Seafood* (Fish, Crustaceans and Shellfish) - One of the nine most common food allergens

*In this pamphlet, the term seafood refers to all edible fish, crustaceans and shellfish from fresh and salt water.

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Allergic reactions

Allergic reactions, which can be severe, are adverse reactions that occur when the body's immune system overreacts to a particular allergen. These reactions may be caused by food, insect stings, latex, medications and other substances. In Canada, the nine priority food allergens are peanuts, tree nuts, sesame seeds, milk, eggs, seafood (fish, crustaceans and shellfish), soy, wheat and sulphites (a food additive).

What are the symptoms of an allergic reaction?

When someone comes in contact with an allergen, the symptoms of a reaction may develop quickly and may rapidly progress from mild to severe. The most severe form of an allergic reaction is called anaphylaxis. Symptoms can include breathing difficulties, a drop in blood pressure or shock, which may result in loss of consciousness and even death. A person experiencing an allergic reaction may have any of the following symptoms:

• flushed face, hives or a rash, red and itchy skin
• swelling of the eyes, face, lips, throat and tongue
• trouble breathing, speaking or swallowing
• anxiety, distress, faintness, paleness, sense of doom, weakness
• cramps, diarrhea, vomiting
• a drop in blood pressure, rapid heart beat, loss of consciousness

How are food allergies and severe allergic reactions treated?

Currently there is no cure for food allergies. The only option is complete avoidance of the specific allergen. Appropriate emergency treatment for anaphylaxis (a severe food allergy reaction) includes an injection of adrenaline, which is available in an auto-injector device. Adrenaline must be administered as soon as symptoms of a severe allergic reaction appear. The injection must be followed by further treatment and observation in a hospital emergency room. If your allergist has diagnosed you with a food allergy and prescribed adrenaline, carry it with you all the time and know how to use it. Follow your allergist's advice on how to use an auto-injector device.

Frequently asked questions about seafood allergies

What is the difference between crustaceans and shellfish?

Crustaceans are aquatic animals that have jointed legs, a hard shell and no backbone, such as crab, crayfish, lobster, prawns and shrimp. Shellfish include bivalve molluscs which have a hinged two-part shell (for example, oysters, scallops, mussels and clams), as well other molluscs such as whelk, snails, squid and octopus.

How can I avoid a fish, crustacean or shellfish-related reaction if I'm allergic to these foods?

Avoid all food and products that contain fish, crustacean or shellfish and their derivatives. These include any product whose ingredient list warns it "may contain" or "may contain traces of" fish, crustaceans or shellfish.

What is the difference between a fish, crustacean or shellfish allergy and histamine poisoning?

When someone has a seafood allergy, his/her immune system has an abnormal reaction to either fish, crustacean or shellfish proteins. Histamine poisoning is caused by eating fish that contain high levels of histamine, a chemical that forms when certain types of fish start to decompose. High levels of histamine develop when fish, such as anchovies, mackerel, mahi-mahi and tuna, are not properly frozen or refrigerated. Histamine poisoning causes symptoms similar to seafood allergic reactions and can often be mistaken for a fish, crustacean or shellfish allergic reaction. If you are unsure whether you have a seafood allergy or histamine poisoning, consult an allergist or seek emergency medical treatment.

If I am allergic to one type of seafood will I be allergic to another?

It is possible for some people who are allergic to one type of seafood (fish, crustacean or shellfish) to eat other types of seafood without having a reaction. However, studies show that when a person has a specific seafood allergy, he/she may also be allergic to other species within the same group. For example, if you're allergic to cod, you may also be allergic to pike, as both are fish; if you're allergic to shrimp, you may also be allergic to lobster, as both are crustaceans; if you're allergic to mussels, you may also be allergic to clams, as both are shellfish. If someone is allergic to one type of seafood—fish or crustaceans or shellfish—he/she will not necessarily be allergic to the other types. Consult your allergist before experimenting.

Can I have a seafood-related reaction even if I do not eat or use seafood and seafood derivatives?

Yes. There have been reported reactions to seafood vapours from cooking, preparing (for example, sizzling skillets) and handling fish, crustaceans and shellfish and/or products that contain them. Avoid these situations. Seafood and seafood derivatives can often be present under different names, such as kamaboko. For other common ingredient label names, refer to the list below. Always read the product ingredient list carefully.

What do I do if I am not sure whether a product contains seafood or seafood derivatives?

If you have a seafood allergy, do not eat or use the product. Get ingredient information from the manufacturer or importer.

Does product size affect the likelihood of an allergic reaction?

It does not affect the likelihood of a reaction; however, the same brand of product may be safe to consume for one product size but not another. This is because product formulation may vary between different product sizes of the same product.

Watch out for allergen cross contamination!

Cross contamination is the transfer of an ingredient (food allergen) to a product that does not normally have that ingredient in it. Through cross contamination, a food that should not contain the allergen could become dangerous to eat for those who are allergic.

Cross contamination can happen:

• during food manufacturing, through shared production and packaging equipment;
• in stores through shared equipment, for example, cheese and deli meats sliced on the same slicer; and through bulk display of food products, for example, bins of baked goods, bulk nuts; and
• during food preparation at home or in restaurants through equipment, utensils and hands.

Avoiding seafood and seafood derivatives

Make sure you read product labels carefully to avoid products that contain seafood and seafood derivatives. Avoid food and products that do not have an ingredient list and read labels every time you shop. Manufacturers may occasionally change their recipes or use different ingredients for varieties of the same brand. Refer to the following list before shopping:

Other names for fish, crustaceans and shellfish

Fish:

Anchovy, basa, bass, bluefish, bream, carp, catfish (channel cat, mudcat), char, chub, cisco, cod, eel, flounder, grouper, haddock, hake, halibut, herring, mackerel, mahi-mahi, marlin, monkfish (angler fish, lotte), orange roughy, perch, pickerel (dore, walleye), pike, plaice, pollock, pompano, porgy, rockfish, salmon, sardine, shark, smelt, snapper, sole, sturgeon, swordfish, tilapia (St. Peter's fish), trout, tuna (albacore, bonito), turbot, white fish, whiting.

Crustaceans:

Crab, crayfish (crawfish, écrevisse), lobster (langouste, langoustine, coral, tomalley), prawns, shrimp (crevette).

Shellfish:

Abalone, clam, cockle, conch, limpets, mussels, octopus, oysters, periwinkle, quahaugs, scallops, snails (escargot), squid (calamari), whelks.

Possible sources of fish, crustaceans and shellfish

• Deli meats, for example, bologna, ham
• Dips, spreads, kamaboko (imitation crab/lobster meat)
• Ethnic foods, for example, fried rice, paella, spring rolls
• Fish mixtures, for example, surimi (used to make imitation crab/lobster meat)
• Garnishes, for example, antipasto, caponata (Sicilian relish), caviar, roe (unfertilized fish eggs)
• Gelatin, marshmallows
• Hot dogs
• Pizza toppings
• Salad dressings
• Sauces, for example, fish, marinara, Nuoc Mâm, steak, Worcestershire
• Soups
• Spreads, for example, taramasalata (contains salted carp roe)
• Sushi
• Tarama (salted carp roe)
• Wine

Non-food sources of fish, crustaceans and shellfish

• Fish food
• Lip balm/lip gloss
• Pet food

Note: These lists are not complete and may change. Food and food products purchased from other countries, through mail-order or the Internet, are not always produced using the same manufacturing and labelling standards as in Canada.

What can I do?

Be informed

See an allergist and educate yourself about food allergies. Contact your local allergy association for further information.

If you or anyone you know has food allergies or would like to receive information about food being recalled, sign up for the Canadian Food Inspection Agency's (CFIA) free email "Food Recalls and Allergy Alerts" notification service available at
www.inspection.gc.ca/english/util/listserv/listsube.shtml?foodrecalls_rappelsaliments. When you sign up you will automatically receive food recall public warnings.

Before eating

Allergists recommend that if you do not have your auto-injector device with you, that you do not eat. If an ingredient list says a product "may contain" or "does contain" seafood or seafood derivatives, do not eat it. If you do not recognize an ingredient or there is no ingredient list available, avoid the product.

What is the Government of Canada doing about food allergens?

The Government of Canada is committed to providing safe food to all Canadians. The CFIA and Health Canada work closely with municipal, provincial and territorial partners and industry to meet this goal.

The CFIA enforces Canada's labelling laws and works with associations, distributors, food manufacturers and importers so that foods are completely and appropriately labelled. The CFIA recommends that food companies establish effective allergen controls to prevent the occurrence of undeclared allergens and cross-contamination. The CFIA has developed guidelines and tools to aid them in developing these controls. When the CFIA becomes aware of a potential serious hazard associated with a food, such as undeclared allergens, the food product is recalled from the marketplace and a public warning is issued. The CFIA has also published several advisories to industry and consumers regarding allergens in food.

Health Canada has worked with the medical community, consumer associations, and the food industry to enhance labelling regulations for priority allergens, gluten sources and sulphites in pre-packaged food sold in Canada. Health Canada is proposing to amend the Food and Drug Regulations to require that the most common food and food ingredients that cause life-threatening or severe allergic reactions are always identified by their common names allowing consumers to easily recognize them.

Where can I get more information?

For more information on:

• food allergies,
• ordering free copies of this pamphlet, and
• subscribing to the "Food Recalls and Allergy Alerts" email notification service, visit the CFIA website at www.inspection.gc.ca or call 1-800-442-2342/TTY 1-800-465-7735 (8:00 a.m. to 8:00 p.m. Eastern time, Monday to Friday).

Below are some organizations that can provide additional allergy information.

Allergy/Asthma Information Association
www.aaia.ca

Anaphylaxis Canada
www.anaphylaxis.ca

Association québécoise des allergies alimentaires
www.aqaa.qc.ca (French only)

Canadian Society of Allergy and Clinical Immunology
www.csaci.ca (English only)

Health Canada
www.hc-sc.gc.ca

Developed in consultation with Allergy/Asthma Information Association, Anaphylaxis Canada, Association québécoise des allergies alimentaires, and the Canadian Society of Allergy and Clinical Immunology and Health Canada.

Cat. No. A104-27/1-2005E
ISBN 0-662-40350-9
P0426-05/09E
HC Pub. 5954