergic Disease Associates, P.C.
Professional Arts Building
205 North Broad Street, Ste 300
Philadelphia, PA 19107

215-569-1111
http://www.asthmacenter.com

Shellfish (Shrimp, crab, lobster) allergies are common among adults. Individuals allergic to one shellfish may or may not be allergic to others in the same family, but until proven tolerant, all shellfish should be avoided. Shellfish are not a primary source of any one nutrient in the United States, and therefore dietary substitutions are not necessary. Foods labeled as “kosher” do not contain shellfish and are safe for shellfish-sensitive individuals.

Hidden Sources of Shellfish
A few hidden sources of shellfish exist. Shellfish may be in ingredients in Asian dishes and in stuffing. Imitation shellfish (surimi) may contain shellfish or used shellfish as flavoring. Cross-contamination in restaurants from common utensils, cooking pans and oils may occur. Cooked seafood vapors may also produce reactions in some individuals, and avoidance of seafood restaurants should be considered by those who are particularly sensitive to shellfish. The possibility of allergic reaction to shellfish through kissing has also been reported and is usually not thought of by people with shellfish allergies. Teenagers and young adults may be particularly at risk during dating to this hidden contact source. Individuals of any age though, should be aware of this vulnerability. Pet foods may also contain protein from shellfish. For children and adults extremely sensitive to shellfish, even trace amounts of shellfish exposure from animal saliva may cause a reaction.

Ingredient Terms that Indicate or May Indicate the Presence of Shellfish
The following is a list of partial terms commonly used on food labels to indicate the presence of shellfish. This list should be distributed to any caregiver, relatives or food service workers who will be providing food to the shellfish-allergic individual. Individuals with shellfish sensitivity should avoid all foods containing these ingredients unless the particular shellfish has been evaluated as safe for the particular individual.

Ingredient Terms that INDICATE the Presence of Shellfish

  • Abalone
  • Clams (cherrystone, littleneck, pismo, quahog)
  • Cockle (periwinkle, sea urchin)
  • Crab
  • Crawfish (crayfish, ecrevisse)
  • Lobster (langouste, langousine, scampi, coral, tomalley)
  • Mollusks
  • Mussels
  • Octopus
  • Oysters
  • Prawns
  • Shrimp (crevette)
  • Snails (escargot)
  • Squid (calamari)

Ingredient Terms that MAY INDICATE the Presence of Shellfish

  • Bouillabaisse
  • Fish Stock
  • Seafood Flavorings (such as crab, clam extract)
  • Surimi

The Food Allergy and Anaphylaxis Network
The Food Allergy and Anaphylaxis Network (FAAN) is a very helpful lay organization based in Fairfax, Virginia that also publishes a number of resources for individuals with food allergies including a bi-monthly newsletter called Food Allergy News. Cookbooks and videos are also available. FAAN also provides to members a convenient, laminated wallet-sized chart that delineates how to read a food label for a shellfish-free diet. Their phone number is 1-800-929-4040, and their website is http://www.foodallergy.org

What Consumers Can do to Help Identify Allergens
If a consumer finds that a product causes a reaction, besides discussing it with your physician at the Asthma Center, please notify the manufacturer and notify the local FDA consumer complaint coordinator (The following provides a list of phone numbers in the US) http://www.fda.gov/opacom/backgrounders/complain.html

In addition, consumers should continue to provide input about concerns and suggestions for allergen labeling issues by emailing comments to fdadockets@oc.fda.gov and noting Docket OOP-1322.

NOTE: There are some individuals who have allergic-like symptoms to shellfish, particularly hives, who are skin test negative to shellfish. These individuals do not have true allergies but react to a sufficient amount of chemicals (e.g. histamines) in the shellfish muscle producing the allergic-looking reaction. Different than the allergic individual, these individuals will not always react to shellfish ingestion. Since reactions are unpredictable, complete avoidance of shellfish is still advisable.

Printed with permission from The Asthma Center, copyright 2008