influenza vaccine and egg allergy… also a word on MMR and egg allergy

September 22nd, 2010

Each fall, many egg-allergic patients wonder whether they should receive the flu shot. Unfortunately, the same genetic predisposition that leads to food allergy may also lead to allergic asthma–a condition that is associated with increased risk for adverse outcomes due to influenza infection.
Egg allergy can be diagnosed by skin testing, in vitro (blood) testing, or a combination of the two. Testing should be considered anytime an individual has allergic symptoms (gastrointestinal, skin, or respiratory) that correlate with egg ingestion. Select individuals may test positive to egg but may in fact receive the vaccination if clinically indicated. This should occur in the context of consultation with an allergist, and may require additional testing to the influenza vaccine.
Regarding MMR vaccine and egg allergy…
The American Academy of Pediatrics and the American Academy of Allergy Asthma and Immunology have recommended that the MMR vaccine can be appropriately administered to egg allergic individuals without testing. Although this vaccine is cultured on hen egg fibroblasts, the amount of actual hen’s egg protein in the vaccine is negligible. Still, some parents of egg-allergic children wish to proceed with testing prior to vaccination as a measure of reassurance.

Kevin Parks MD

The September asthma epidemic

September 8th, 2010

Each year in the U.S., pediatric asthma hospitalization, ER visits, and unschedule office visits peak in September due to what is now commonly referred to as the “September asthma epidemic”. Although likely a multifactorial phenomenon, the primary cause is likely viral upper and lower respiratory infections. The most likely microbe this time of year is human rhinovirus (HRV), which has been closely linked to asthma exacerbations in children, infants through adolescents. In fact, recent research at the University of Wisconsin has pointed to HRV as a more likely trigger for preschool age asthma exacerbations when compared to RSV (which peaks in December and January).

If your child has asthma, please watch for early signs of viral respiratory infections and follow your asthma action plan carefully this time of year. You may prevent unnecessary visits and other more adverse outcomes by remaining extra vigilant in September!

Kevin Parks MD