Shellfish allergy in 4 yr old questions

[DysonsMom]

DS, 4 yrs old, had a reaction to a nibble of shrimp last Wednesday. He had small red bumps on his face and his lip swelled up. I gave benedryl and took him to the pediatrician the next day. Pediatrician said he is allergic to shellfish, put him on prednisone for 3 days, and gave a script for an epipen.
Last night he got a welt on his face after eating pizza (a brand he has eaten many times). It resolved with Benedryl and there was no other reaction. Others suggested his system and skin are still sensitive from the shellfish reaction. I have gotten such wonderful advice from everyone under the welcome section--I am brand new to all this!
We will not be able to get the epipen until at least Monday. He will see an allergist at the first of February--3 weeks.

To what extent should I be micromanaging? Is there a typical threshold level? I mean, I know to not let him eat any shellfish. I am going to keep him away from fish and restaurants that have any shellfish on their menu, as well. I also know to avoid items that note that they are processed with shellfish.

Should I worry about the fish food (which probably has shrimp) for his pet beta fish (in his bedroom)? His gummy vitamins? Would he be likely to react if he touched the fish food? 

I have been trying to find information about typical threshold levels for shellfish allergies, but I can't find anything. Is he likely to have suddenly developed a very low threshold? Could he suddenly react to touching something like the fishfood, whether he ingests it or not? 

[twinturbo]

Yeah, this is the tough part. You've got a dynamic set of circumstances. We all do.

Out of all of those things I'd maybe just replace the fish food, and because you do not have a rescue device your only other card to play here is prevention. So I'd try to as casually as possible step up attention to contamination of food, hand washing, stay out of restaurants or other med to med-high risk until you've at least got some rescue med in hand. Until rescue medicine is in hand stay on the lower risk part of the risk continuum. No high risk - low benefit calculus. Stay casual.

From there it's about balance. What you will have to look out for more permanently aside from obvious seafood restaurants is Asian foods whether it's restaurant or manufactured grocery items like nori (toasted seaweed sheets).

Shrimp is a crustacean. It may be ONLY shrimp, or it may be all crustaceans meaning not necessarily extending to bivalve mollusks like scallops, but then's there contamination concerns regardless. His body sensitized to a protein. How specifically sensitized we can't tell, nor will we know what his triggering threshold is. But that will come in time for now we have to wait for an EpiPen so by all means allow yourself extra caution.

Let me know if I didn't make sense. I'm really foggy this morning. 

[Macabre]

If it was Pizza Hut, their sauce is a may contain for shellfish. I've had a few reactions to it--before I stooped eating it. It was a weird connection to make, because it's not expected. But after reading the label it made sense

So other things to watch out for:
Grilled anything at a restaurant. They typically don't have dedicated grills for seafood. They may say they clean their grill. My response: how?  And no, water doesn't remove the protein by itself.

Anything fried at a restaurant. Tortilla chips and other things are fried in the same oil as shrimp at some restaurants. Ask.

Boiled pasta if the restaurant has a lobster ravioli.

Small kitchens that serve a lit if shellfish. Or any shellfish. Ask how they keep shellfish away from other food. They often reasond better to "cross contact" rather than "cross contamination".

Fish in the grocery store. Cross contamination is a huge concern. Kosher markets would be a great place to go for fish.

When I order food I mention my allergy, say that I have to avoid cross contact, even with utensils a (my worst rxns was from that).


So---google histamine and shellfish. It might not have been the shellfish itself but the high histamine levels.  I hope so.

[DysonsMom]

After doing some reading, I don't think it was just histamine poisoning. I wish it were. I would rather my family think I am an over protective mom than be right about the danger to my LO.
But my LO took a tiny little nibble of the shrimp and didn't like it. He didn't eat any more, thank God. My oldest son and I finished the entire platter (We probably ate 20 shrimp each). If he ate 1/4 of a shrimp, we probably ate 80 times more than he did. From what I read, if it was histamine poisoning, my oldest son and I would have gotten sick, too.
Thanks for the tip about the pizza and other things to avoid. I am going to be very careful about what he eats until I have an epi in hand!

[Macabre]

And after.