Island vacation and new shellfish allergy!

[shortbun]

We just got back from the beach-Hatteras Island, land of nothing modern. The first day we were there, our son had a "life threatening" reaction to shellfish. Shellfish-shrimp and crab-is the primary food group on the island. It was very scary as he began this reaction while we were on the beach and had no cell phone service. My husband literally dragged him to the car and raced to the Fire Station where they transported him to a clinic that was staffed by a very knowledgable Nurse Practioner. At first, I thought he had been stung in the face. Then I walked back to the main road and got my phone working where I found a picture of a man with a shellfish reaction-duplicate of my son's face. My son has had a complicated life, health wise. His allergies are off the charts and get worse as we go. Most kids grow OUT of allergies, he seems to develop them.
Any advice from people with shellfish allergies? We now have a couple Epi-pens, a few packs of benedryl and limited knowledge about how to avoid shellfish, ie. avoid fried foods where shrimp is being fried and talk to waitstaff or chefs about clean utensils, oil, steaming and just avoiding some spots.
Thanks for listening to my rant and extending advice.

 

[Mermaid02]

My son also has a shellfish allergy. His allergies started appearing around age 5. He has outgrown his peanut allergy, and he is no longer allergic to walnuts or haddock- but the shellfish allergy just keeps getting worse.

We tend to avoid places that serve a lot of shellfish. And always ask if they use the same oil for fried clams etc that they do for french fries!

 

[Christine]

My son has a shellfish allergy that developed when he was about 9 years old.

We don't go to places that are predominantly seafood. We do go to places that serve seafood and we always ask about their cooking practices (sharing of oils, grills, cooking surfaces). It's actually worked out well and he has not had a cross-contamination issue yet (he is 17).

 

[shortbun]

Did you know that people allergic to shellfish usually have a severe allergy to dustmites and cockroaches? We've had to wrap my son's bed now for several years and we wash sheets in hot water weekly. Now that I know about the shellfish allergy, I'm thinking his stomach aches might be part of an allergic reaction to something-headaches too. Back to the allergist.

 

[Megster1]

Some people with shellfish allergies also have reactions to medical iodine. It's probably worth getting that checked out. I have a shellfish allergy, but not the iodine reaction. I've also noticed that I have a hard time taking vitamins and some other medications. I've been told this is because some companies use ground shellfish shells as a filler. I've never done any research, so I'm not 100% sure this is true, but I do notice that my symptoms go away when I stop taking those pills.

 

[EMom]

Merely being in the same house as shellfish being boiled once set off an allergic reaction in me. The epipen stays with me at all times. I always alert the restaurant, but want the epipen as backup.

 

[NotUrsula]

Some people with shellfish allergies also have reactions to medical iodine. It's probably worth getting that checked out. I have a shellfish allergy, but not the iodine reaction. I've also noticed that I have a hard time taking vitamins and some other medications. I've been told this is because some companies use ground shellfish shells as a filler. I've never done any research, so I'm not 100% sure this is true, but I do notice that my symptoms go away when I stop taking those pills.

It's true that they are often included, but not as filler. The reason they are put in is to add iodine or glucosamine sulfate to the nutrient mix; these are most concentrated in the shells rather than the flesh of the organism.

Most people with this allergy are not as careful as they probably should be about identifying WHICH shellfish they are allergic to. Shellfish is a common culinary name used for two completely different kinds of organisms: crustaceans and molluscs. MOST people who are allergic to "shellfish" are allergic to one but not the other (though some people are unlucky enough to be allergic to both), and it is really helpful to people who are trying to help you to know which allergen is the real culprit.

If you are allergic to crustaceans only, you can usually still eat things such as scallops or clams, but not such things as shrimp, lobster, crawfish, or crab. If you are only allergic to molluscs, you have to avoid scallops, clams, mussels, oysters and squid, but may be able to eat shrimp, for instance. (Yes, squid are molluscs; calamari counts.) I'm not actually allergic to any seafoods, but have a sensitivity to scallops; they make my throat itch. AFAIK, there is no other seafood product that is a problem for me.
(Which is a good thing; my extended family is in the business.)

The simplest way to avoid shellfish altogether when dining out or eating processed seafood products is to look for Kosher certification: Jews who keep Kosher can eat finfish but not crustaceans or molluscs.

If you can eat finfish, and want to, at an island destination, look for a place that specializes in broiling; they will normally be a bit more likely to be able to properly segregate shellfish from finfish unless the specialty of the house is lobster. Best bet is to buy it direct from the boat and cook it yourself, but look for a boat WITHOUT nets on booms; those will almost always be trawlers that pick up shellfish as bycatch even if they are not targeting it. Also, be careful of finfish species in the cod/hake family; they can have codworm, and codworm has chitin.

Also, be careful of fish sauce in asian restaurants; it is often thickened with ground crustacean shells. The usual allergen culprit in shellfish allergies is chitin, the protein that makes up crustacean shells; it can turn up as an ingredient in cosmetics as well as in nutritional supplements.

BTW for the OP, my good wishes for your child's continued good health, but my condolences on your loss of the beach as a happy place: beaches are not really safe for anyone who is allergic to mollusks, in particular, and if you have always been a beach person, having to give up those visits will be hard.

 

[minkydog]

What a scary experience! And how frustrating, too. I am not allergic to seafood(God help me if I ever develop that allergy!) but my sister is. DSis(48) had her first reaction when she was in college. She never liked shrimp & crab all that much,so it wasn't a huge deal for her. She went to Hawaii with her DH last year and the first day at the beach,she developed a horrible red itchy rash and she felt like she couldn't sit still. Finally, she went to the ER.Turns out, she was havign a reaction to the SAND. DSis had what amounted to small 2nd degree burns all over her body--she spent 5 days sitting in the hotel, wrapped in bandages. Needless to say, that pretty much ruined their Hawaii vacation.

I'm really sorry for your son. I know it must be frightening for you as his parent to try to keep him safe.

 

[NotUrsula]

What a scary experience! And how frustrating, too. I am not allergic to seafood(God help me if I ever develop that allergy!) but my sister is. DSis(48) had her first reaction when she was in college. She never liked shrimp & crab all that much,so it wasn't a huge deal for her. She went to Hawaii with her DH last year and the first day at the beach,she developed a horrible red itchy rash and she felt like she couldn't sit still. Finally, she went to the ER.Turns out, she was havign a reaction to the SAND. DSis had what amounted to small 2nd degree burns all over her body--she spent 5 days sitting in the hotel, wrapped in bandages. Needless to say, that pretty much ruined their Hawaii vacation.

I'm really sorry for your son. I know it must be frightening for you as his parent to try to keep him safe.

Hawaii doesn't have any quartz for sand, so the "white sand" beaches there are all composed of naturally ground-up marine organisms. She probably would have done better on a black beach; the sand on those is mostly basalt.

She should also avoid any beach that has a large population of mole crabs (aka "sand fleas"); those shed chitin all through the sand. Siesta Key comes to mind; the sand is pure quartz, but there are tiny little mole crabs living under just about every inch of the tideline. (Chitin is not poop, you understand; it is the equivalent of the way humans shed skin cells where ever we go.) Come to think of it, mole crabs may be what set off the OP's child's reaction; beaches in the Carolinas tend to have a lot of them as well.

 

[shortbun]

NotUrsula, you are giving me a headache!! We spend two weeks at the beach every year. We get our rythym from the beach...DS surfs and loves it!
We had planned to buy a summer/retirement house at the beach as soon as DS heads for college so he had a place to live/work/surf during the summers. My head is spinning. He didn't seem to react to the beach on Hatteras this vacation but he was full of steroids and benedryl. I'm sure you are right about the shedding because the beaches are covered with crabs night and day. He's allergic to crab for sure but we've got an appointment with our allergist to retest for everything again. Geesh!! My other fav beach destination is the gulf coast of Florida. If Siesta is bad, I'm guessing the others are as well.

 

[Christine]

My son is one of the lucky who are allergic to both crustaceans and mullosc.

So far, he's had no problem at the beach though.

 

[shortbun]

My son is one of the lucky who are allergic to both crustaceans and mullosc.

So far, he's had no problem at the beach though.

That's good to hear! I'm collecting information. Could be I'm over reacting, typical of me.

 

[LisaR]

I developed a shellfish allergy while on a vacation where we went specifically to eat shellfish. I was so sick and while I did improve after going to the ER, I was still so sick when I got home that I had to go to the ER again.

Being the highly intelligent adult that I was at that point (21 y/o), I figured the doctors didn't know what they were talking about. It couldn't be a shellfish allergy because I had eaten that for years without problems. And if it was, I figured it was just the quantity I ate.

About 6 months later, we went to a seafood restaurant. I got fish instead of shellfish but I had ONE spoonful of my DH's broth from his crab soup. OMG! I don't remember the next hour but the hospital staff was really sweet when I started to come around.

Needless to say, I learned my lesson. I did go into a seafood market about fifteen years ago with the intention of picking up some shellfish for Father's Day. That didn't work out. My throat started to close and I left and took some Benadryl in the car.

I don't have a hard time avoiding shellfish. I am vegan now but even before it was easy to avoid. I didn't find it to be a hidden ingredient like so many other allergens are.

Good luck! My son has numerous food allergies and shellfish is one of them. He has never even tasted it in his lifetime since my allergy was in full force before he was born and then he tested allergic to it at a young age.

PS: We live 5 minutes from the ocean and my son does break out in hives every single time we go to the beach but my son is one that gets hives regularly. I never equated it to shellfish. Who knows? I have never gotten hives from the beach and I am guessing my allergy to shellfish is worse than his.

 

[Megster1]

She should also avoid any beach that has a large population of mole crabs (aka "sand fleas"); those shed chitin all through the sand. Siesta Key comes to mind; the sand is pure quartz, but there are tiny little mole crabs living under just about every inch of the tideline. (Chitin is not poop, you understand; it is the equivalent of the way humans shed skin cells where ever we go.) Come to think of it, mole crabs may be what set off the OP's child's reaction; beaches in the Carolinas tend to have a lot of them as well.

This is great info, and explains why I am CONSTANTLY itchy at the beach. Thank you!

 

[NotUrsula]

NotUrsula, you are giving me a headache!! We spend two weeks at the beach every year. We get our rythym from the beach...DS surfs and loves it!
We had planned to buy a summer/retirement house at the beach as soon as DS heads for college so he had a place to live/work/surf during the summers. My head is spinning. He didn't seem to react to the beach on Hatteras this vacation but he was full of steroids and benedryl. I'm sure you are right about the shedding because the beaches are covered with crabs night and day. He's allergic to crab for sure but we've got an appointment with our allergist to retest for everything again. Geesh!! My other fav beach destination is the gulf coast of Florida. If Siesta is bad, I'm guessing the others are as well.

Sorry, didn't mean to.

I grew up in a fishing family in an area that had a military base; in school I knew a lot of kids who had issues, and most of them were the military kids who had not grown up eating this sort of stuff, and discovered after moving there that it was a problem for them.

MOST people that I know that have issues with crustaceans only have issues with eating them or touching mucous membranes after touching them (like handling a crab and then rubbing your eyes). I don't know of very many people who have environmental reactions, but I do know they are possible. However, since your DS apparently wasn't eating when this happened, I was trying to throw all of the instances I could think of where someone could have a serious reaction that wasn't related to actual consumption. I was thinking of it more as a list of things to try to rule out as triggers, but I guess i didn't finesse that properly.

On the issue of mole crabs, I know a lot of people who get just generally itchy if they handle them (they make GREAT live fish bait, btw), and some who come out in hives, but I don't personally know anyone who has had an anaphylactic reaction from just encountering the chitin in the sand, so it is probably pretty rare. However, I do know that the chitin is there, and that chitin can be a serious trigger for people who are sensitive to it (seafood processing plants have issues with an occupational disease they call "crab asthma" that some people develop from handling shells all day), so it follows that someone who is allergic to shellfish and also "allergic to the sand" should try to stay away from places where there is a lot of shellfish matter in the sand -- but that's Minky's sister, not your DS; who may not have any problem whatsoever with organic matter in sand. (FWIW, not all Gulf beaches in Florida have lots of mole crabs -- for instance, I haven't really seen many of them on St. Pete Beach. I noticed, because DD loves playing with them in her sand bucket, and she gets disappointed if they are not there.)

Most of the time what is lying around on beaches is mollusc shell, not crustacean, and it has been there so long that there isn't much protein left in it. The thing is, though, once you have had a child in your family inexplicably react on a beach, I can't help but think that fow a while at least, it isn't going to be the same kind of refuge that it once was, and that has to be a hard thing.

To look more on the bright side, I'll bet that with some detective work you will be able to narrow down the things that are real problems for him and not out-there long shots, and that will be a lot less stressful to think about.

PS: If you want me to collect some Siesta Key tideline sand samples for you, just let me know -- I'd be happy to contribute to the cause of ruling out mole crab shedding!

 

[Christine]

I'm not the OP; however, I wanted to say THANK YOU to NotUrsula for the great information!

 

[EMom]

Yeah....I am allergic to crustaceans and not mollusks. But if I tell a waiter I am allergic to crustaceans, I'd probably get a blank stare. So I just say "shellfish."

 

[shortbun]

Btw, my son had just eaten a crabcake sandwich, told me his stomach hurt as we left the restaurant and we went directly to the beach. I know I didn't say that but since it's now been discussed-he had ingested crab, so I know he's allergic to crab. We'll be testing for the rest of it in a few weeks.

 

[rascalmom]

NotUrsula - this is great info! Thank you for sharing.

I developed an allergy to cod fish when I was about 11 years old (living in OK, I wasn't exposed to a lot of fish, but they used to always serve it on Fridays in the school cafeteria).

As I got older, around 25 or 26, I started having more problems. DH had moved to Southern California and were eating fish a lot more often. For a long time, I was in denial that it was other species besides cod - I was determined to blame it on cross-contamination. OH the stomach cramps!! Worse than labor with either of my children.

At about 35, I finally gave in when I had a very severe reaction to fresh-water catfish. I had already realized I couldn't eat shrimp.

I've never been tested, but I know to very carefully avoid certain things that have "hidden" ingredients. Worcestershire Sauce is one of the worst for me - it is made, generally with anchovies. Ceaser dressing is obviously out and I have to read labels on prepared barbeque sauces and other dressings very carefully. Soups - particularly French onion also sometimes contain Worcestershire.

I absolutely can not take most vitamins. ColdEaze with zinc made me have mouth sores (like a severe burn) for over a week. It is not a fun allergy to deal with - I am no fun at pot lucks at all.

I know I should really go get tested. Through some kinetic testing at a dinner with some doctors a couple of years ago, I have discovered that I can eat scallops. My enjoyment is pretty tainted with the worry that there could have been cross-contamination. I keep benedryl with me at all times, but haven't ever gotten an epi-pen prescribed. I've have my mouth swell up though, so I know I should.

OP - I wish your son luck with this. I hope it was "just" ingestion - as frustrating as that is to someone who loves seafood, a contact allergy to the sand sounds like it would be as much, if not more, disappointing to your surfer son.

 

[NotUrsula]

Btw, my son had just eaten a crabcake sandwich, told me his stomach hurt as we left the restaurant and we went directly to the beach. I know I didn't say that but since it's now been discussed-he had ingested crab, so I know he's allergic to crab. We'll be testing for the rest of it in a few weeks.

Oh, good -- not that he's allergic, but that it *was* obvious ingestion and probably not contact.

The PP who is also allergic to finfish is in an unfortunate minority; true finfish allergies are pretty rare. An ingestion allergy to shellfish usually isn't too awful; as long as you are careful about cross-contamination at places like seafood markets it shouldn't be really difficult to avoid ingesting shellfish products.

Remember, no black and white pasta if you're allergic to molluscs. (I know someone who got tripped up by that one; she didn't realize the pasta sauce contained squid ink.)