Food Allergy Point-of-Care Tool for Family Physicians

Immunoglobulin E (IgE)-mediated food allergies affect more than 5.6 million children and more than 27 million adults in the United States.^1–3 In IgE-mediated food allergic reactions, symptoms — including anaphylaxis — develop rapidly following exposure to an allergen.⁴ By contrast, non-IgE food allergies cause delayed reactions that mostly affect the digestive system,⁵ and food intolerances do not affect the immune system at all.⁶ Although more than 170 foods are known to cause IgE-mediated food allergic reactions, nine foods account for 90% of all cases.^7,8

The American Academy of Family Physicians developed this point-of-care tool to help family physicians recognize, evaluate and manage IgE-mediated food allergy and prevent anaphylaxis.

Peanuts – Peanut butter, sauces, candies

Tree Nuts – Almonds, cashews, hazelnuts, pistachios

Milk – Cheese, yogurt, baked goods

Eggs – Mayonnaise, pasta, baked goods

Wheat – Bread, pasta, processed foods

Soy – Tofu, soy milk, soy sauce

Fish – Salmon, tuna, sauces

Shellfish – Shrimp, crab, lobster

Sesame – Seeds, tahini, bread

Hidden sources of food allergens include cross-contact in shared fryers, processed foods, unlabeled ingredients, and cross-reactivity between pollen and certain foods.

Food label reading: “Contains” vs. “May contain” vs. “Processed in a facility with”

Cross-contamination: Avoidance of shared utensils, buffets, shared fryers

School/workplace plans: Food allergy action plan (e.g., www.foodallergy.org/living-food-allergy/food-allergy-essentials/food-allergy-anaphylaxis-emergency-care-plan); allergy response training for school/workplace staff

Emergency preparedness: Use of epinephrine auto-injector (e.g., EpiPen, Auvi-Q)