Travelling to Italy

WELCOME TO ITALY!

As everybody knows, Italian cuisine is known and loved worldwide. The Mediterranean diet is based on a few essential ingredients: durum wheat pasta, milk, cheese, egg, meat, shellfish and fish, vegetables, fruits and nuts (often used for preparing desserts, cakes and icecreams).

Therefore when a tourist who suffers from food allergies comes to Italy, they need to know which foods containing allergens can cause a reaction.

This is why you must always inform restaurants, bars, caterers etc., about your food allergy.
Here in Italy (as you do in your country), you must read ingredient labels every time you buy a product or order a dish from a menu.

If you are allergic to milk or peanuts, you must not order fried food at restaurants because the kitchen staff probably use a combination of oils which may contain peanut oil or use the same oil to fry food with milk protein. You must not order stuffed pasta as you can often find nuts or milk in it or pasta with pesto as which contains pine nuts and cheese, you must not try mortadella as which may contain pistachio nuts, hazelnut also spread you must be careful with baked products because they could contain lupins flour and also with icecreams.

As it might be difficult to find a native English speaker immediately, you or your child should bring a note in Italian to tell people at restaurants, bars, etc. what you/he/she cannot eat and one to tell people that you are having an allergic reaction and you need to call the Italian emergency number which is 118/112.
Italian hospitals are equipped to deal with anaphylaxis. If you call 118/112 for an anaphylaxis emergency, you will be sent an ambulance and a medical car with a doctor who can administer the epinephrine.
You must always remember to carry your autoinjector with you because you would need a medical prescription to buy it in Italy.

This is an example of note you could use at restaurants, bars, etc.:

“Ho una grave allergia alimentare a …………………………………. (write down the allergen/allergens you can’t eat) ed ai loro derivati. Nel caso venissi a contatto con questi alimenti, anche se in piccolissima quantità (contaminazione accidentale), potrei avere una reazione allergica così grave da arrivare ad uno shock anafilattico e aver bisogno della somministrazione urgente di adrenalina. Potrebbe cortesemente indicarmi quali sono i piatti del menù che non contengono gli ingredienti che ho menzionato
È molto importante che la pietanza non contenga …………………………………. (write down again the allergen/allergens you can’t eat) nemmeno come contaminante. Chiedo anche la cortesia di pulire a fondo le mani con acqua e sapone, i piani di lavoro, gli utensili e le stoviglie che saranno utilizzati per ridurre il rischio di contaminazioni. La ringrazio molto.”

This is the note to call 118 if you have a health emergency:

“Sto avendo uno shock anafilattico da alimento. Sono gravemente allergico a …………………………………. (write down the allergen/allergens you can’t eat).
Per favore chiamate urgentemente il 118″.

This is the first note translated into English:

“I have a severe food allergy to …………………………………. and their derivatives. Even if I eat only a minuscule amount of this, I will have an anaphylactic shock and I will need a dose of epinephrine. Could you please tell me what I can eat in your restaurant that does not contain any of the ingredients mentioned above
It is very important that the food does not contain even a very small amount of …………………………………. even as contaminant. I kindly ask you to thoroughly clean work areas, surfaces, serving areas, hands, utensils and equipment to remove traces of food allergens. Thank you very much”.

This is the second note translated into English:

“I am having an anaphylactic shock due to a food allergy. I’m allergic to …………………………………. Please call the emergency number 118 “.

We are working to prepare a list of safe food. However, unfortunately, the job is particularly delicate and complex because the companies often contacted are not still in a position to supply reassuring answers about the absence of the allergens, even on the eventual possibility of cross-contamination.

Labelling rules in European Directives 2003/89/EC and 2006/142/EC ensure that all consumers are given comprehensive ingredient listing information and make it easier for people with food allergies to identify ingredients they need to avoid. However, following the implementation of the Food Information for Consumers Regulation (EU) No. 1169/2011, allergen labelling rules changed in December 2014.

The new regulation, published in October 2011, builds on allergen labelling provisions for prepacked foods and introduces a new requirement for allergen information to be provided for foods sold non-packed or prepacked for direct sale. The three-year transition period allowed businesses to make the necessary changes to their processes and labelling designs to meet the provisions laid out in the legislation.

The rules for pre-packed and non-prepacked foods establish a list of 14 food allergens, which have to be indicated by reference to the source allergen whenever they, or ingredients made from them, are used at any level in pre-packed foods, including alcoholic drinks. The list consists of cereals containing gluten, crustaceans, molluscs, eggs, fish, peanuts, nuts, soybeans, milk, celery, mustard, sesame, lupin and sulphur dioxide at levels above 10mg/kg, or 10 mg/litre, expressed as SO2.

The core problem comes from seeking alternative food substitutes, mainly due to legal issues. Therefore the food industry has been increasingly relying upon the issuing statements such as “may contain traces of” (può contenere tracce di) or “product manufactured where X is also used ”(prodotto in uno stabilimento dove si lavora anche con) to indicate the possibility of cross-contact through the list stated in the European Regulation 1169/2011.

Nowadays, restaurants are obliged to inform customers if there are allergens in dishes being prepared. In Italy, allergic consumers are given information orally, but at the same time, written information regarding ingredients must always be available to the consumer for consultation in the ingredients register.

Unfortunately, we are unable to give you a list of restaurants, bakeries, or food shops that provide safe foods as the Food Business Operators (chefs, producers) are not obliged to attend any courses on the preparation, use, distribution or conservation of food for patients suffering from food allergy.

The following tips are essential for the success of your vacation:

• the Italian name of epinephrine is adrenalina
• you must always remember to carry your autoinjector with you because you would need a medical prescription to buy it in Italy (Italian autoinjector are FastJekt and Jext)
• you must read ingredient labels every time you buy a product or you order a dish from a menu
• you must bring a note explaining your food allergies
• you must always inform restaurants, bars, caterers etc… about your food allergy
• you must ask caterers if there are allergens present in dishes that are being prepared
• you must order simple dishes with few ingredients to avoid the risk of cross contamination
• you must ask caterers to clean thoroughly work areas, surfaces, serving areas, hands, utensils and equipment to remove traces of food allergens
• you must not order fried food at restaurants
• you must not order stuffed pasta at restaurants
• you must avoid buffet
• you have to be carefull with icecreams and cakes
• you must call the health emergency number 118 in case of reaction

List of major allergens with which you can fill in the note above:

1. latte (milk)
2. uovo (egg)
3. grano (wheat)
4. arachidi (peanut)
5. frutta a guscio (nut, tree nut, hazelnut, walnut, pine nut, almond, pistachio nuts)
6. soia (soy)
7. pesce (fish)
8. crostacei (shellfish: crustacean)
9. molluschi (shellfish: mollusc)
10. semi di sesamo (sesame’s seeds)
11. frutta (fruit)
12. verdura (vegetables)
13. sedano (celery)
14. senape (mustard)
15. lupini (lupins)
16. additivi (additives)

IN CASE OF ANAPHYLACTIC REACTION

In case of anaphylactic reaction, epinephrine should be administered promptly and you must call the health emergency number 118 immediately. The following tips are important for the success of your call:

• call 118/112;
• give them your name, the address and telephone number;
• inform the 118/112 staff that the person next to you is having an anaphylactic shock due to food allergies, describing the symptoms and the conditions;
• never hang up the call;
• do not leave the person alone;
• avoid panic trying to reassure the person waiting for help;
• do not give him/her anything to drink;
• leave the person where he/she is, avoiding to keep him/her in upright position;
• If the person is conscious put him/her in anti shock position, raising the legs up to facilitate the flow of blood to the head and heart. If the person has breathing difficulties (asthma) raise his/her upper body off the ground;
• If the person is unconscious, put he/she in recovery position according to the rules of first aid.

We wish you a nice trip to Italy and to enjoy your holiday in our country!

Avv. Marcia Podestà
Food Allergy Italia President

Ing. Davide Contato
Food Allergy Italia Vicepresident