STORY BYSusan Brown was in her 20s the first time she went into shock and thought she was going to die. A doctor had just given her a shot of penicillin and procaine to treat her sore throat. She remembers muttering that something was terribly wrong. Her blood pressure plummeted, and in a matter of minutes, she passed out.
Her physician immediately recognized her symptoms. She was having a severe allergic reaction, which is called anaphylaxis or anaphylactic shock.
Dr. Gailen Marshall, former director of the Division of Allergy and Clinical Immunology at The University of Texas Medical School at Houston, says as many as two percent of people in the United States have an anaphylactic episode at some point during their lives.
This severe allergic reaction occurs when an individual is exposed to a protein or allergen to which he or she is allergic. This sets off a chain of events in the immune system that may lead to swelling of the airways, decreased blood pressure and loss of consciousness.
Most cases can be treated with such medications as antihistamines and epinephrine, but in some instances, anaphylaxis can be fatal. An estimated 500 to 1,000 people die each year, often because the symptoms of anaphylaxis go unrecognized or because treatment is not prompt enough.
“Rapid treatment is critical to good outcome,” says Marshall, associate professor of medicine and pathology. “People usually die or get better in the first 10 minutes. If they suddenly experience a rash that looks like hives or swelling around their face or neck, and this is accompanied by difficulty breathing or dizziness, they need to get to the nearest medical facility or call 9-1-1.”
Epinephrine should be the first line of defense for someone who is in anaphylactic shock. Epinephrine raises blood pressure, relaxes the airway and constricts blood vessels—much needed actions during anaphylactic shock.
Marshall says he prescribes an EpiPen, a self-injectible dose of epinephrine, to all of his patients with a history of anaphylaxis and tells them to carry it wherever they go. This can help halt the potentially fatal symptoms and creates a window of time for patients to reach emergency medical care.
EpiPens are self-contained measured doses of epinephrine with a spring-activated, concealed needle, similar to a ball point pen. The syringe can be swiftly injected into the thigh, for instance, by the patient.
“If they are nowhere near a medical facility, rapid use of an over-the-counter or prescription antihistamine can buy them precious time,” Marshall says. “But injected epinephrine is the best protection against fatal reactions when given early. Anyone who has had an anaphylactic reaction should always carry a prescription EpiPen with them.”
The three most common triggers of anaphylaxis are:
Allergies to latex and even exercise can bring on symptoms of anaphylaxis, and in rare cases, the cause of the allergic reaction may never be known.
Symptoms vary widely. The most distinctive symptoms include:
There also may be:
“It’s hard to describe the feeling, but I know when it’s happening,” says Brown, who has been a patient of Marshall’s for more than five years. “It’s an awful kind of weakness, as if I’m going to pass out. Sometimes I do pass out. There have been six or seven times when I thought, `Well, I’m checking out. Here I go.’”
As Brown got older, her sensitivities to certain allergens, proteins and chemicals became worse. The smell of household cleaners began to make her weak, as did chlorine in swimming pools. She couldn’t eat shellfish, chicken or garlic without getting sick.
Now, at the age of 74, Brown has to be extremely careful with the types of medication and beauty products she uses. Certain sunscreens and shampoo can cause itching and weakness. “ It really is just a horrible feeling,” Brown says.
With Marshall’s help, Brown has been able to get her allergies under control, and it’s been more than a year since she has had an anaphylactic episode. She takes an antihistamine and a medication known as an H2 blocker, which is an antacid that can help control blood pressure during an anaphylactic attack.
She also carries her epinephrine everywhere she goes.
“You can’t be careless,” she says. “You have to avoid the things you know will make you sick and do exactly what your doctor says. You can’t take any chances with your life.”
UPDATED: 9-04-2003
Editorial Board | Legal Disclaimer | Privacy & Security | Contact Us
©2000-2006 Office of Institutional Advancement, UT-Houston
Food Irradiation
and Safety
On August 22, 2008, the Food and Drug Administration (FDA) published a final rule that allows the use of irradiation to make fresh iceberg lettuce and fresh spinach safer and last longer without spoiling.
Irradiating fresh iceberg lettuce and spinach will help protect consumers from disease-causing bacteria such as Salmonella and Escherichia coli O157:H7 (E. coli). Illnesses from these bacteria range from uncomfortable symptoms to life-threatening health problems.
The foods affected by the final rule are
Irradiation (also sometimes termed "ionizing radiation") is a process of treating products with a measured dose of radiation. Food irradiation is not new. FDA has conducted irradiation safety evaluations for more than 40 years and has determined the process to be safe for use on a variety of foods.
After studying the safety of irradiating fresh iceberg lettuce and fresh spinach, FDA has determined that these greens, when irradiated under the conditions specified in the final rule, retain their nutrient value and are safe to eat.
FDA considers irradiation a complement to, not a replacement for, proper food-handling by producers, processors, and consumers. Irradiation is just another tool to reduce the levels of disease-causing microorganisms on fresh iceberg lettuce and fresh pinach.
Irradiation does not take the place of washing. FDA continues to recommend that consumers wash fresh and bagged produce before eating unless the packaging specifically states that the product has been pre-washed.
For more information, go to: http://www.fda.gov)
