Egg allergy is one of the commonest allergies, affecting 1 in 50 children in the UK. It is caused by proteins present in both the egg white and yolk.
Symptoms usually occur immediately after eating food containing egg. They often consist of a rash (hives or “nettle” rash), swelling of the lips or around the eyes, and itching. Some children develop an itchy throat, others feel sick, vomit or have diarrhoea.
Severe reactions (anaphylaxis) are much less common but include difficulty breathing (with wheeze or swelling of the mouth or throat), feeling faint or dizzy.
Delayed reactions may lead to flares of a child’s eczema.
Most children only have mild reactions. Severe reactions are uncommon but need urgent medical attention.
Diagnosis is usually based on a history of a typical reaction. Allergy tests such as skin prick tests and blood tests provide evidence of reaction to raw egg, and may be positive in patients who tolerate cooked egg. Where the history is unclear and you want to know if the child can tolerate cooked egg or if the child has outgrown their egg allergy an oral challenge is required.
Avoid eating egg in a form that cause reactions. Cooking changes the protein in eggs and makes it less likely to cause allergic reactions. For example, although a child may get hives or swelling if they touch raw egg in cake mix, they often tolerate the mix once it has been baked into cakes or biscuits. If baked egg is tolerated in biscuits and cakes, these foods should not be taken out of their diet. Continuing to eat egg in a form that is tolerated may help your child grow out of their allergy more quickly.
For children who have suffered severe reactions, all egg-containing foods listed below might need to be avoided. It is important to read all food labels and packaging.
egg white egg yolk egg solids/powder globulin
ovalbumin livetin ovoglobulin ovomucin
ovovitellin egg albumin egg lecithin (E322)
Lecithin can be made from egg, soya or sunflower. If an ingredient does not specify the type of lecithin used check with the manufacturer.
Mumps, Measles and Rubella (MMR) vaccine can be given to all children with egg allergyat the GP surgery.No special precautions are required.
800 UK children with egg allergy, a third of whom had previous suffered anaphylactic reactions to egg, were given the ‘flu vaccine in the “Sniffle study”. None suffered a serious allergic reaction. ‘flu vaccine can be safely given at the GP surgeryto anyone with an egg allergy, except for children who have had a previous anaphylactic reaction requiring intensive care, in which case they should seek advice from their allergy doctor.
After a reaction to egg, your child should be provided with advice about what to do if they have another reaction. The plan is usually written down – Allergy Management Plan.
Mild reaction – hives, swelling or vomiting, but no breathing problems or faintness:
If possible, get the child to spit out the food. Give an antihistamine.
Severe reaction – difficulty breathing(wheezing, noisy breathing, blue colour); swelling in the throat(noisy breathing, drooling); feeling faint or dizzy, looking very pale(lie the child down with their legs raised).
Get help straight away and dial 999 stating “anaphylaxis” (ana-fil-ak-sis).If you have an adrenaline pen – use it.
It is important to inform the nursery/school and any after school clubs. Any other carers will also need to know.
Most children tolerate well cooked egg in biscuits and cakes. Your allergy team may suggest trying less well-cooked egg. If your child has suffered breathing problems or faintness, egg may first be tried in a hospital challenge. Up to two thirds of children will grow out of their allergy to egg by 10 years old.