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©2013 UpToDate ® Print Email Key messages in anaphylaxis education*: Anaphylaxis = Killer allergy Who is at risk? Anyone, especially those allergic to foods such as peanut, tree nuts, shellfish, fish, milk, or egg, or to insect stings or bites, medications, or natural rubber latex. When can it happen? Within minutes, anytime the allergic person comes in contact with his or her trigger. How do we know? Several symptoms occur at the same time, such as sudden onset of itching, hives, flushing, hoarse voice, difficulty breathing, vomiting, diarrhea, dizziness, confusion, or shock. Where can it happen? Anywhere, such as home, restaurant, school, child care or sports facility, summer camp, car, bus, airplane. What should we do? Inject epinephrine, call 911 or local emergency medical service number, and notify the individual's family (in that order)! Act quickly. Anaphylaxis can be mild, or it can be fatal. Why is follow-up needed? Anaphylaxis recurrences can occur. The trigger needs to be confirmed, and long-term preventative strategies need to be implemented. * For individuals at risk and their caregivers, and for the general public. Reproduced with permission from: Simons FER. Anaphylaxis, killer allergy: Long-term management in the community. J Allergy Clin Immunol 2006; 117:367. Copyright © 2006 Elsevier.