DR.D.

JASMINE JENIFER
ASSISTANT PROFESSOR
WOMEN’S CHRISTIAN COLLEGE
CHENNAI
Allergies, Allergens
and Food Handlers

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 What is an Allergen?

 Food allergens, are substances that

initiate chemical change in the body
producing the symptoms of an allergic
reaction.
 Allergens are generally a problem of
absorption through the alimentary mucosa
into the circulatory system. Allergens
may also enter the circulatory
system through the nasal passage
(respiratory mucosa) and through the skin
(percutaneous absorption which is rare).

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Types of Allergies

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Types of Allergies

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 Adverse Food Reaction

An adverse reaction is any

Allergy abnormal reaction to a food or
food components and other
ingredients, whether caused by
an allergic or non allergic
Intolerances
reaction.

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What is a Food Allergy?

A Food Allergy (Food

Hypersensitivity) has its basis
in an immunologic response
after food consumption.

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 Immune system function
 Super-sensitive
 Allergens
 Usually the protein part
 Allergens react to antibodies
 Release chemicals causing symptoms
 What is a Food Intolerance

 Adversereaction to food that

does not involve the immune
system.

Food Additives

Celiac Disease

Lactose Intolerance
Toxins

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 Most people can eat foods without any
problems although they may have
different likes or dislikes that influence
what they choose.

 However, some people react to certain

foods and eating them may cause
uncomfortable symptoms or, in rare
cases, a severe illness.
 Intolerances
 The body can usually tolerate small
amounts of the offending food
 Intolerances are not immune
reactions
 Intolerances are more common
than food allergies
 Some causes
• Lack of a digestive enzyme - Milk
• Contaminants – naturally toxic foods
(Rhubarb), decayed fish, some mushrooms
• Food Additives - sulphites, MSG
• Psychological

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• Gluten (coeliac disease) – the protein
found in wheat, rye, barley and some
oats;
• Dairy (lactose) – the sugar found in all
mammals’ milk, e.g. cow’s, goat’s and
buffalo;
• Yeast – bread and cereal products
containing yeast, fermented or ripe
foods, vinegar and salad dressing.
 There are many reasons for unpleasant
reactions to food. A general term for
those that are not caused by food
poisoning are food intolerances.

 Food intolerance is more common in

children than in adults. Children often
grow out of the intolerance before they
go to school.
 Food intolerances are more common than
food allergies. The symptoms of food
intolerance tend to come on more slowly,
often many hours after eating the problem
food. Typical symptoms include bloating
and stomach cramps.

A food allergy is a rapid and potentially

serious response to a food by your immune
system. It can trigger classic allergy
symptoms such as a rash, wheezing and
itching.
 Most unpleasant reactions to food are not
true food allergies.

A food allergy is one particular type of

food intolerance that involves the body’s
immune system. Food intolerances may
cause uncomfortable symptoms, but only
true allergies involve the immune
system.
 When the body’s immune system mistakenly
believes a harmless substance is harmful to
the body. It tries to protect the body by
releasing histamines and IgE antibodies to
attack the substance.
 Chemical triggers like histamine and IgE
antibodies are released in response to an
allergen and can cause allergic reactions
with a variety of symptoms
 Symptoms may vary from person to person
and not all reactions appear the same
 The immune system is part of the body’s
defence system, as it protects against
foreign organisms like bacteria and
viruses. In some people, they may also
react to substances in foods, or in the
environment, e.g. pollen or animal fur.

 Thisresponse is known as an allergic

reaction.
 About 3 to 8 percent of children have
reaction
 Only 1 to 2 percent have true food allergies
 Children usually grow out of sensitivity by
age 4 (not peanuts, tree nuts, shellfish)
 About 1 to 2 percent of adults
 Most foods may cause an allergy, the
symptoms of which can be
uncomfortable but when severe can be
fatal.

 Themost common food allergies are to

eggs, milk, fish, peanuts and tree nuts
(such as walnuts, Brazil nuts
and almonds).
 Foods Responsible
for Allergic and Adverse Reactions
 Peanuts
 Tree Nuts
 Sesame Seeds
 Eggs
 Soybeans
 Milk
 Various grains and flours
 Fish
 Shellfish
 Sulphites (10 ppm)

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Common Food Allergies
Scandinavia – Fish

Japan – Rice & Soy

North America – Peanuts & Tree Nuts

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 Children
 Milk, egg, peanuts, wheat, soy, tree nuts
 Most will outgrow eggs, milk, wheat, and soy
 Adults
 Peanuts, tree nuts (almonds, walnuts), fish,
shellfish (shrimp, lobster, crab), mollusks
(oysters, clams, scallops)
 Reaction within minutes to two hours
 How soon and how severe depend on
sensitivity to food, how much was consumed,
other foods consume, and preparation
 May have minor symptoms at first
A food allergy usually occurs between a
few minutes and a few hours after eating
a particular food.
 Thesymptoms of food allergies vary from
person to person and can include:
• Coughing;
• Dry, itchy throat and tongue;
• Nausea and feeling bloated;
• Wheezing and shortness of breath;
• Swelling of the lips and throat;
• Runny or blocked nose;
• Sore, red and itchy eyes.
 Symptoms
 Shortness of breath  Wheezing
 Tingling lips  Diarrhea
 Flushing  Itchy skin
 Nasal obstruction  Weakness
 Dizziness  Shock
 Total respiratory  Loss of
failure consciousness
 Drop in Blood  Itchy eyes
Pressure  Vomiting
 Hives  Restricted Throat

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 Digestive system  Bodysystems (skin,
 Swelling, itching lungs, etc)
 Tightness  Hives, skin swelling
 Hoarseness  Anaphylaxis – BP falls,
 Nausea wheezing, breathing
 Cramping problems, nausea,
rapid pulse, flushing,
 Pain faintness, passing out
 Vomiting  Can lead to death
 Diarrhea
 Severe reactions more common in peanuts,
tree nuts, shellfish, fish, and eggs
 Also more common in those with asthma
 Death usually seen in peanuts or tree nuts
 What is Anaphylaxis?

Anaphylaxis is a severe allergic reaction

that can sometimes be fatal. It occurs
after exposure to an antigen (allergen)
to which a person was previously
sensitized.
Anaphylaxis

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Milk
Allergy to cows' milk is the most common food allergy
in childhood. A reaction can be triggered by small
amounts of milk, either passed to the baby through
the mother's breast milk from dairy products she has
eaten, or from feeding cows' milk to the baby.
 Symptoms: Often mild symptoms can appear and can
affect any part of the body. They can include rashes,
stomach cramps, bloating, heaviness in the stomach,
flatulence, diarrhoea, vomiting, etc. In very few
cases, milk allergy can cause anaphylaxis.
 Food substitutes: Almond milk, rice milk, soy milk,
hemp milk, coconut milk are good substitutes to use
in milkshakes, baking and with cereal. Calcium
substitutes include leafy vegetables, chickpeas, eggs
and seeds. Protein can be substituted with soy,
pulses, meat or eggs.
 Allergy to peanuts is often lifelong and can cause severe
reactions, including anaphylaxis. Peanut allergy can be so
severe that very tiny amounts can cause a reaction in people
who are sensitive. They contain allergens that are not
destroyed by cooking or roasting. Refined peanut oil is
thought to be safe for people with peanut allergy, because the
proteins that cause allergic reactions are removed during the
manufacturing process. However, cold pressed, or unrefined
peanut oil can contain small amounts of peanut allergens,
which can cause a reaction in people who are sensitive.
 Symptoms:Runny nose, skin reactions, such as hives, redness
or swelling, itching or tingling in or around the mouth and
throat, digestive problems, such as diarrhoea, stomach
cramps, nausea or vomiting, tightening of the throat,
shortness of breath or wheezing, anaphylaxis,etc.
 Food substitutes: The easiest and the most common peanut
butter alternative is almond butter and sunflower seed butter
is also a great substitute for peanut butter and contains
healthy fats and proteins.
 Egg allergy is more common in childhood and is
often outgrown. Trigger is mostly egg proteins:
ovomucoid, ovalbumin and conalbumin. Mostly
children grow out of it by the age of 3.
 Symptoms: Skin reactions like red patches or
rashes all over the body, stomach aches,
diarrhoea,wheezing or shortness of breath,
sneezing and nasal congestion, nausea and
vomiting, anaphylaxis – in some casesetc.
 Food substitutes: Eggs are widely used for
baking and can be replaced with yoghurt or plant
alternatives or egg substitutes. The protein
content can be obtained from milk, pulses or
meat.
 Fish allergy can often cause severe reactions,
including anaphylaxis. Trigger is fish proteins.
Cooking doesn't destroy fish allergens. In fact,
some people with a fish allergy can be allergic to
cooked but not raw fish.
 Symptoms: Skinirritations, swelling of the
throat, mouth and nose, vomiting and diarrhoea,
breathing difficulties, a severe drop in blood
pressure, anaphylaxis in some cases, etc.
 Food substitutes: Daily dose of protein can be
obtained from eggs, dairy products, meat,
poultry, pulses, lentils, black beans, etc.
 Allergy to nuts from trees (e.g. walnuts, hazelnuts,
almonds, cashew, pistachio, coconut etc.) is usually
lifelong. On rare occasions, all these nuts can cause
anaphylaxis in people who are sensitive.
Sometimes, people with an allergy to one type of
nut will also react to other nuts.
 Symptoms: Mild swelling of tongue, lips and eyes,
itchy mouth, throat or eyes, shortness of breath,
nausea and vomiting, skin irritations and rashes,
abdominal pain, anaphylactic reactions in severe
casesetc.
 Food substitutes: Seeds are the best replacement
for nuts nutritionally. Omega 3 can be obtained
from egg yolk and the protein can be obtained from
milk.
 Shellfish (e.g. shrimp, lobster, crab, oysters,
scallops, mussels, clams, etc.) allergy can
often cause severe reactions, and some people
can even react to the vapors from cooking
shellfish.
 Symptoms: Tingling in the mouth, nausea,
vomiting and diarrhoea, skin irritations,
dizziness and fainting, throat swelling and
breathing difficulty, drop in blood pressure and
rapid pulse, anaphylaxis, etc.
 Food substitutes: Daily dose of protein can be
obtained from eggs, dairy products, meat,
poultry, pulses, lentils, black beans, etc.
 It is a common childhood allergy. Most people grow
out of it by the age of two, but occasionally adults
are allergic to soybean. It is known as a potent
food that leads to hormonal imbalances; it isn’t
easy to digest for some kids.
 Symptoms: They are similar to milk allergy and
include ashes, diarrhoea, vomiting and stomach
cramps. Also includes swelling on the hand and
feet, tongue and lips, puffed eyes, flatulence and
bloating Very rarely, it can cause anaphylaxis.
 Food substitutes: Since soy is mainly eaten for its
complete protein content, any animal foods like
milk, eggs or meat can be a good replacement.
Alternatively, pulses, beans, grains (e.g. quinoa)
and sprouts are good substitutes too.
 Wheat allergy is common, particularly among babies and is
usually outgrown by age three. It is sometimes confused with
celiac disease, which is a digestive disorder that creates an
adverse reaction to gluten (Gluten intolerance). Individuals
with celiac disease must avoid gluten, found in wheat, rye,
barley, and sometimes oats. While, people who are allergic
to wheat have an immune mediated response to wheat
protein and may tolerate other grains.
 Symptoms: Watery diarrhoea, bloating and cramping,
indigestion that could lead to nausea, headache, excessive
burping, stomach aches due to swelling of the intestinal
wall, mouth ulcers, muscle pains, skin irritations,etc.
 Food substitutes: Wheat can be substituted by a number of
flours like millets (jowar, ragi, bajra), rice, maize,
amaranth, etc. These substitutes can be used in breads and
pancakes. Alternatively, potato starch and tapioca can be
used as baking agents for muffins and cakes.
 Sesame allergy is increasing, possibly because it's
now more commonly used. Sesame seeds,
sesame oil, and other sesame products, can
cause
 Symptoms: Skin irritations and rashes,
abdominal pain, nausea, vomiting and diarrhoea,
itchy mouth, throat or eyes, swelling of the
face, nose or mouth, shortness of breath,
anaphylactic reactions in severe cases, etc.
 Food substitutes: Sesame oil can be substituted
with roasted peanut oil, nut oil such as walnut
oil, olive oil, perilla oil, avocado oil, canola oil,
grape seed oil, etc. Also instead of sesame seed
one can use sunflower seed, perilla seed,
pumpkin seed, etc.
 Corn and corn-derived products (includes baking powder,
caramel, cellulose, citric acid, dextrin, dextrose, inositol,
malt, maltodextrin, monosodium glutamate (MSG), semolina,
sodium erythorbate, sorbitol, starch, vanilla extract, xanthan
gum, xylitol, etc.) are used in many processed foods, as well
as in many other everyday items.
 Symptoms: Hives or a skin rash, nausea, stomach cramps,
indigestion, vomiting or diarrhoea, stuffy or runny nose,
sneezing, headaches, asthma, anaphylaxis (less common),
etc.
 Food substitutes: A substitute for corn or its product can be
used depending upon its function or flavor. Corn oil can be
substituted with another oil Similarly instead of using baking
powder which contains corn starch, can replace it with soda
and other leavening agents. Instead of using corn starch as
thickener, can replace it with arrowroot starch, wheat starch,
tapioca starch, potato starch, xanthan gum, etc. Corn syrup
can be substituted with other liquid sweeteners such as honey,
 Spices are commonly used in Indian diet and
allergen city to it can be problematic.
Reactions to spices are usually mild, but severe
reactions can happen occasionally. Some people
react to mustard, coriander, caraway, fennel,
paprika, saffron, ginger, garlic, etc..
 Symptoms: Stomach problems,
sneezing,anaphylaxis, etc.
 Food substitutes: One can avoid that particular
spice and substitute it with herb or spice with
similar flavor and aroma.
 People with fruit and vegetable allergies
generally also have hay fever because some
tree and weed pollens share characteristics
with certain fruit and vegetable proteins.
Such allergies often develop in adulthood.
 Symptoms: These allergies are usually mild,
with symptoms like an itchy mouth or throat,
and can be addressed by heating fruits and
vegetables prior to consumption.
 Food substitutes: Vinegar, tomato juice
and apple cider vinegar are good substitutes
for citrus fruits.
 People who have an allergic reaction to
foods or ingredients must be particularly
careful about what they eat and reading
labels and menus carefully is especially
important.
 New rules that came into effect include
the way allergen information appears on
labels and on food that is pre-packed,
sold loose or served in a restaurant, café
or take-away.
Fourteen major allergens have been
identified and will be highlighted on the
label within the ingredients list. They are:
• Cereals containing gluten;
• Crustaceans, e.g. prawns, crabs, lobster
and crayfish;
• Eggs;
• Fish;
• Peanuts;
• Soybeans;
• Milk;
• Nuts, such as almonds, hazelnuts,
walnuts, pecan nuts, Brazil nuts,
pistachio, cashew and macadamia nuts;
• Celery (and celeriac);
• Mustard;
• Sesame;
• Sulphur dioxide which is a preservative
found in some dried fruit such as
apricots;
• Lupin;
• Molluscs, e.g. clams, mussels, whelks,
oysters, snails and squid.
The fourteen major allergens will be
highlighted on the label within the
ingredients list rather than in a separate box
as has been done in the past.

The allergen could be identified in bold,

highlighted, underlined or in italics.

The example below is for a basic Victoria

sponge:
Eggs, wheat flour, butter, sugar, vanilla essence,
baking powder
From December 2014, information on any
of the 14 allergens used as ingredients
will need to be provided for foods sold
without packaging or wrapped on site,
e.g. in delis, cafes and restaurants.

This information could be written down on

a chalk board or chart, or provided orally
by a member of staff.
 Most severe allergic reactions are triggered
by an ingredient that was intended to be in
the product but the consumer did not read
the label or menu carefully or had been
misinformed by staff when eating out.
Examples of this could be:

• Peanut flour used to thicken the sauce in a

takeaway curry;
• Nuts present in a coronation chicken salad;
• Milk present in a minor ingredient in a pre-
packed or catered food.
 People with allergies or preparing food
at home need to be aware that:
• Peanuts are also known as groundnuts;
• Satay sauce is made with peanuts;
• Marzipan, praline, nougat and frangipane
are made with nuts;
• Pesto sauce can be made with nuts, and
also contains milk;
• Waldorf salad contains nuts;
• Dishes containing sesame include tahini
and hummus;
• Whey and casein are proteins in milk
and therefore must be avoided by
people with milk allergy;
• Caesar salad dressing normally contains
anchovies;
• Worcestershire sauce is likely to contain
anchovies.
 Physician
 Medical history, physical exam
 Skin test
 Lab tests
 Oral food challenge
 Elimination diet
 Double-blind food challenge
 Ragweed- Watermelon, cantaloupe,
honeydew, bananas
 Birch pollen-carrots, apples, hazelnuts,
potatoes
 Banana – latex
 * If allergic to one shellfish or legumes, likely
allergic to all!
 Do not consume allergic foods
 Read the ingredient list
 must clearly state food allergen (milk, eggs, fish,
crustacean shellfish, tree nuts, peanuts, wheat,
or soybeans)
 If
traveling, bring special foods
 When eating out, ask about foods
 Know which children have allergies and what
those are
 Know how to recognize symptoms
 Have a plan in cause of allergic response
 Wash hands with soap, surfaces with cleaners
for peanut allergies
 Identifythose at risk
 Consult a doctor
 Maternal diet avoiding eggs, cow milk,
peanuts, fish
 Take medication
 Seek medical help
 Keep injectable epinephrine
 Wear Medic-Alert bracelet
 Forbabies, discuss formula options with
doctor
 Don’t introduce solid foods too early – wait
about 6 months
 Wait on foods with common allergens
 Cow milk – age 1
 Eggs – age 2
 Peanuts, nuts or fish – age 3 or after
 Cow’s milk common – cause hives, asthma,
colic, sleeplessness, blood in stool, poor
growth
 Immature immune systems
 May change to soy or elemental formula
 Drugs to severe cases
 Breast milk helps
 Put hands to mouth, pull or scratch tongues,
voices may change
 “Food is too spicy”
 “My tongue is hot, something is poking it”
 “My mouth is tingly, itches, or feels funny”
 “My tongue feels full, my throat feels thick”
 What is the responsibility of a food
company in Allergen Management?
 What is the responsibility of the Food
handler in Allergen Management?
 What is the consumers responsibility in
Allergen Management?

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 There is no cure for food allergies. Strict
avoidance of food allergens and early
recognition and management of allergic
reactions to food are important measures
to prevent serious health consequences.
Responsibility of a Food Company in
Allergen Management?

 Providesafe, wholesome food to the

marketplace.

 Provide proper information with the

product to allow the consumer to make
an informed choice.

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Provide Safe, Wholesome Food
to the Marketplace.
 Allergen policy and
program
 Risk Assessment
 Formulation Control
 Ingredient
Management
 Process Controls
 Packaging Management
 Label Control
 Employee Training

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 Provide Safe, Wholesome Food
to the Marketplace.
Allergen policy and program
• Expectation of program • Production environment
• Training • Responsibilities
• Restriction of non • Consequences
approved ingredients • Be aware of employees
• Marketing program with food allergies
• Hygienic practices • Have a response
program in place

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 Provide Safe, Wholesome Food
to the Marketplace.
 Policy,
GMP, SOP, Monitoring,
Deviation Procedure and Verification
must state
• Who
• What
• When
• Where
• Why
• How

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Provide Safe, Wholesome Food
to the Marketplace.

Risk Assessment
• Likelihood of occurrence
• Severity of Reaction

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Provide Safe, Wholesome Food
to the Marketplace.

 Formulation Control
• No unapproved changes to
formulation
• Use only most recent approved
formula
• Follow SOP for scaling and use

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Provide Safe, Wholesome Food
to the Marketplace.

Ingredient Management
• Purchase only from approved
suppliers
• Purchase and use only approved
ingredients
• Store to prevent damage and cross
contamination

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Provide Safe, Wholesome Food
to the Marketplace.
Process Controls
• Sequencing Products
• Scaling (Scoop & Bins)
• Shielded lines
• Rework
• Label control
• Cleaning of equipment

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Provide Safe, Wholesome Food
to the Marketplace

Packaging Management
• Purchase only from approved
suppliers
• Purchase and use only approved
packaging
• Store to prevent damage and
cross contamination
• Discard obsolete packaging

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Provide Safe, Wholesome Food
to the Marketplace

Label Control
• Check label name and ingredient
list against formulation.
• If generating labels verify
information in computer is
accurate and labels print clearly.
• Check labels for warnings.
• Check instructions for use.

74
Provide Safe, Wholesome Food
to the Marketplace

Employee Training
• Train to approved GMPs & SOPs
• Hygiene Training
• HACCP Training

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Provide Proper Information
with the Product Label

• Ingredient list
• Instructions for use
• Warnings
• Information
• Contact

76
Provide Proper Information
with the Product
 Accurate labelling is required
by legislation and controlled
by guidelines and inspection.
 Label misrepresentation is
fraud
 Knowingly selling a product
with an undeclared allergen
can be interpreted as a
criminal offense in case of
illness or fraud.

77
Responsibilities of the Food Handler

 Advise of formulation or process

inefficiencies
 Use only approved ingredients
 Do not make decisions which can affect
food integrity or safety unless
empowered and trained to do so
 Use product rework only in the product
for which it was originally produced
 Understand your responsibilities
 Understand and do the job as trained

78
Responsibilities of the Food
Handler

 Prepare foods which contain

known allergens after all
other products have been
produced, follow sequence as
directed.
 Avoid cross-contamination
 Wash hands thoroughly after
handling known allergens
 Wash hands thoroughly after
eating

79
Responsibilities of the Food Handler

 Keep aprons and clothing free of

allergens
 Follow a very thorough sanitation
program to prevent cross-
contamination.
 Keep dust down
 Keep all ingredients closed
when not in use
 Use only specified equipment and
utensils

80
Consumers Responsibility

 Avoid products which may

contain allergens.
 Report non conformities in
labelling
 Educate family and a
Consumers Responsibility dvise
associates of concerns
 Be aware of pitfalls
 Make educated decisions
based on reliable information

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 Eggs – baked goods, noodles
 Milk – pies, cheese
 Soy – baked goods, candy, tv dinners
 Wheat – flours, soup mixes, snacks
 Peanut – candy, baked goods, ice cream
 Fish – seafood flavors
 New food labels should help
 Chinese, Indonesian, Mexican, etc dishes
usually made with peanuts
 Cross-contamination of allergens
 Not as easy to read ingredient list
Consumers Responsibility

84
Consumers Responsibility

85
 Remember
 Don’t assume all people can eat
all foods
 Do your job as trained
 Do not make decisions for the
consumer
 Do not cross contaminate
 Properly label all foods

86
 Listencarefully when someone in your group
indicates he or she has a food allergy.
 Try to find out ahead of time if someone in your
group has a food allergy, and adjust the menu or
lesson whenever possible.
 Explain to the person what you know to be true
about the food being served or used in the
lesson---don't be afraid to say you don't know.
 Keep foods simple and safe.
 Be aware that allergens often hide in soups, dips, and
homemade goodies.
 Check ingredient labels on food packages for allergens every
time--food products may change.
 The new food labeling law requires food manufacturers to
disclose in plain language whether products contain any of the
top eight food allergens.
 Do not serve a food if you can't guarantee it will be allergen
free, or ask the person with an allergy to bring his or her
own snack.
 Disclose ingredients used to prepare meals.
 Avoid using "secret" ingredients. Always indicate whether
key allergens are included in the recipe or may have come
in contact with the food you are preparing or serving.
 Prevent cross contact between allergen-containing and
allergen-free foods.
 Keep even a trace amount, part, or product of an allergenic
food (e.g., peanut, peanut butter, peanut oil) from coming
in contact with an allergen-free food or allergen-free food or
surface (e.g., counter, bowl, spoon).
 Cross contact measures are not the same as cross contamination
measures used to prevent foodborne illness. That is, while many
foodborne diseases can be prevented by cooking foods
thoroughly, cooking a food containing an allergen will not make
the food safe to eat by someone allergic to it.
 Wash your hands, workspace, utensils, and pans, and make
sure dishes are allergen-free before preparing foods.
 Thoroughly clean up workspace after use.
 Be in control of the eating situation. Keep kids
from trading meals and snacks.
 Confine food to eating areas.
 Have participants wash hands and eating areas
after meals and snacks. (For example, a smudge
of peanut residue on the table could trigger a
reaction.)
 Limit crafts that use food items.
 The steps above will help prevent a food allergy from
being triggered. Unfortunately, accidents do happen. And
sometimes a reaction occurs in someone who had not
previously experienced a reaction; therefore, to play it
safe, know what to do in an emergency. Symptoms may
appear within seconds to hours.
 Learn the symptoms: tingling sensation, itching, or
metallic taste in the mouth; hives; a sensation of warmth;
asthma symptoms; swelling of the mouth and throat area;
difficulty breathing; vomiting; diarrhea; intestinal
cramping; drop in blood pressure; and/or loss of
consciousness.

If someone reports feeling sick after eating, take him or
her seriously, and act quickly.

Call your local emergency service.
 Be Concerned

Be
Allergy Aware.

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