The cornerstone of management of egg allergy is the avoidance of all egg and egg containing products (1).
Children who are highly allergic to egg may react when they are in a kitchen when eggs are being fried, being in the next room when a pavlova is being prepared, being touched by an individual who has been handling raw egg even after hand washing or even when sitting next to someone who is eating egg (2). However, some patients may tolerate cooked egg and even small amounts of raw egg (1). It is important to find other dietary alternatives which provide a source of high biological value protein, vitamins B1 B2 + Folic Acid + Vitamin E and fats (2). Indicators of the beginning of the resolution of egg reactivity, is usually seen through the tolerance of small amounts of cooked egg (1). This may progress to all forms of egg, though this is not always the case (1). Generally 50% Egg Allergic Children are tolerant by the age of 3 years and 66% by the age of 5 years. An oral food challenge may be warranted to confirm results, though this will be dependent on IgE and skin prick testing (1).
Foods that list any of these ingredients on their labels need to be avoided in patients with Egg Allergy:
Egg/fresh egg (including those from all birds)
Egg powder, dried egg, frozen egg, pasteurised egg
Egg proteins (albumin, ovalbumin, globulin, ovoglobulin, livetin, ovomucin, vitellin, Ovovitellin)
Egg white, egg yolk
Egg lecithin, dried egg, powdered egg
Classifications of egg-containing foods:
Cakes, Biscuits, Dried and well cooked fresh egg pasta, Egg in sausages and prepared meat dishes, Egg glaze on pastry, Sponge fingers, Quorn, Nougat, Milky Way, Mars bar, Chewits, Egg in some gravy granules, Dried egg noodles
Loosely cooked Egg:
Meringues, Lemon curd, Quiche, Scrambled egg, Boiled egg, Fried egg, Omelette, Poached egg, Egg in batter, Egg in breadcrumbs, Hollandaise sauce, Egg custard, Pancakes and Yorkshire Pudding (some patients who can eat well-cooked egg can tolerate these, but it depends on how well cooked they are and if they contain any `sticky` batter inside).
Fresh mousse, Fresh Mayonnaise, Fresh ice cream, Fresh sorbet, Royal icing (both homemade Royal icing and commercial Powdered icing-sugar mix), Horseradish sauce, Tartar sauce, Raw egg in cake mix and other dishes awaiting cooking (children of all ages love to taste!) `Frico` Edam cheese or other cheeses containing egg- white lysozyme, Wine and clear soups (egg white is used to get rid of cloudiness). Egg-free products: (1). Egg-free mayonnaise, Egg-free cakes and muffins, Egg-free puddings, Egg-free omelette mix, Egg replacers, Whole-egg replacers, Egg-white replacer, Whole egg replacer (allergycare), Ener-G egg replacer (General Dietary), Loprofin egg replacer (SHS International), No-egg replacer (Orgran), Loprofin egg white replacer (SHS International)
Other Considerations for Managing Egg Allergy
Non-food items such as medication can also contain traces of egg protein (1). Some vaccines may contain traces of egg derivatives, and this is an important consideration when the individual requires vaccination. Vaccines of significance include MMR; Yellow Fever; Influenza (1). The influenza vaccine is cultured in egg and may cause reactions in individuals with egg allergy (2). The MMR vaccine is cultured in tissue of the developing chicken embryo and has been safely administered to thousands of children with egg allergy, in rare circumstances a child may experience a rash after the injection (2). Other non-food items like cosmetics, toiletries and perfumes which contain traces of egg-derivatives should be avoided if they cause irritation (1). Indications of the labelling are often written as ovum or ovo (1).
Article Contributed by Julie Albrecht. You may also be interested in Egg Allergy Prevalence.