I was 14 years old when I developed my peanut allergy. Though I have lived with it for half my life, I vividly remember that moment. After school, I ate Chinese chicken lo mein, had a Snickers for dessert, and napped. I woke up from my nap with extreme difficulty breathing and an insane amount of hives all over my body. I stumbled out of bed to tell my mom to call the ambulance. I was experiencing anaphylaxis, a severe and potentially life-threatening allergic reaction. This was shocking to me because, until that day, peanuts were something I ate regularly. The emergency technicians gave me epinephrine and transported me to the hospital, where I was hospitalized for two days.

There are valid concerns for traveling abroad with severe food allergies, particularly to countries where the food preparation and labeling regulations are not strongly regulated and there is little awareness about allergies. However, I’ve traveled to 28 countries, including many that would be considered high-risk for someone with a peanut allergy, and I’ve lived to tell the tale. Through trial and error, I’ve learned how to minimize the risks of traveling abroad with a nut allergy. Don’t let your nut allergy stop you from seeing the world!

Here are vital tips for traveling abroad with a nut allergy:

Have these Nut Allergy Survival Essentials in Your Bag

• Epinephrine auto-injector. If your nut allergy is severe, this should be your first-line treatment. Epinephrine is highly effective at reversing severe symptoms, but it must be administered quickly. I currently have an incredibly large EpiPen, but I’ve also had the Auvi-Q, which is compact and pocket-size.
• Antihistamines. If your nut allergy is mild, this should be your first-line treatment. Antihistamines can relieve symptoms like itching, sneezing, hives and rashes. Benedryl is my go-to antihistamine. It is important to note that this medication is not enough for severe reactions and does not treat anaphylaxis, but it can be used as a second-line defense.
• Albuterol (emergency inhaler). I’m mildly asthmatic, so I have an albuterol to use as needed. This can help relieve any wheezing associated with anaphylaxis.
• Copies of your Food Allergy & Anaphylaxis Emergency Care Plan. Go to your doctor, develop a food allergy plan, and carry a copy while traveling.
• Lysol wipes
• Food allergy translation in local languages

Conduct a Body Assessment

• Visit an allergist. After my initial incident, I went to an allergist, who confirmed that I was allergic to peanuts and tree nuts.
• Know what triggers your allergic reaction. Allergic reactions can be triggered in three different ways: 1) ingestion, 2) skin contact (although this is the least likely, the allergen can cause a reaction if it touches sensitive areas like the eyes, mouth, or nose), and 3) inhalation (for some people, breathing in peanut particles can cause a reaction).
• Know your body’s response to allergies. If I consume peanuts, my body will go into anaphylaxis within 10-15 minutes, with hives and shortness of breath as the most prominent symptoms. However, there are many other symptoms of peanut allergies, including nausea and tingling sensations around the mouth or throat. It’s essential to recognize how your body responds so you can know when to take immediate action.

What to do…

Before You Get on the Airplane

• Notify your airline in advance. When you check in online, make a special meal request notifying the airline of your peanut allergy. This is important because some flights may not readily offer alternative meal options. You can also call the airline to learn about the meals that will be served and decide if you want to bring your meal. Also, if your peanut allergy is triggered through inhalation, you should inform the airline about it. There are a few airlines that no longer serve peanuts on flights, or they create a peanut-free buffer zone on flights.
• Research main ingredients in cuisines. Before you leave, look up the staple ingredients and food items used in the country you are visiting. This will help you know which items to avoid.
• Create translation cards with your allergies listed. This can be a physical card or a note on your phone to show your server. Google Translate is a helpful translation service. Its mobile app is available offline in 59 languages, and instant camera translation is available in 38 languages. The Food, Allergy, & Research Education group also has food allergy chef cards in a few languages.
• Inform & prep your travel buddies. If you’re traveling with others, make sure someone knows about your nut allergy, where to find your EpiPen, and how to administer it.
• Get familiar with your epinephrine auto-injector. I’ll be completely honest and say that the design of the EpiPen is a bit intimidating. For a long time, the thought of having to inject myself with a huge pen in my thigh was anxiety-provoking. In the few times that I’ve had to use my EpiPen, I always had someone present to do it for me, except one time when I had an anaphylactic reaction to the yellow fever vaccine and was by myself. I gave myself the following pep talk, “Jewels, you trying to die or live?! You better suck it up and stick yourself in the thigh!”. The EpiPen needle is not painful at all. Each epinephrine auto-injector has a training device so that you can practice and relieve some of the anxiety around it. The design of the Auvi-Q is more compact, and the training device talks you through administering the needle.

While You are on the Airplane

• Wipe down the seat and surrounding area. It’s good practice to wipe down your seat and surrounding areas with a Lysol wipe to remove any possible peanut residue left by the previous passenger. Airplanes are breeding grounds for germs, which is generally a good practice.

While Eating at Restaurants

• Notify your server. Use your translation cards to tell your server about your allergy. This is good to ask, even if you don’t think a dish has nuts.
• Have your friend taste your food. If something looks suspicious on your plate, have your friend taste it to ensure it is nut-free.

If You Experience Anaphylaxis in a Foreign Country

If you are experiencing anaphylaxis in a foreign country, you should first administer your EpiPen. The second thing you do is go to an emergency room immediately. It is important because you must be monitored as your symptoms can reappear within a few hours.

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Disclaimer: I’m not a medical professional. I’m just someone who has been traveling abroad with a severe nut allergy for 8+ years. I strongly recommend you consult with your doctor to develop a food allergy plan specific to your needs.