Falafel burger anaphylaxis due to sesame seed allergy

With the increasing demand for vegetarian food the consumption of vegetable burgers as an alternative to beef burgers has now become widespread. Since products of this kind are often not provided with a clear description of their components or ingredients, potential allergens generally cannot be identified by the consumer. Their ingestion, however, may lead to severe allergic reactions in sensitized individuals. Here we describe nine systemic allergic reactions to sesame seeds that were diagnosed at the Allergy Unit, Department of Dermatology, Zürich, Switzerland between 1978 and 1991. In 1991 alone, we registered three cases of anaphylactic reaction to falafel vegetable burgers in patients allergic to sesame seeds. A falafel is an oriental specialty consisting of a wheat flour bun filled with chickpea balls. It is served together with a white sauce containing freshly ground sesame seeds. Our cases highlight the potential danger of vegetarian food and underline the importance of a proper allergologic assessment to recognize food allergy promptly so that the patient can eliminate the causative allergen and use suitable medication in the event of a dietary indiscretion.