[Trigger Warning]
On January 25, 2025, 28-year-old Gayathiri Jeyatheesan, a mother from Bootle, England, had purchased crab as a special treat for her mom, who was visiting from Sri Lanka. Gayathiri had a known allergy to shrimp, a crustacean shellfish.
Around 2PM that day, she started experiencing a sore throat and difficulty breathing. She notified her husband, who was working at the family shop. He called emergency services at 2:36PM.
EMTs arrived at the scene at 2:51PM and found Gayathiri in cardiac arrest. They successfully resuscitated her at 3:15PM and transported her to Aintree University Hospital in critical condition.
At the inquest into her death this week, Coroner Julie Goulding issued the following ruling:
Gayathiri was in a critical condition when she arrived at the hospital and notwithstanding the continued administration of aggressive, advanced life support and emergency treatment, Gayathiri’s condition continued to deteriorate and she was tragically pronounced deceased at 4.49pm.
Post mortem examination showed a markedly elevated mast cell tryptase (a sign of of anaphylaxis – a severe allergic reaction).
Taken together with the circumstances, the known allergy to prawns and the ingestion of crab meat, Gayathiri is highly likely to have developed an acute anaphylactic reaction and as a consequence suffered a catastrophic cardiorespiratory collapse that led to her death.
The cause of death was found to be anaphylaxis due to a shellfish allergy. Coroner Goulding concluded Gayathiri had died by misadventure.
Left behind were her husband and 15-month-old son. She had celebrated their three-year anniversary just two days before her death.
We extend our heartfelt condolences to Gayathiri’s family, who were celebrating the arrival of her mother from abroad when the tragedy occurred. We hope the conclusion of the inquest brings them some small measure of closure.
As we do when reporting these anaphylactic tragedies, we search for strategies to implement so that others in the food allergy community avoid similar incidents.
First, it’s important to discuss the food allergy itself. When diagnosed with a shrimp allergy, there is a high likelihood of reactivity with other crustacean shellfish such as crab and lobster, so these should be strictly avoided.
In the US, only foods that contain crustacean shellfish are required to follow allergen labeling guidelines. It is important to note that molluscan shellfish, including clams, oysters, mussels, and scallops, do not require special labeling.
No mention of epinephrine was made at the inquest. Epinephrine is the only drug that can halt and reverse the progression of anaphylaxis, a life-threatening reaction to a food, drug, insect venom, or environmental substance like latex. However, it needs to be administered in a timely fashion to yield the best outcome. We presume Gayathiri did not have it on hand or failed to administer it.
If you have been diagnosed with a food allergy, you should be prescribed epinephrine and have two doses on hand everywhere you go, every time, and be sure to administer the first when you first suspect anaphylaxis.
If you know of someone with a food allergy who does not routinely carry epinephrine, please intervene and advise them of the danger they are putting themselves in. We all need to do our part to prevent tragedies like this from anaphylaxis.
