The failure to recognize anaphylaxis episodes when they occur is becoming an increasingly important issue as these life-threatening reactions become more common, says Dr. Estelle Simons. “There’s this paradox. Despite anaphylaxis becoming more common, it is under recognized,” Simons explained to Allergic Living, following a speech at the annual conference of the Canadian Society of Allergy and Clinical Immunology (CSACI) in Winnipeg in September. “The reason is: it’s not so easy to recognize.”

Simons, who is the current President of the American Academy of Allergy, Asthma and Immunology (AAAAI), a past president of the CSACI and a professor in the Departments of Pediatrics and Immunology at the University of Manitoba, says this is not only a problem for lay people – but also for medical professionals. Symptoms of anaphylaxis can include hives and itching; breathing problems (throat closure, wheezing or coughing); gastrointestinal distress (stomach cramps, vomiting or diarrhea); as well as faintness and passing out due to low blood pressure.

But not all symptoms occur in every attack, and they may vary from one attack to another, even in the same person. Hives, for instance, are an obvious clue that someone might be reacting to a food or insect sting. But 10 per cent of people with anaphylaxis don’t get hives, says Simons. She notes that breathing problems can cause confusion over whether a person is suffering from anaphylaxis or an asthma attack. In an infant, they might be mistaken for choking.

If someone is having their very first allergic reaction, he or she might not have a clue what’s happening to them. “With anaphylaxis, we are now where we were with asthma 30 years ago,” says Simons. “Lack of recognition is a major issue for our patients and their families.” She stresses the need for greater public awareness, and urges physicians to tell patients about helpful resources such as Anaphylaxis Canada ^[1] and the Food Allergy and Anaphylaxis Network ^[2].

“We need to get the message out,” she says. “It should be public policy to teach people that anaphylaxis can be fatal and that lives can be saved by prompt injection of epinephrine.”

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