Egg Allergy

Egg allergy is included in the “Big 8” most common food allergies in childhood, affecting between 1-2% of preschool children. Egg allergy usually begins early in life and usually presents in infancy as a rash, including eczema or atopic dermatitis, or gastrointestinal symptoms. Egg allergy symptoms usually decrease over time and may completely disappear by age five to seven years of age. In some cases, the egg allergies may be life-long.

Egg allergy symptoms can vary, but they most commonly present as hives around the mouth or generalized hives (urticaria) on other parts of the body. Swelling of the lips and around the eyes can also occur. These symptoms may occur upon ingestion of egg protein or with direct skin contact.  Presenting symptoms of egg allergies are usually mild, but, on rare occasions, anaphylaxis can occur in highly sensitized individuals.

Egg white is generally more allergenic than egg yolk.  An allergic reaction is most likely to occur after exposure with raw or poorly cooked eggs ,which explains why tasting raw batter, playing with egg shells, or eating egg white icing may induce acute symptoms. The more it is cooked, the less allergenic it becomes, as the heating process can break down the allergenic proteins. Mildly egg allergic children can often eat food prepared with small amounts of egg, such as cakes and muffins, without an immediate reaction. However, these trace quantities, even if cooked well, may aggravate eczema or cause other allergy symptoms in the highly egg allergic individual.

Until recently there was great concern with the administration of the influenza or flu vaccine, including the Swine Flu or H1N1 virus vaccine, to egg allergic children and adults. Flu vaccine is prepared in egg culture and the vaccine does contain minute amounts of egg protein. Fortunately, the amount of protein is so small that allergic reactions are very rare, and, if they do occur, they are generally very mild. In the highly egg allergic person, it has been recommended that they be skin tested to the vaccine. If negative, it should be safe to administer. If positive, the vaccine can still be given successfully in most cases. The allergist may give the vaccine in split or divided doses over an hour or so. Such patients should wait and be observed over approximately an hour after the injection(s).

The measles, mumps, and rubella vaccine (MMR) is normally cultured in chick embryo cells, and not in eggs, as commonly thought. Therefore, the very minute amount of egg protein that may be found in the MMR vaccine should not cause an allergic reaction. However, severe allergic reactions to the MMR have been reported. Such reactions are extremely rare, even in egg allergic children, and it is suspected that these reactions were likely caused by another ingredient in the vaccine, and not the egg protein. In infants who have demonstrated an extreme allergic to eggs, some advise skin testing to the vaccine prior to its administration. Based on the reaction to testing, the allergist will then decide if the injection should be given in its entirety or in split doses. Fortunately, almost all egg allergic children can be safely immunized to the MMR vaccine.

Food Label Ingredients to Avoid for an Egg Free Diet

  • egg white
  • egg yolk
  • albumin
  • egg powder
  • egg substitutes
  • dried egg
  • mayonnaise
  • egg solids
  • ovomucin
  • eggnog
  • globulin
  • livetin
  • lysozyme (used in Europe)
  • Simplesse
  • ovalbumin
  • meringue
  • ovomucoid
  • ovovitellin

Other Possible Egg Products

  • A shiny glaze or yellow baked goods may indicate the presence of egg.
  • Simplesse is used as a fat substitute and is made from either egg or milk protein.
  • Egg white and shells may be used as clarifying agents in soup stocks, consommes, bouillons, and coffees.
  • Caution should be used if consuming these products.

Create an Egg substitute

For each egg, one of the following may be substituted in recipes:

  • 1 tsp baking powder, 1 Tbsp water, 1 Tbsp vinegar
  • 1 tsp yeast dissolved in 1/4 cup warm water
  • 1 Tbsp apricot or banana puree
  • 1 1/2 Tbsp water, 1 1/2 Tbsp oil, 1 tsp baking powder
  • 1 packet gelatin, 2 Tbsp warm water (do not mix until ready to use)

These substitutes may not work well in recipes that call for more than three eggs.

Additional Recommended Reading for Egg Allergy
Recommended Reading for Food Allergies
Helpful Food Allergy Video Resources

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