ANYBODY living with an allergy, whether it’s their own, their child’s or their partner’s, will know how big an impact it can have.

Not only can the symptoms be deeply unpleasant and distressing, but identifying and avoiding triggers can be hit-and-miss too.

This is a fact of life for thousands of individuals and families across the UK, where about one in four are affected in some form or another, putting us in the top three countries for highest allergy rates. It’s estimated that by the end of the decade, more than half of the population across Europe could have an allergy, so it’s no surprise that the subject appears so much in the media or that associated products and remedies line so many pharmacy shelves.

Less talked about, however, is the very serious end of the allergy scale, where an allergic reaction isn’t just something that might make somebody very uncomfortable or unwell, but is a very real threat to their safety.

“If I was to eat a nut, my throat would swell up and I would stop breathing. My allergy is so severe that I can’t walk into a room if someone has just opened a bag of nuts. It’s dangerous for me, because I’m allergic to the nut dust as well,” says 22-year-old secretary Penny Watson., a secretary from London.

Diagnosed with a severe nut allergy as a baby, she’s lived with the threat of anaphylaxis – the most serious type of allergic reaction – her whole life.

It can develop very rapidly, possibly causing skin to erupt into an itchy red rash, wheezing and light-headedness, sudden swelling of the eyes, hands, feet, lips, mouth, tongue and throat – which makes breathing difficult – and if emergency treatment isn’t administered very quickly, it can be fatal.

The number of people, including children, arriving at hospital with severe allergic reactions has been steadily rising. Quick and appropriate treatment means the vast majority will make a full recovery, but according to NHS figures, there are still around 20 anaphylaxis-related deaths each year.

Sufferers carry an adrenalin injector (EpiPen) as a speedy dose is vital, but, as Penny explains, just carrying the pen doesn’t take away the fear, or seriousness of having a reaction.

Though she hasn’t actually gone into full-blown anaphylactic shock since she was younger, the knowledge that it could happen is never out of Penny’s mind, and she says the anxiety this causes has increased as she’s got older.

As a child, Penny and her parents were able to minimise her risk of exposure, by ensuring the school and friends’ families all understood the risks, for instance.

But moving out, getting a job and socialising as an adult all mean she has far less control and no idea whether she’ll encounter somebody who’s eaten, or has recently eaten, nuts.

Assessing risk is a 24/7 priority for Penny. Every time she goes out, whenever she meets new people, that concern is there.

“Last year, I had my worst episode of anxiety. It got to a point where it literally took over my life. I had a mental breakdown and was thinking, ‘I can’t eat anything, I can’t touch anything’. It might sound silly, but when you’re put into so many positions in a day where you haven’t got control of it [exposure to nuts], that’s where the anxiety comes in.”

Public transport is one of the biggest ‘worry zones’, particularly for people whose reactions can be triggered by the merest trace of nut dust which can travel through air-con systems on planes - so even somebody 20 rows back opening a packet of nuts can potentially put the allergy sufferer’s life at risk. Explaining this to people who have no real experience or knowledge of serious allergies, however, can be difficult.

“I’ve been on a plane and when the air hostess has asked everybody not to open any packets of nuts, I’ve heard people say things like, ‘How selfish - why do we all have to suffer, why don’t they just get off the plane’. It’s so frustrating. You just think, ‘You don’t have a clue what we have to live with!’” Penny says.

Recent research by Allergy UK found that 92 per cent of those living with severe allergies are concerned about eating out, while 82 per cent worry about going on holiday. Over half (52per cent) say their allergy impacts their social life, and 32% admit it hurts self-confidence.

“It can definitely have an impact on social activities, because of the difficulties faced in these situations,” says Lindsey McManus, Allergy UK’s deputy CEO. “For someone with a food allergy to be safe at all times, they need to avoid what they are allergic to, and this information isn’t always as readily available as one would think. Add to that a risk of cross-contamination, which can happen in many situations, and it is understandable that people can become anxious.”

Awareness of the psychological needs (and therefore the support available) of people living with long-term health conditions is, on the whole, still fairly poor, but is, in some areas, improving.

Allergy UK is keen to see greater awareness of this aspect of serious allergies. Charities like them are often the frontline of support, and can advise people on things like referrals to specialist clinics, as well as providing “the emotional support often needed when going through both the diagnosis period and the ongoing journey of living with an allergy”, explains McManus.

lFor more information, head over to allergyuk.org. To read about anaphylactic shock, and what to do if somebody is showing signs of a severe allergic reaction, visit nhs.uk/Conditions/Anaphylaxis.