Allergic emergencies during air travel
Studies show that allergic reactions are common on board flights. About 9% of people with peanut allergies have experienced some form of allergic reaction during a flight.
About 2 – 4% of medical emergencies on board commercial flights are allergic reactions. Between 2002 and 2007, “allergy” was the 7th most common cause of in-flight medical problems and asthma was the 14th.
Allergic reactions are most often caused by foods (peanuts, tree nuts and seafood) and medications.
There are reports of passengers experiencing idiopathic anaphylaxis in-flight, self-injecting adrenaline in the lavatory and not notifying a flight attendant. There are also reports of flights being diverted to the nearest airport to due allergic reactions.
Treating allergic reactions on board a flight
Treating allergic reactions in flight is a major challenge and air travel is an important concern for people with asthma and/or a history of allergies. Resources on board an aircraft are limited. In the US, the Federal Aviation Authority (FAA) requires that epinephrine is included in the on board emergency medical kits.
The World Allergy Organisation (WAO) recommend:
- For asthmatic emergencies: inhaled bronchodilator and oxygen. For moderate to severe symptoms, an oral, intramuscular or intravenous corticosteroid and intramuscular epinephrine can be considered for severe symptoms.
- For allergic emergencies: for mild, moderate, and severe reactions, intramuscular epinephrine should be injected in the anterior lateral thigh and repeated as necessary.
Preventing Allergic Reactions on airplanes
Prevention strategies for allergic reactions on board aircraft should be planned early. Advice should be sought from a physician or allergy specialist about prevention measures that need to be implemented before and during the flight. A treatment plan should be instituted in case of contact with an allergen.
Contact the airline in advance to discuss your allergy. A study has shown that making your allergy known and asking for accommodations (see table below) reduces the likelihood of an allergic reaction in flight. Once you board the plane, remind the air stewards of your allergy and wipe down the tray table, armrests and seat.
Make sure your adrenaline pen is close by and easily accessible, not in the over head locker. In the event of a reaction, inform the flight attendants immediately and use your adrenaline.
Airline crew should immediately call for a doctor on board for any emergency to determine what treatment is needed and if the plane should divert to the nearest airport.
Measures to reduce peanut and tree nut exposure have resulted in less in flight reactions from these foods. However, these measures are not implemented by all airlines due to difficulty, discomfort for other passengers or higher costs.
Measures that reduce the risk of an in-flight reaction to peanut and tree nuts
|Passengers requesting any kind of special accommodation.
|Peanut/tree nut-free meals.
|Wiping of tray tables
|Avoidance of airline pillows or blankets
|Buffer zones around which peanut or nut products cannot be consumed
|Request other passengers not to consume peanut/tree nut-containing products
|Announcement that passengers do not eat peanut/tree nut containing goods
|Not consuming airline-provided food
As greater numbers of people fly, and the numbers of people with allergies increase, the amount of allergic reactions on board flights will also increase. Passengers who are at risk should be aware of the risks and implement strategies to prevent and manage reactions. Airlines should also work to prepare for these emergencies by introducing measures to reduce the risk of reactions and to treat reactions when they occur.
Useful Products when travelling with allergies.
Consider an insulated wallet such as FRIO. FRIO wallets keep your adrenaline autoinjector within safe temperatures of 18-26°C (64.4-78.8°F) for a minimum of 45 hours, even in a constant environmental temperature of 37.8°C (100°F).
Wear an alert wristband with allergy information and emergency contact numbers
Disclaimer: The information provided is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Allergy Lifestyle Limited (t/a) Allergy Lifestyle) uses reasonable endeavours to check the accuracy of information provided however no warranty is given that they are error-free. Always seek the advice of an allergy specialist and follow your anaphylaxis emergency care plan.