A shellfish allergy is not exactly the same as a seafood allergy. Seafood includes
fish (like tuna or cod) and shellfish (like lobster or clams). Even though they both
fall into the category of "seafood," fish and shellfish are biologically
different. So fish will not cause an allergic reaction in someone with a shellfish
allergy, unless that person also has a fish allergy.
Shellfish fall into two different groups:
crustaceans, like shrimp, crab, or lobster
mollusks, like clams, mussels, oysters, scallops, octopus, or
Some people with shellfish allergies are allergic to both groups, but some are
allergic only to one.
Most allergic reactions to shellfish happen when someone eats shellfish. But sometimes
a person can react to touching shellfish or breathing in vapors from cooking shellfish.
Shellfish allergy can develop at any age. Even people who have eaten shellfish
in the past can develop an allergy. Some people outgrow certain food allergies over
time, but those with shellfish allergies usually have the allergy for the rest of
What Are the Signs & Symptoms of a Shellfish Allergy?
When someone is allergic to shellfish, the body's immune
system, which normally fights infections, overreacts to proteins in the shellfish.
Every time the person eats (or, in some cases, handles or breathes in) shellfish,
the body thinks these proteins are harmful invaders and releases chemicals like
. This can cause symptoms such as:
a drop in blood pressure, causing lightheadedness or loss of consciousness (passing
Allergic reactions to shellfish can differ. Sometimes the same person can react
differently at different times. Some reactions can be very mild and involve only one
system of the body, like hives on the skin. Other reactions can be more severe and
involve more than one part of the body.
Shellfish allergy can cause a severe reaction called anaphylaxis,
even if a previous reaction was mild. Anaphylaxis might start with some of the same
symptoms as a less severe reaction, but can quickly get worse. The person may have
trouble breathing or pass out. More than one part of the body might be involved. If
it isn't treated, anaphylaxis can be life-threatening.
How Is an Allergic Reaction to Shellfish Treated?
If you have a shellfish allergy (or any kind of serious food allergy), the doctor
will want you to carry an epinephrine auto-injector in case of an
An epinephrine auto-injector is a prescription medicine that comes in a small,
easy-to-carry container. It's easy to use. Your doctor will show you how. Keep it
nearby, not in a locker or in the nurse's office.
The doctor can also give you an allergy action plan, which helps you prepare for,
recognize, and treat an allergic reaction. Share the plan with anyone else who needs
to know, such as relatives, school officials, and coaches. Also consider wearing a
medical alert bracelet.
Every second counts in an allergic reaction. If you start having
serious allergic symptoms, like swelling of the mouth or throat or trouble breathing,
use the epinephrine auto-injector right away. Also use it right away if your symptoms
involve two different parts of the body, like hives with vomiting. Then call
911 and have someone take you to the emergency room. You need to be under
medical supervision because even if the worst seems to have passed, a second wave
of serious symptoms can happen.
It's also a good idea to carry an over-the-counter (OTC) antihistamine, as this
can help treat mild allergy symptoms. Use
after — not as a replacement for — the epinephrine shot during life-threatening
What Else Should I Know?
If allergy testing
shows that you have a shellfish allergy, you must not eat shellfish. You also must
not eat any foods that might contain shellfish as ingredients. Anyone who is sensitive
to the smell of cooking shellfish should avoid restaurants and other areas where shellfish
is being cooked.
Always read food labels
to see if a food contains shellfish. Manufacturers of foods sold in the United States
must state whether foods contain any of the top eight most common allergens, including
crustacean shellfish. The label should list "shellfish"
in the ingredient list or say "Contains shellfish" after the list.
Some foods look OK from the ingredient list, but while being made they can come
in contact with fish. This is called cross-contamination. Look for
advisory statements such as "May contain fish," "Processed in a facility
that also processes fish," or "Manufactured on equipment also used for fish."
Not all companies label for cross-contamination, so if in doubt, call or email the
company to be sure.
Manufacturers also do not have to list mollusk shellfish ingredients
because mollusk shellfish (clams, mussels, oysters, or scallops) are not considered
a major food allergen. When labels say a food contains shellfish, they refer to crustacean
shellfish. Contact the company to see about cross-contamination risk with mollusks.
Cross-contamination often happens in restaurants. In kitchens, shellfish can get
into a food product because the staff use the same surfaces, utensils (like knives,
cutting boards, or pans), or oil to prepare both shellfish and other foods.
This is particularly common in seafood restaurants, so some people find it safer
to avoid these restaurants. Shellfish is also used in a lot of Asian cooking, so there's
a risk of cross-contamination in Chinese, Vietnamese, Thai, or Japanese restaurants.
When eating at restaurants, it may be best to avoid fried foods because many places
cook chicken, French fries, and shellfish in the same oil.
When eating away from home, make sure you have an epinephrine auto-injector with
you and that it hasn't expired. Also, tell the people preparing or serving your food
about the shellfish allergy. Sometimes, you may want to bring food with you that you
know is safe. Don't eat at the restaurant if the chef, manager, or owner seems uncomfortable
with your request for a safe meal.
Also talk to the staff at school about cross-contamination risks for foods in the
cafeteria. It may be best to pack lunches at home so you can control what's in them.
Other things to keep in mind:
Make sure the epinephrine auto-injector is always on hand and that it is not expired.
Don't eat cooked foods you didn't make yourself or anything with unknown
Tell everyone who handles your food — from relatives to restaurant staff — that
you have a shellfish allergy.
Stay away from steam tables or stovetops when shellfish is cooked (especially
places where food is cooked on a communal grill, like hibachi restaurants).
Carry a personalized "chef card," which can be given to the kitchen
staff. The card details your allergies for food preparers. Food allergy websites provide
printable chef card forms in many different languages.
Shellfish ingredients also might be used in some non-food products, like nutritional
supplements, lip gloss, pet foods, and plant fertilizer. Talk to your doctor if you
have questions about what is safe.