egg allergy

Egg is one of the most common food allergens affecting young children. The first reaction usually occurs when the child is between six and 15 months of age, when they have been given egg for the first time. Egg allergy is much more common in children than it is in adults, with the majority of sufferers outgrowing their allergy by the time they reach 16 years of age.¹

Egg is one of the most common foods contributing to eczema (atopic dermatitis) in infants. Reactions can range from a flare in eczema, to hives or swelling around the mouth or more widespread, gastrointestinal reactions with tummy pain and
vomiting, to severe reactions (anaphylaxis).

Most children with egg allergy have mild symptoms, but some children have severe, life-threatening reactions to even the tiniest amount of egg. Some egg-allergic children can eat well-cooked egg, e.g. in a biscuit or cake, without any ill effects but not raw or lightly cooked egg. Others are allergic even to egg that has been well cooked.

If you are worried that you or your child has an egg allergy, seek your GP’s advice and see a specialist if necessary. Your GP or specialist will make a diagnosis based on history of previous reactions. The allergy can be confirmed by skin prick tests and/or blood tests, which measure the allergy antibody. People at risk of severe reactions are normally prescribed an adrenaline auto-injector, such as the EpiPen.

If you are allergic to eggs, you will need to avoid eggs from other poultry, such as duck, goose and quail. You also need to avoid both the egg white and the egg yolk.

Most people with egg allergy can eat chicken meat safely, but in rare cases people allergic to eggs are sensitive to chicken meat as well.

Other food allergies in children with an egg allergy

Because egg allergy is one of the most common food allergies in young children, it’s possible that this is an isolated problem. It doesn’t necessarily mean that they will go on to develop other, more serious allergic conditions.

However, an egg allergy is a good marker for an allergic tendency and a warning that there is increased risk of developing allergic rhinitis and asthma. This is called the Allergic March.

There is also a possibility that children with a history of egg allergy may also have other food allergies.

Vaccines and egg allergy

Chicken and egg products are used in the manufacture of some types of immunisations. The MMR vaccine is grown in egg fibroblast cultures. Children with egg
allergy, even if severe, are not at increased risk of an adverse reaction to this vaccine compared with other children. However, you may wish your child to have the vaccine at your doctor’s office rather than school.

On the other hand, the flu vaccine and the yellow fever vaccine are grown in chicken eggs and are not safe for individuals with egg allergy.

Always check before taking any new medication or vaccine.

Egg substitutes

There are commercial egg substitutes available, or you can try some of the following. Each recipe will replace one egg:

1 tsp baking powder, 1 tbsp liquid, 1 tbsp vinegar
1 ½ tbsp water, 1 ½ tbsp oil, 1 tsp baking powder
1 sachet plain gelatine, 2 tbsp warm water (do not mix until ready to use)
2 tbsp water, ½ tsp baking powder
1 tbsp linseed/flaxseed, ½ cup water – boil until it becomes a gel
2 tbsp golden syrup, ½ tsp baking powder
beer – can be used instead of egg when making batter
½ large mashed banana – for cakes and muffi ns
½ cup apple sauce/apple puree or pureed prunes
1 tbsp ground flaxseed/linseed mixed with 3 tbsp water
1 cup soft mashed tofu
½ tsp xanthan gum with ½ cup water – let stand; it thickens and can be whipped like an egg white
milk, oil and lemon juice, or melted butter – brush over the food or dip food into these to replace egg as an adhesive for crumbing

Egg labelling guide

Avoid foods that contain egg or any of these ingredients:

albumin
egg – whole, dried, powdered, solids, white, yolk
egg from any type of poultry e.g. chicken, duck, quail, etc
egg-based lecithin (E322). Most lecithin in New Zealand-made products is soy-based
globulin
livetin
lysozyme
ovalbumin
ovomucin
ovomucoid
ovovitellin
ovum
silici albuminate
vitellin

Note: always read labels as egg may appear in foods not listed here.

Some examples of where egg protein may be present:

baked goods
batter coating on fried foods
biscuits
cakes
croquettes
custard
doughnuts
eggnog
glaze on pastries/baked goods
fish sticks
frittata, fritters
ice cream
chocolates and confectionery/sweets
icing and frosting
macaroon
marshmallows
marzipan
mayonnaise
meringue
meat loaf
muffins
meat jelly
noodles and egg noodles
nougat
omelette
pancakes
pasta
pastry, pies
pavlova
pikelets
pudding
quiche
salad dressing
sauce: e.g. bernaise, hollandaise, tartare
scotch egg
slices
surimi
wines clarified with egg white
souffl�
egg added to other foods e.g. egg strips in fried rice, egg pieces in kedgeree

Non-food items

Egg is not often used in medicines, but it is important to remind your doctor and pharmacist every time you get a new prescription or over-the-counter medication.

The anaesthetic drug Diprivan (Propofol) contains soya bean oil and purified egg phosphatide. If you’re having an operation, ensure your anaesthetist is aware of your/your child’s egg allergy.

Non-food items, such hair products and cosmetics, may also contain egg and this could be labelled as “ovum”.

Avoid handling egg cartons used at preschool or schools for art, as well as newly hatched chickens and birds nests, which are a potential site of egg shells. If egg shells are used, wrap them very well in newspaper to put in the rubbish bin.

1. Savage JH, et al “The natural history of egg allergy”
J Allergy Clin Immunol 2007; DOI: 10.1016/j.jaci.2007.09.040.

This fact sheet is based on information available at the time of going to press but may be subject to change.

Remember too that all of us are different and individual cases require individual medical attention. Please be guided by your GP or specialist.

Acknowledgments: We would like to thank Dr Jan Sinclair, Paediatric Immunologist, and Jennifer Heyward, Paediatric Dietitian, from the Starship Hospital for their assistance in writing this information.

November 2008