An Overview of Egg Allergy

Close-Up Of Brown Eggs Against Black Background
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Egg allergies are among the most common food allergies in children, coming in second to milk allergies and affecting nearly 2% of the population. Typically, an egg allergy is diagnosed before age two. Often, the reaction begins within a few hours after eating eggs and can include symptoms such as skin reactions, stomach upset, or a runny nose.

An egg allergy may be difficult to pinpoint as the cause of your child's symptoms, and a diagnostic evaluation can be helpful in identifying this condition. Avoiding eggs is considered the best solution for an egg allergy. You may need to use egg substitute products when preparing baked goods.

An egg allergy can cause a reaction to certain childhood and adult vaccines, so you need to be aware of this possible complication.

Symptoms

Egg allergies disproportionately affect children. Experts estimate that between 50 to 80% of children with an egg allergy will see it resolve by age 10. By the teen years, most kids will have outgrown their egg allergy.

Your child may develop the effects of an egg allergy after eating eggs or foods that contain eggs.

An egg allergy causes a range of symptoms, including:

  • Skin reactions such as itching, hives, or a rash
  • Gastrointestinal (GI) symptoms such as nausea, diarrhea, stomach pain, and vomiting
  • Itchy, red, or watery eyes
  • Swelling of the throat, lips, tongue, or face
  • Upper respiratory symptoms such as coughing or a runny nose

These symptoms can worsen over the course of about an hour before resolving or stabilizing, and lasting between an hour and a day.

If the effects persist or continue to worsen, this can be a sign of a more severe allergic reaction that requires emergency medical intervention.

Complications

Very rarely, severe reactions such as wheezing, trouble breathing, or anaphylaxis may occur. Anaphylaxis is an allergic emergency with systemic (whole-body) effects. It can manifest with shortness of breath, low blood pressure, confusion, loss of consciousness.

Sometimes, anaphylaxis begins with milder allergy symptoms, such as itching or a runny nose, but quickly progresses to cause more serious effects.

Causes 

An egg allergy is a physical reaction that occurs after consuming raw or cooked eggs. Some people have this reaction after eating fried or boiled eggs, but some can also have an allergic reaction from consuming eggs that are present in baked foods.

Keep in mind that eggs are hidden in many food products including canned soup, salad dressing, crackers, cereal, bread, ice cream and meat-based dishes such as meatballs and meatloaf.

While it is rare, some people may experience an allergic reaction from touching products that contain eggs.

Allergic Reaction

The allergic reaction that occurs after consuming eggs is caused by an inflammatory response to proteins found in eggs. The body mistakes the protein for a harmful substance and mounts an immune response. A harmless substance like egg protein that induces an immune response is described as an allergen.

This immune response activates a specific antibody (immune protein) called IgE. This antibody rapidly produces a number of physical responses that cause the symptoms of an egg allergy.

It isn't completely clear why some people tend to have skin reactions, while others have GI symptoms or respiratory symptoms after exposure to egg protein.

The allergens that stimulate an allergic reaction to eggs are found in egg whites. But since the egg yolk and egg whites are in such close contact with each other, it is very hard to separate them perfectly—and consuming any part of the egg can trigger an allergic reaction.

Diagnosis

Diagnosis of an egg allergy can be challenging. If the effects begin within a short time after eating eggs or other types of food, that is a clue that it could be food-related. However, because eggs are found in so many baked goods, you might not immediately realize that your symptoms or your child's symptoms are associated with egg consumption.

Be sure to discuss the problem with your doctor. Even if avoiding eggs or egg-containing products reduces or completely eliminates your symptoms, it may be important for you to know if you or your child has an egg allergy because egg protein may be contained in medical products such as vaccines.

Diagnostic Methods

There are a number of approaches that can help with the diagnosis of an egg allergy. You and your doctor can determine whether one or more of these approaches could be helpful in your situation.

Oral food challenge: An oral food challenge involves eating a small amount of egg under medical supervision to see if a reaction develops. Eating the food may trigger allergic symptoms, verifying the cause of your allergy.

It is not safe to do an oral food challenge on your own because the reaction may be severe, necessitating urgent medical intervention.

Food elimination diet: A food elimination diet is different than an oral food challenge because it entails avoiding the possible allergen. If you are going to try a food elimination diet as a way to try to identify an egg allergy, it is important that you only exclude eggs from your diet, so that the results will not be confusing.

It can take weeks to see the results of a food elimination diet as you wait to see if the symptoms recur when eggs are not consumed.

Skin prick test: This test, also called a scratch test, is a common way of testing for allergies. This test involves placing the allergen on the skin and observing the skin to see if there is a reaction. Like the oral food challenge, this test is not safe to do on your own, and should only be done under medical supervision.

A skin prick test is not commonly used to diagnose egg allergies because it is more sensitive for identifying contact allergies (allergies induced by touch). Consuming eggs triggers the effects of an egg allergy, but touching eggs does not typically induce symptoms.

A skin prick test will identify whether touching eggs causes a skin reaction, but is highly unlikely to identify an allergy that is triggered by eating eggs.

Blood test: A blood test can help identify signs of inflammation, such as white blood cells, or antibodies such as IgE. A blood test can be used to assess generalized signs of an allergy, but it is not usually helpful in diagnosing the specific cause of the allergy.

In some instances, a blood test can help distinguish the difference between a food allergy and food intolerance. Food intolerance is a decreased ability to metabolize or digest food. Food intolerance may cause stomach upset and diarrhea, while a food allergy is an inflammatory reaction that occurs in response to food. If you and your doctors cannot determine whether your problem is related to food intolerance or a food allergy, a blood test can be helpful.

Treatment

If you have a serious or persistent allergic reaction after eating eggs, you may need treatment with an antihistamine or an EpiPen. Antihistamines can ease discomfort from a rash or dry eyes, while an EpiPen delivers epinephrine for the treatment of severe anaphylactic reactions.

The most effective way to manage an egg allergy is to avoid eggs. If you don't have a problem with eggs as an ingredient in baked goods, then it is not necessary to avoid them in baked goods. You only need to avoid the forms of eggs that cause you to experience problems.

Approximately 70% of people with egg allergy can tolerate small amounts of egg in baked products like cake, cookies, or bread. During the process of baking, heat alters the egg protein so that it is less allergenic.

Simply baking an egg, however, isn’t likely to reduce its ability to induce allergies. In baked foods, the amount of egg exposure is diluted among other ingredients.

It can be hard to know whether you or your child will be among the 70% who can tolerate eggs in baked goods. Work with your doctor to determine what foods are safe.

Reading food labels and asking about the ingredients of foods prepared by others will be vital to your success on an egg-free diet. The Food Allergy Labeling and Consumer Protection Act (FALCPA) is legislation that requires manufacturers of products regulated by the Food and Drug Administration (FDA) to list egg as a potential allergen ingredient for the consumer.

Avoiding Cross-Contamination

Products may also contain advisory labeling with statements such as “may contain egg” or “this product has been made in a facility that also produces an egg.” This labeling is not regulated, so products that may have egg residue might mot be labeled this way.

If you are unsure about the contents of a product, there are two things you can do—call the manufacturer and inquire about the specific ingredients contained in the product, and/or skip eating the product.

Newborns

If you are a breastfeeding mom, you should avoid eggs in your diet if your baby is allergic to them. The allergy-inducing egg proteins pass through breastmilk to the baby and may trigger symptoms.

Egg-Free Options

Eggs are a good source of many nutrients, including protein, vitamin D, folate, selenium, riboflavin, pantothenic acid, and iron. If you have to avoid eggs, it is important that you get an adequate amount of these nutrients from other foods such as meat, fish, poultry, whole grains, and vegetables.

Baking without eggs can prove to be a bit challenging. The most common egg substitutes in baked goods are:

  • Flaxseed: 1 tablespoon of ground flax mixed with 3 tablespoons of water to replace one egg
  • Baking soda and vinegar: 1 tablespoon of baking soda mixed with 1 tablespoon of white vinegar to replace one egg
  • Mashed banana: Half of a large banana or one small banana to replace one egg

Egg Substitute and Egg Replacers

Egg substitutes and egg replacers are not always egg-free. Some of these products are produced to be lower in calories, cholesterol, or fat than whole eggs, but they still may contain some egg in them. Be sure to read the labels carefully.

Ingredients such as albumin, globulin, lysozyme, lecithin, livetin, vitellin, and any ingredients starting with "ova" or "ovo" typically are made with eggs.

Egg Allergies and Medical Products

There are several medical treatments that contain egg protein. For example, some anesthetics, such as propofol, may contain egg protein. Several vaccines contain small amounts of egg protein because they are produced either in eggs or in chick embryos.

Vaccines that may contain eggs include:

MMR (measles, mumps, and rubella) vaccine: This vaccine contains a low amount of egg protein, but the American Academy of Pediatrics (AAP) states that the MMR vaccine can be safely administered to children and adults who have an egg allergy. If you are concerned, however, be sure to discuss your concerns with your child's pediatrician.

Influenza (flu) vaccine: The influenza vaccine contains a small amount of egg protein. According to the American Academy of Allergy, Asthma & Immunology (AAAAI), a child or adult who has an egg allergy may receive this vaccination under the supervision of a medical professional who has expertise in handling severe allergic reactions, and where emergency treatment is readily available—not at your local pharmacy or grocery store.

However, there are several options when it comes to the flu vaccine. Flublok is a flu vaccine that does not use chicken eggs during manufacturing. Flublok is approved for adults ages 18 and up.

According to the Centers for Disease Control and Prevention (CDC), the nasal spray version of the flu vaccine may be contraindicated if you have an egg allergy.

Rabies: The rabies vaccine typically contains egg protein. However, there are rabies vaccines that are not cultured in chick embryos. Even if you have an egg allergy, you can have one of these options if you need a rabies vaccine

Yellow fever: The yellow fever vaccine contains egg protein, and there are no alternatives that do not contain this allergen. Both the World Health Organization (WHO) and CDC state that a severe egg allergy is a contraindication for that vaccine. 

A Word From Verywell

Egg allergies are not uncommon. Eggs are consumed in a few different forms, and not everyone has a reaction to the same form of egg consumption. Be sure to note that you have an egg allergy in your health record so that you will not be given any medications that could contain eggs.

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