From Mr M. H. Franks, MRPharmS
SIR,-One of my patients who is allergic to fish has just returned from a trip abroad. She flew with a budget airline and, as no food was available on the flight, purchased a sandwich at the departure airport.
The cheese sandwich should have given her no problems. However, she noticed that her throat became tight, her lips became swollen and itchy and her mouth sore. She concluded that the sandwich had been made with a knife that may have been used to make a fish-based product and went to see her general practitioner, who gave her an antihistamine.
Her mouth was sore so she decided to eat ice cream and soup. The problem continued and in fact got worse. She went to see her GP again, who gave her prednisolone tablets to try to control the symptoms.
While I was dispensing the prescription, we got into a discussion as to whether the symptoms could still be from the sandwich seven days previously. I said that would be unlikely and that she must have either eaten another fish-based product or become allergic to another product.
To cut a long story short, the ice cream contained "fish molluscs" that were not declared on the label. The product is a premium ice cream with American origins so readers should be warned.
If any patient complains of allergic reactions ask if they are eating ice cream. The strange part is why the item is not listed in the ingredients. The company said it would contact the States.
M. Franks
Highgate, London