[Paddlewise] "Food Poisoning"

Allergic reactions to seafood seem to be caused by proteins and related
compounds rather than from iodine.  Cross reactivity is not uncommon even
between different groups such as between mollusks and crustaceans. Symptoms of
allergic reaction to marine edibles are same as those of allergy to other
foods (such as peanuts, chocolate, tomatoes), i.e.,  1) anaphylaxis, which can
be rapidly deadly because of asthma like breathing problems and bad
hypotension but also sometimes causes abdominal cramping and diarrhea  , 2)
urticaria  , the typical "hives" which causes diffuse itching and raised
welts,  3) angioedema, a deep swelling of the skin often on the hands, feet or
face which is only really dangerous when it occurs in the mouth and can thus
cause obstruction of the airway.  There is another syndrome that may account
for some of the variability seen in the reaction of an individual to the same
seafood at different times.  It is called "food-dependent exercise-induced
anaphylaxis" in which folks at rest can eat food without problems but if they
eat food to which they are allergic and then exercise within 2-4 hours they
can develop an allergic reaction.  


As an ER doc in South Louisiana I see a fair amount of seafood allergy.  In
fact, people who know they are allergic to seafood often premedicate
themselves with oral Benadryl before a crawfish or crab boil.  This generally
works out pretty well but is risky business.


Treatment of allergy (seafood or otherwise) involves antihistamine (such as
Benadryl) and if things are going downhill fast (e.g., patient can't breath,
gets profoundly weak or passes out) a shot of adrenaline such as by an epipen
usually clears things up in a miraculously quick fashion.  Of course the
swallowed allergen usually sticks around in the body longer than the
epinephrine(adrenaline) so you've got to get some antihistamine in and watch
the sufferer closely for a while.


I don't personally know what to make of the notion of allergy to iodine.  It
is an essential mineral that must be ingested or we'd all get big goiterous
necks ( and other more significant problems) from hypothyroidism.  Almost all
table salt is iodinated to prevent this.  Clearly people can be allergic to
iodine containing compounds like Betadine. ( And then again, I'm not an
allergist.)


There are a host of other seafood derived gastrointestinal and other system
illnesses to complicate the picture.





Larry Koenig





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