Death after having prawn curry: How does it affect some people, how to stay safe from food allergies?

Time and again, reports on allergies or deaths experienced after consuming prawn-based dishes make headlines, just like they did recently in Thodupuzha. As per reports, a 20-year-old girl lost her life allegedly after consuming a small portion of a prawn curry that was served at the paying guest facility where she stayed. According to her relatives and neighbours, Nikitha N, who was allergic to prawns, ate the curry by mistake and developed breathing issues soon after. Though she was hospitalised, her blood pressure went low eventually, leading to cardiac arrest. 

People can be allergic to a variety of food items and other things depending on a variety of factors like genetics, environmental factors, early introduction to allergenic foods before the development of their immune systems and more. However, can it always be fatal? Also, what can be done if an allergic person accidentally exposes themselves to prawn-based preparations? Dr Krithi Raviraj Ullal, Head of the Department of Dermatology at Lourdes Hospital in Kochi, explains:

Why does prawn trigger intense reactions?
According to the doctor, consuming 'crustaceans' (a group of invertebrates) like prawns, crabs, and shrimps results in allergies in some people. "Susceptible individuals can experience severe reactions even if they consume a small portion of such dishes and should be very careful about staying away from them," she says. At the same time, there are times when people complain that they were never allergic to prawns before but suddenly developed it at some point. The doctor says, "In such cases, it is often not because of prawns, but probably a new ingredient they weren't aware of being allergic to, or environmental factors. It can even be the sting of an insect which they did not notice," says the doctor. 

How does one develop such allergic reactions?
Interestingly, such reactions are developed in the early years, when one is introduced to food items as a baby. "This is one of the reasons why people say don't give nuts to babies. Introducing potential allergens, like prawns to infants whose immune systems are not fully developed, can create the risk of developing food allergies," the doctor says. 

What should the patient do?
Doctors can help individuals have a general understanding of what they are allergic to, through various tests, in advance of experiencing an allergy anew, says Dr Krithi. "Some of the common allergy tests are Patch Test, Prick Test and Specific Antibodies Test. If one eats a food item they are allergic, to by mistake, they should immediately take an antihistamine medication prescribed by their doctor. This is also the reason why abroad, people often carry an auto-injectible device called EpiPen with them, for emergency treatment of severe allergic reactions including anaphylaxis (life-threatening allergic reaction)." The doctor says it's similar to Avil injections in India. "When you travel abroad or eat from outside, you will never know the ingredients of your food for sure. In such situations, these medications can help. People with allergies should have Avil tablets (pheniramine) or any antihistamine medication with them to handle such situations," Dr Krithi explains. 

Any science behind saying 'Don't have prawns with lemon juice?'
Kerala has read many stories and social media posts on people reportedly losing lives after consuming prawn-based dishes and lemon juice together. Interestingly, this is even though lemon is often used as a flavour enhancer in seafood dishes. Though some people believe that the citric acid in lemon affects the taste and quality of seafood, Dr Krithi clarifies it is a culinary myth at best without a scientific basis.