Anaphylaxis (pronounced asan-a-fi-LAK-sis) is a serious and potentially life-threatening allergic reaction. In children most anaphylaxis episodes are cause by foods, medications, or insect bites.

How does anaphylaxis happen?

Anaphylaxis is an hypersensitivity reaction where the body reacts to an external allergen. For anaphylaxis to happen, the child would have been exposed to the allergen at least once in the past. The first exposure does not lead to any symptoms but the body learns to recognize the allergen and builds antibodies against it. With any subsequent exposures, the body reacts to the allergen leading to an anaphylaxis. The allergen is usually a substance which is harmless in most children but can react badly in some. The commonest example being peanuts, cashew, almond etc. While most people can eat them without any problems, some children have an anaphylaxis when exposed to these nuts.

What are the symptoms and signs of anaphylaxis?

Anaphylaxis is an allergic reaction but with two differences. The first, it involves more than one organ system of the body and second, the reaction can be severe and life threatening.
Anaphylaxis usually starts with skin symptoms like itching, flushing, hives, swollen lips or tongue but sometimes there may not be any skin symptoms. The symptoms of anaphylaxis can be classified:

A. AIRWAY: Persistent cough, Hoarse voice, Difficulty swallowing, Swollen tongue

B. BREATHING: turning blue, difficult or noisy breathing, wheeze or persistent cough

C. CONSCIOUSNESS: Persistent dizziness, pale or floppy, suddenly sleepy, collapse/unconscious

There can be additional symptoms like vomiting, abdominal pain and diarrhea.
If any of the above are present in the setting of an allergic reaction consider anaphylaxis.

How is anaphylaxis treated?

The vital part is to recognize anaphylaxis and acting quickly. The life saving medicine is epinephrine or adrenaline. Epinephrine is available as auto-injectors. Many commercial brands are available such as EpiPen, Jext and Emarade. They can be safely given by parents, teachers, or even by children themselves if they are old enough. Most of these are although expensive and their availability is limited in Indian set up.
Some other medicines also have role in treating such condition. Anti-histamines are used to help with itchiness and hives. Salbutamol nebulization or inhaler can help open up the airways. Steroids can decrease swelling and inflammation. Intravenous fluids might be needed to help increase blood pressure.

How can you protect your child from Anaphylaxis?

There are ways in which we can protect our children from anaphylaxis.

  1. Have an Allergy Emergency Action Plan made with your allergy specialist
  2. Share the Emergency Action Plan with the family, close friends, school staff and other caregivers.
  3. Protect your child from accidental exposure to triggering allergens
  4. Have two epinephrine Auto Injectors available for emergency
  5. Have your child wear a medical alert bracelet.