Recommendations for administering the triple viral vaccine and antiinfluenza vaccine in patients with egg allergy

Piquer-Gibert, M.; Plaza-Martin, Ana María; Martorell-Aragonés, A.; Ferré-Ybarz, L.; Echeverría-Zudaire, L.; Boné-Calvo, J.; Nevot-Falcó, S.

doi:10.1157/13110316

Cited by 6 publications

(2 citation statements)

References 14 publications

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“…Studies have provided evidence that the MMR vaccine was acceptably safe in populations at risk such as children with anaphylactic sensitivity , . Clinical reports pertaining to the safety of influenza vaccines revealed controversy; however, current recommendations strongly advocate its safe use, pending precautionary measures involving a two-dose administration procedure (a 1 / 10 dose followed by a 9 / 10 dose with a 30 min interval) using a vaccine containing no more than 1.2 µg/mL of egg protein – . Yellow fever vaccine is much less routinely administered, and limited scientific evidence was found on the risks for egg-allergic patients, but current guidelines (e.g., Centers for Disease Control in the United States and the World Health Organization) contraindicate its administration in egg-allergic individuals.…”

Section: Clinical Presentation Of Egg Allergymentioning

confidence: 99%

Recent Advances in the Understanding of Egg Allergens: Basic, Industrial, and Clinical Perspectives

Mine

Yang

2008

J. Agric. Food Chem.

171

123

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The emergence of egg allergy has had both industrial and clinical implications. In industrialized countries, egg allergy accounts for one of the most prevalent food hypersensitivities, especially in children. Atopic dermatitis represents the most common clinical manifestation in infancy; however, the range of clinical signs is broad and encompasses life-threatening anaphylaxis. The dominant egg allergens are proteins and are mainly present in the egg white, for example, ovalbumin, ovomucoid, ovotransferrin, and lysozyme. However, egg yolk also displays low-level allergenicity, for example, alpha-livetin. Strict avoidance of the offending food remains the most common recommendation for egg-allergic individuals. Nevertheless, the omnipresence of egg-derived components in prepackaged or prepared foods makes it difficult. Therefore, more efficient preventive approaches are investigated to protect consumers from inadvertent exposure and ensuing adverse reactions. On the one hand, commercial kits have become readily available that allow for the detection of egg contaminants at trace levels. On the other hand, attempts to produce hypoallergenic egg-containing products through food-processing techniques have met with promising results, but the approach is limited due to its potentially undesirable effects on the unique functional and sensory attributes of egg proteins. Therefore, the development of preventive or curative strategies for egg allergy remains strongly warranted. Pilot studies have suggested that oral immunotherapy (IT) with raw or cooked preparations of egg may represent a safe alternative, immediately available to allergic subjects, but remains applicable to only nonanaphylactic patients. Due to the limitations of conventional IT, novel forms of immunotherapy are sought based on information obtained from the molecular characterization of major egg allergens. In the past decade, promising approaches to the treatment and prevention of egg allergy have been explored and include, among others, the production of hypoallergenic recombinant egg proteins, the development of customized peptides, and bacterial-mediated immunotherapy. Nonspecific approaches have also been evaluated, and preliminary trials with the use of probiotic bacteria have yielded encouraging results. The current understanding of egg allergens offers novel approaches toward the making of food products safe for human consumption and the development of efficient immunotherapeutic strategies.

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Section: Clinical Presentation Of Egg Allergymentioning

confidence: 99%

Recent Advances in the Understanding of Egg Allergens: Basic, Industrial, and Clinical Perspectives

Mine

Yang

2008

J. Agric. Food Chem.

171

123

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“…The investigators from Italy administered the measles vaccine safely to 23 children with severe egg allergy confirmed by positive open food challenges. Subsequently, the same group has safely immunized an additional 60 children with allergy to eggs [13].…”

Section: Discussionmentioning

confidence: 99%

Safe Measles, Mumps and Rubella Vaccine Administration in Atopic Children with High Levels of Egg White-Specific IgE Antibody

Stavrikj

Peova

Petlickovski

et al. 2011

Macedonian Journal of Medical Sciences

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Position document: IgE-mediated allergy to egg protein

Martorell¹,

Alonso²,

Bone³

et al. 2013

Allergologia et Immunopathologia

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Egg is the food that most often causes allergy in young Spanish children, with an incidence of 2.4-2.6% in the first 2 years of life. The prevalence of sensitisation and allergy to egg is greater in children with allergy to cow's milk and in those suffering atopic dermatitis. The protein component from egg white is the cause of the allergic response in child. The major allergens in egg white are ovomucoid and ovalbumin. Most of the allergic reactions affect the skin, followed by gastrointestinal and respiratory systems. Egg allergy is one of the most common causes of severe anaphylaxis. The diagnosis of egg allergy is based on the existence of a suggestive clinical history, a positive allergy study and the subsequent application of controlled exposure testing, which represents the gold standard for confirming the diagnosis. The treatment of egg allergy is based on the avoidance of egg protein intake. A subgroup of egg-allergic patients are tolerant to cooked egg. In these cases, only uncooked egg must necessarily be avoided. Maintaining a diet with strict egg avoidance is difficult, and transgressions are relatively common. The patient, family, and school environment should receive education and training in the avoidance of egg and in the management of possible allergic reactions. With an avoidance diet, up to 15-20% of children will remain allergic and the severity of the reactions will increase over the years. In these more severe cases of egg-allergy, it becomes more difficult to adhere to the avoidance diet over the years, with a significant decrease in patient quality of life. Oral tolerance induction can be regarded as a therapeutic option for IgE-mediated egg allergy. The anti-IgE, omalizumab, might become another genuine therapeutic option for food allergy, not only to prevent allergic reactions after a contact with egg, but also as a complementary treatment to oral tolerance induction for egg allergy, with the purpose of reducing adverse reactions. The administration of influenza vaccine to children with egg allergy is safe in children that do not manifest severe reactions after egg intake, and in children who tolerate cooked egg. The triple viral vaccine (MMR) can be given to egg-allergic children in their usual vaccination centre, with no added risk. Different medicinal products can be formulated with egg proteins, and therefore should be avoided in children with egg allergy.

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Recommendations for administering the triple viral vaccine and antiinfluenza vaccine in patients with egg allergy

Cited by 6 publications

References 14 publications

Recent Advances in the Understanding of Egg Allergens: Basic, Industrial, and Clinical Perspectives

Recent Advances in the Understanding of Egg Allergens: Basic, Industrial, and Clinical Perspectives

Safe Measles, Mumps and Rubella Vaccine Administration in Atopic Children with High Levels of Egg White-Specific IgE Antibody

Position document: IgE-mediated allergy to egg protein

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