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    Maryland Department of Health
    Office of Food Protection

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    Food Allergy Awareness

    The prevalence of food allergies in America is estimated to be around 8% in children and somewhere less than 10% in the populations as a whole.  The number of people with food allergies appears to be growing, but explanations for the increase are uncertain, and studies are complicated by inconsistent case definitions. According to a study released in 2013 by the CDC, food allergies among children 0 – 17 years of age increased from 3.4% to 5.1%, an increase of 50%, between 1997 and 2011. 
     
    The nine most common food allergens, which account for 90% of food allergies, are:
     
    • Milk
    • Eggs
    • Peanuts
    • Tree nuts (for example: almonds, walnuts, or pecans)
    • Fish (for example: ​bass, flounder, or cod)
    • Crustacean shellfish (for example: lobster, crab, or shrimp)
    • Soy
    • Wheat
    • Sesame (new for 2023)
     
    When an individual eats or drinks something containing their allergen, they can have a reaction anywhere from itching and tingling, all the way to severe and potentially fatal reactions such as anaphylaxis involving circulatory collapse and cardiac arrest.  There is currently no preventive treatment or cure for food allergies; only strict avoidance will prevent a reaction. 
     
    Read the Complete 2014 Report of the Food Allergy Awareness, Food Safety, and Food Service Facility Letter Grading Task Force
     
    Requirements For Food Establishments
     
    As of March 1, 2014, state law (Maryland Code Annotated, Health-General 21-330.2(A)) requires that 'a food establishment shall display prominently in the staff area of the food establishment a poster related to food allergy awareness that includes information regarding the risk of an allergic reaction.' 
     
    ​NEW! As of January 1, 2023 the FDA includes sesame as the ninth major food allergen. The posters below have been updated to include sesame.
    DO​WNLOAD THE ​ALLERGY AWARENESS POSTER   EN ESPANOL *

    *Note -- In some browsers this poster may not print correctly.  If the poster prints with edit marks, please use a different browser or download and print directly from Adobe Acrobat. 
     
    Emergency Use​ Auto-Injectable Epinephrine Program

    The Emergency Use Auto–Injectable Epinephrine Program is established under Health-General in §13-7A-02 and allows for an employee or designee of a food service facility or a recreation or wellness facility at an institution of higher education to obtain a certificate to receive a prescription for auto-injectable epinephrine. For more information, including the requirements to participate in this voluntary program, please see Health-General §13-7A-02 and COMAR 10.13.04. 

    The Department is currently updating COMAR 10.13.04 to expand the program to food service facilities. If you would like to participate in the Emergency Use Auto–Injectable Epinephrine Program, please email mdh.envhealth@maryland.gov.