Egg allergy – common questions

Egg allergy is often a cause of eczema

Egg allergy is common. With 1 in 20 babies being affected.
Most children with egg allergy also have eczema. Skin reactions (urticaria and eczema) are the most common symptoms.
However, some children will get choking and wheezing with larger amounts of egg.

Usually OK by 5 years

These reactions can be frightening and even may appear life-threatening.  However, children recover.  Most children will be able to tolerate eggs again by school age (by 5 or 6 years old). Skin prick testing is very helpful for diagnosis as most egg allergy is a quick onset reaction. Children with egg allergy often also have peanut and cow’s milk allergy.  So it is important to get them properly tested.

Egg allergy – common questions

Do the skin tests tell me how bad the egg allergy is?

The bigger the skin tests, then the longer the egg allergy persists. However, 80% of children will outgrow their egg allergy by 6 years of age. Getting skin tested again at 5-6 years old is a good idea. That will give you a good idea if there is continuing egg allergy. A skin prick test of over 10mm suggests a longer time before getting over the egg allergy.

Could my child have an anaphylactic reaction?

Yes, if enough egg is eaten, then a child with a positive egg skin test can develop an anaphylactic reaction. But a child will spit out the food immediately and often will vomit, this protects the child.

What about cooked egg?

Yes, many children can tolerate tiny amounts of egg in baking but would get sick if given any obvious egg products.

Does egg allergy cause eczema?

Yes it does, Dr Ford’s research shows that egg is the most common food allergy in babies and toddlers in causing eczema.

Can egg get through in breastmilk?

Yes, egg easily gets into breast milk. So if your breastfeeding child has eczema, then Dr Ford suggests that the baby gets skin tested, if positive, then mum should go off eggs until the baby is weaned.

How long does egg allergy last?

Most children (80%) get tolerant to egg by 6 years old. Get another skin test then to see.

Is egg allergy a lifelong condition?

About 20% of egg allergy children continue to be allergic to egg into adulthood. Most of these people have a big skin test to egg early on and remain positive throughout childhood.

Book suggestion: You can learn a lot more about food allergy and eczema in Dr Ford’s book “Eczema! Cure it!”

Symptoms from egg allergy

Skin reactions (urticaria/ hives/ wheals and eczema) are the most common symptoms. Most children with egg allergy have eczema. Some children will get choking and wheezing with larger amounts of egg. The reactions can be frightening and may appear life-threatening. However, children invariable recover.

Diagnosis of egg allergy

Skin prick testing is very helpful for diagnosis because most egg allergy is a quick onset type of reaction. They shoulkd be tested for a panel of foods, as children with egg allergy often also have peanut and cow’s milk allergy. Most children with egg allergy have eczema.

Egg allergy and vaccines (MMR) – is it safe?

A very common question about egg allergy is: Is it safe to give MMR vaccine to my child who is allergic to egg? “The answer is yes!

MMR is safe

This is an abstract from an early paper on egg allergic children and the MMR vaccine: N Engl J Med 1995 May 11;332(19):1262-6 Safe administration of the measles vaccine to children allergic to eggs. James JM, Burks AW, Roberson PK, Sampson HA. Department of Pediatrics, Arkansas Children’s Hospital Research Institute, Little Rock, USA.

BACKGROUND. The safety of administering the combined measles-mumps-rubella (MMR) vaccine to patients who are allergic to eggs has been debated for decades because of concern about potential anaphylaxis, since the live attenuated virus used in the vaccine is grown in cultured chick-embryo fibroblasts. METHODS. We recruited 54 children (mean age, 18.5 months) who had not previously been vaccinated and were allergic to eggs. The children’s histories of allergy were confirmed with skin tests and double-blind, placebo-controlled food-challenge tests; some children also underwent skin testing with the MMR vaccine. We then routinely administered the vaccine to the children in one subcutaneous (0.5-ml) dose. RESULTS. All 54 children had positive results on skin testing with egg. Allergy to eggs was confirmed in 26 of the children by convincing histories of anaphylaxis after the ingestion of eggs, in 22 children by food-challenge tests, and in 6 patients by convincing histories of recent allergic reactions occurring after the ingestion of eggs. Of the 17 children who underwent skin testing with the MMR vaccine, 3 had positive results. All 54 children received the MMR vaccine as a single subcutaneous injection; none had an immediate or delayed adverse reaction.

CONCLUSIONS. The MMR vaccine can be safely administered in a single dose to children with allergy to eggs, even those with severe hypersensitivity.

This is the recommendation from the Immunisation Handbook 2014

Recommendation -The MMR vaccine is safe to give children with egg allergy.