FOOD allergy is a global health concern. Globally, incidence of food allergies have increased over the last decade as 11 per cent of the world’s population, especially children under five years old, are now allergic to at least one type of food.

In the United States alone, approximately 200,000 people annually seek emergency medical care due to food allergies. Unlike the more developed regions of the world, data on the incidence of food allergies in the Caribbean is lacking, however, due to risk factors such as urbanisation, gender, family history and age, it can be concluded that anyone can experience a food allergy.

What is a food allergy?

A food allergy is a response of the body’s immune system to specific types of proteins in foods. The outcome of the response ranges from mild to more severe health conditions and even death.

Common food allergens

More than 160 different types of foods have been implicated in allergic reactions globally; however, the following food items have been identified as the most common food allergens: Milk and milk products, eggs and egg products, fish and fish products, peanuts and peanut products, other tree nuts such as almonds, walnuts, pecans and their products, wheat and wheat products, soy beans and soy bean products, sesame seeds and sesame products, crustaceans such as shrimp and lobster, and their products.

Food allergy versus food intolerance

Both food allergy and food intolerance are associated with similar symptoms; however, a food intolerance is a response that takes place in the digestive system as an individual’s body is unable to digest a particular food compound such as lactose in milk. On the contrary, food allergies occur as the immune system identifies the particular compound in the food item as a danger thereby triggering a defensive response.

Major signs and symptoms associated with food allergies

The symptoms associated with food allergies are often external which may occur within minutes to two hours after ingesting the food allergen. Individuals with Alpha-gal syndrome which is allergy to red meat and other products made from mammals may experience allergy symptoms hours after exposure to the allergen. Rashes, hives (swelling on the skin), shortness of breath, difficulty breathing, swelling of the throat, itching, redness of the skin and in severe cases anaphylactic shock and death are often named as common symptoms or conditions reported in cases where an individual experiences a food allergy episode.

Food allergy misconceptions in Jamaica

Food allergies are often referred to as ptomaine poisoning in Jamaica, as individuals experience swelling of the eyes, itching of the skin, rashes and hives amongst other symptoms, usually after eating tinned foods. In many instances, bissy tea which is made from the kola nut is used as a home remedy when this situation occurs, which is a total misconception. The association between ptomaine poisoning and allergic reaction has been passed down through generations and dates back to a time in history when the term “ptomaine poisoning” was used to describe all cases of illnesses due to the consumption of unhealthy foods, in particular tinned foods that were not prepared properly.

What to do when a food allergy is identified

It is imperative that individuals who experience food allergies, as well adults responsible for children with food allergies, take responsibility by seeking medical attention once a food allergy episode has been experienced.

Identifying the food allergy trigger and sharing the information with their doctor or health-care professional and recording or journalling allergy symptoms such as hives, itching of the skin as well as the time the incident occurred will provide useful information that can be used as a guide for treatment and the prevention of future exposures. It should be noted that there are no cures for food allergy-associated illnesses and in most cases individuals find it difficult to identify the particular food or foods to which they have an allergy; journalling is therefore recommended for children and adults alike.

Disclosing food allergies especially when dining out, as well as paying attention to posted disclaimers regarding the handling of food allergens in a food establishment.

Preparing meals in an environment that will not allow for cross contact of allergens with non-allergen foods or food contact surfaces.

Paying attention to food labels. Many manufacturers tend to add an allergen disclaimer to food packages. Where a food allergy is known, keen attention must be paid to labels when purchasing foods.

Always keeping prescribed medication such as EpiPen (Epinephrine) nearby in the event it is needed for use.

Avoiding the consumption of bissy tea as a remedy for episodes of food allergies. Kola nut/bissy nut is a seed; however, its role as a food allergen is not fully understood; in fact, some researchers have highlighted its role in causing food allergies.

Moreover, the management of food allergies in Jamaica requires a multi-faceted approach.

Restaurateurs, food manufactures and processors along with retailers and regulators as well as policymakers and academia are all important stakeholders with responsibility to ensure that actions are taken to manage food allergies and ultimately protect the health of the population.

Restaurateurs, food processors and other food suppliers are required to demonstrate a duty of care towards their customers. The implementation of in-house food safety management systems geared towards the protection of food and the minimisation of allergen cross contact; factual labelling statements about the preparation and handling environment of food items and the institution of a national food recall policy outlining how mislabelled allergens should be handled are strategies necessary to protect the health of the consumer and minimise the incidence of food allergies and other foodborne illnesses.

A modern food safety policy for Jamaica that is underpinned by the Public Health Act and other regulations is long overdue. A national food handler’s training programme guided by current scientific information relating to epidemiology and present trends in the food industry must be forthcoming. Academia and public policymakers should also seek to collaborate and work together in areas of research so that useful information can be garnered to develop well-need policies for allergen management and food safety. Irrefutably these actions and strategies will result in the facilitation of health-care planning and decision-making, as well as the implementation of public health measures that will reduce morbidity and mortality relating to the occurrence of food allergies.

Karlene Atkinson is a public health specialist and lecturer at the School of Public Health, University of Technology, Jamaica.