Fragrance Allergies: Can They Cause Slow-Onset Anaphylactic Shock?

Anaphylaxis is a severe and potentially life-threatening allergic reaction that can be caused by food, medicine, insect stings, or fragrances. It occurs when the body's immune system releases a flood of chemicals, causing a range of symptoms such as skin rash, nausea, vomiting, and a sudden drop in blood pressure, which can lead to anaphylactic shock. While anaphylaxis typically occurs within minutes of exposure to an allergen, there are rare cases where symptoms may be delayed for hours. Fragrances, such as those found in candles, soaps, detergents, and even tissues, can trigger allergic reactions in some individuals, leading to symptoms such as sneezing, coughing, and itchy or runny noses. However, it is important to note that the time frame for fragrance allergy symptoms to progress to anaphylaxis is currently unclear and requires further investigation.

What are the symptoms of anaphylactic shock?

Anaphylaxis is a severe, life-threatening allergic reaction that can be caused by food, medicine, or insect stings. Symptoms of anaphylactic shock can include:

• Swelling of the mouth, throat, and tongue
• Tightness in the throat and difficulty breathing or swallowing
• Wheezing, coughing, or noisy breathing
• Feeling tired, confused, faint, or dizzy, and even fainting
• Skin that feels cold to the touch
• Blue, grey, or pale skin, lips, or tongue
• A rash that is swollen, raised, or itchy
• Abdominal pain
• Nausea, vomiting, or diarrhea
• A weak and rapid pulse
• Low blood pressure

These symptoms can occur within minutes of exposure to an allergen, but sometimes they can take up to half an hour or longer to appear. In rare cases, anaphylaxis may be delayed for hours. It is important to seek emergency medical help if you or someone else is experiencing these symptoms.

What are the causes of anaphylactic shock?

Anaphylactic shock is a rare but severe allergic reaction that can be deadly if left untreated. It is caused by a severe allergic reaction, which can occur within seconds or minutes of exposure to an allergen, although in rare cases it can be delayed for hours.

The most common causes of anaphylactic shock are:

• Food allergies, especially nuts, shellfish, milk, eggs, fish, seeds, and cows' milk.
• Insect stings, such as bee, wasp, and hornet stings.
• Latex, found in items such as disposable gloves, catheters, and adhesive tapes.
• Certain medications, including antibiotics, aspirin, and penicillin.

During anaphylaxis, the immune system releases a flood of chemicals, causing a range of symptoms, including:

• Skin rash or redness.
• Itching or hives.
• Swelling of the lips or tongue.
• Difficulty breathing.
• Weak and rapid pulse.
• Nausea and vomiting.
• Dizziness or fainting.

If you suspect that you or someone else is experiencing anaphylactic shock, it is important to act quickly. Use an adrenaline auto-injector (such as an EpiPen) if one is available and call for emergency medical help immediately.

How to treat anaphylactic shock

Anaphylactic shock is a rare but severe allergic reaction that can be deadly if not treated immediately. Here are the steps to treat anaphylactic shock:

Recognise the Symptoms

Anaphylactic shock can happen very quickly, usually within minutes of exposure to an allergen. Symptoms include:

• Swelling of the throat and tongue
• Difficulty breathing or very fast breathing
• Tightness in the throat
• Wheezing, coughing, or noisy breathing
• Skin that feels cold
• Pale skin, lips, or tongue
• Hives or itching
• Low blood pressure
• Weak and rapid pulse
• Nausea, vomiting, or diarrhoea
• Dizziness or fainting

Call for Emergency Medical Help

Dial 911 or your local emergency number immediately. Anaphylaxis is a medical emergency and requires prompt treatment.

Administer Epinephrine

If an epinephrine auto-injector (such as an EpiPen) is available, use it right away by pressing it into the person's thigh. This will reduce the body's allergic response. If symptoms do not improve after 5 minutes, a second injection may be needed.

Position the Person Appropriately

Lay the person flat and elevate their legs. If they are having trouble breathing, help them sit up slowly. If the person is unconscious, put them on their side and open their airway by lifting their chin.

Monitor Vital Signs

Check the person's pulse and breathing. If they are not breathing or their heart has stopped beating, administer cardiopulmonary resuscitation (CPR) or other first aid measures.

Seek Further Medical Treatment

Even if the person's symptoms improve, they should still be taken to the nearest emergency room for further monitoring and treatment. Anaphylaxis can cause a second wave of symptoms, known as biphasic anaphylaxis, which can occur hours or even days after the initial reaction.

Prevent Future Reactions

Work with a healthcare provider to develop an anaphylaxis emergency action plan. This may include carrying an epinephrine auto-injector at all times, wearing a medical alert bracelet, and avoiding known allergy triggers.

Preventing anaphylactic shock

Anaphylactic shock is a severe and potentially life-threatening allergic reaction that requires immediate medical attention. Here are some ways to prevent anaphylactic shock:

• Avoid known triggers: The best way to prevent anaphylactic shock is to stay away from substances that are known to cause severe allergic reactions. Common triggers include certain foods, insect stings, medications, and latex. It is important to read food labels carefully, ask about ingredients and preparation methods at restaurants, and inform caregivers, schools, and other relevant parties about any allergies.
• Wear a medical alert bracelet: It is a good idea to wear a medical alert bracelet or necklace to let others know about your allergy in case of an emergency, especially if you are unable to communicate.
• Carry an epinephrine injection kit: If you have severe allergies, it is crucial to carry an epinephrine injection kit (such as an EpiPen) with you at all times. Epinephrine is the first-line treatment for anaphylaxis and can save your life.
• Educate yourself and others about anaphylaxis: It is important to know the signs and symptoms of anaphylaxis and how to respond. Educate your friends and family about your allergy triggers, the signs of anaphylactic reactions, and how to administer an epinephrine injection.
• Seek medical advice: Consult a healthcare provider or allergist if you have severe allergies. They can help you identify triggers, prescribe necessary medications, and create an emergency plan to manage anaphylactic reactions effectively.
• Be cautious around insect stings: If you are allergic to insect stings, take precautions such as wearing long-sleeved shirts and pants, avoiding walking barefoot on grass, and refraining from wearing bright colours, perfumes, or scented lotions that may attract insects.
• Read food labels and ask about ingredients: Food allergies are a common trigger for anaphylaxis. Always read food labels and ask about ingredients and preparation methods when eating out to minimize the risk of accidental exposure to allergens.
• Have an emergency plan: Prepare an emergency plan in advance if you have severe allergies. This includes carrying your injector kit, having medical ID that identifies your allergy, and knowing when and how to administer epinephrine promptly.

What to do if you don't have epinephrine

Anaphylaxis is a severe allergic reaction that can be life-threatening and requires immediate treatment. While epinephrine is the only effective treatment for anaphylaxis, here is what you can do if you don't have access to it:

Recognise the signs and symptoms of anaphylaxis:

• Skin rash or redness, itching, hives, and flushed or pale skin.
• Low blood pressure (hypotension), which can lead to dizziness, lightheadedness, confusion, or loss of consciousness.
• Constriction of the airways, swollen tongue or throat, wheezing, and difficulty breathing.
• A weak and rapid pulse.
• Nausea, vomiting, abdominal pain, diarrhoea, and a feeling of doom or dread.

Take immediate action:

• Call 911 or your local emergency services immediately. Do not delay, as anaphylaxis can be life-threatening.
• If the person is carrying an epinephrine autoinjector (EpiPen, Auvi-Q, or a generic version), help them use it if needed. Typically, the autoinjector is pressed into the person's thigh.
• Lay the person flat and elevate their legs. If they are vomiting, turn them on their side to prevent choking. If breathing is difficult, help them sit up.
• If the person stops breathing, perform CPR.
• Monitor their vital signs, including breathing and pulse.
• If antihistamines are available, they can be administered to provide some relief. However, they are not a substitute for epinephrine in treating anaphylactic shock.

Seek emergency medical treatment:

• Even if the person's symptoms improve, it is crucial to seek emergency medical treatment. Go to the nearest emergency room, as anaphylaxis requires immediate medical attention and monitoring.
• Inform the medical staff about the suspected allergy triggers and any medications the person is taking.
• The emergency room doctors can administer epinephrine and provide further treatment, such as fluids, steroids, and antihistamines, to manage symptoms and prevent a second reaction.

Frequently asked questions