Fish anaphylaxis: recognise and respond

Anaphylaxis is a severe allergic reaction that can affect breathing, blood pressure, skin, and digestion. After fish exposure, warning signs may include widespread hives, swelling of the lips or tongue, tightness in the throat, wheezing, repeated vomiting, dizziness, or collapse. Symptoms can progress quickly and may occur without a rash. A reaction can follow eating, touching, or inhaling particles during cooking in a sensitised person.

Use an adrenaline auto-injector immediately if one has been prescribed, following its instructions. Call emergency services, say that anaphylaxis is suspected, and do not leave the person alone. Lie down with legs raised unless breathing is difficult; then sit with the upper body raised. Avoid standing or walking. If symptoms continue and another prescribed device is available, follow the emergency plan. Even if symptoms improve, hospital observation is needed because they can return.

Treat breathing difficulty, throat swelling, faintness, sudden drowsiness, or rapid deterioration after fish exposure as an emergency. Do not wait to see whether an antihistamine works. Emergency clinicians can provide monitoring and treatment for airway or circulation problems.

Ask about referral for Allergy Testing, an adrenaline prescription, an action plan, and how to explain the risk to family, school, or workplace contacts. Discuss label reading and avoiding cross-contact with fish.