Traveling can be exciting, but for the 200 million people worldwide with food allergies,1 it also presents safety concerns, especially when flying is involved. Airlines cannot guarantee an allergen-free flight, and at 30,000 feet with limited medical resources, an allergic reaction can quickly become life-threatening.
An incident involving reality TV star Jack Fowler underscores this risk, which he discussed in the featured interview above with “Good Morning Britain.”2 On June 17, 2024, Fowler posted a video of himself self-administering an epinephrine auto-injector (EpiPen), a life-saving treatment for a potentially lethal anaphylactic allergic reaction, following what he described as a near-fatal allergy attack, which was triggered by a meal he ate on board an Emirates plane.
He stated that despite informing the crew about his severe nut allergy and receiving repeated assurances that his meal was nut-free, it apparently still contained cashews, triggering an allergic reaction. Surprisingly, Fowler’s experience is not isolated, which further emphasizes the importance of thorough preparation and vigilance prior to traveling.
Emirates Airlines Called Out for Negligence
Fowler, who’s known for his appearance in the TV shows “Love Island” and “Love Island Games,” alleged the crew didn’t give him an allergen menu and simply asked him to choose between a chicken and a fish dish, meaning he wasn’t able to personally check the ingredients. When he asked which one did not have nuts, the crew told him that neither of the options did.3
“My friend with me at the time said, ‘[There’s] severe nut allergy here, so make sure there’s no nuts.’ When the food came, it was a chicken curry, I said again, ‘Just to make sure, there’s no nuts in this food?’ and they said, ‘No, just chicken and rice.’
So, I trust them. I really, honestly trusted them and started to eat what I thought was something safe. And it actually contained the one thing that I really couldn’t have, and that was cashew nuts. That is the worst nut for me, so straight away I knew my throat was closing up. I couldn’t breathe and it was extremely scary for me.”
Fowler recounted that he sensed something was amiss immediately after taking his first bite. Upon feeling the initial symptoms, he approached the crew again to double-check about the presence of nuts in his meal, and they reassured him once more that the dish was nut-free. It wasn’t until Fowler’s friend persistently requested to see the menu that they finally saw “creamy cashew nut chicken curry” listed there, directly contradicting the crew’s earlier assurances.
“There’s just complete negligence here,” Fowler added. In his social media post, he shared that aside from having to administer his EpiPen, he was also given five tanks of oxygen. Once the plane landed, he was rushed to the Dubai International Airport hospital where he received further treatment. Fowler told the hosts that he received hundreds of messages from his fans who had similar experiences, and questioned when airlines would “take food allergies seriously.”
An Emirates spokesperson has apologized for the incident, stating that they take customer safety and health very seriously. “While Emirates aims to cater to customers with specific needs by offering a variety of special meals that cover medical, dietary and religious requirements, we cannot guarantee a nut-free inflight environment,” they said in a statement.
Survey Reveals Challenges for Travelers With Allergies
In a survey4 presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting, researchers aimed to evaluate the challenges faced by travelers with food allergies. Among the 4,704 respondents, 8.5% reported experiencing in-flight allergic reactions, some severe enough to require emergency landings. Common allergens included peanuts, tree nuts and milk.
The survey also found that while 47% of respondents received promised allergen-free accommodations from airlines, 36% did not receive them. Moreover, 35.6% experienced unprofessional behavior from airline staff and 11.8% were denied boarding or asked to leave a flight. “There’s such an unfair burden on the passengers with food allergies,” said Lianne Mandelbaum, founder of the nonprofit organization No Nut Traveler, who helped launch the survey.5
Case in point, in May 2024, the family of a BBC weather presenter was kicked off a flight after they personally asked fellow passengers to avoid eating peanuts due to their daughter’s severe allergy after the airline staff refused to make an announcement on their behalf.6 In 2022, a 14-year-old girl experienced anaphylaxis on a flight from London to Antigua after another passenger refused to stop eating nuts despite being told he was putting the teenager at risk.7
Moreover, in 2023, Dr. Lindsey Ulin, an internal medicine resident physician at Brigham and Women’s Hospital in Boston, unexpectedly had an allergic reaction mid-flight the Southwest Airlines but discovered that the plane’s medical kit did not have an epinephrine auto-injector like EpiPen, leading her to call for a change in the Federal Aviation Administration’s policy.8
What Are the Current International Rules on Flying and Food Allergies?
Despite these concerns, there’s currently no international agreement among airlines on food allergy policies. According to an article9 by The Independent:
“There is no specific legislation for passengers. In the 580-page Manual of Civil Aviation Medicine, published by the U.N. body responsible for international aviation, ICAO, the only references to allergies concern flight crew … In lieu of international rules, each airline makes its own policy. These vary dramatically.”
Generally, airlines cannot provide an allergen-free flight for several reasons. The variety of foods served or brought on board by passengers, the potential for cross-contamination, and the confined space of an aircraft cabin where allergens like nut dust can circulate create a uniquely challenging environment for passengers with food allergies.10
The International Air Transport Association (IATA), the airlines’ trade body, places responsibility on passengers, saying:11
“Severe allergic reactions on board are an extremely rare occurrence. However, when they do occur, the consequences may be amplified because of the remote environment. In that context, allergen-sensitive passengers susceptible to severe allergic reactions should do everything in their power to prevent these cases or be prepared if it does happen.”
What to Do Before and on the Day of Your Flight
With the lack of international consensus and varying airline policies, it is indeed important to be your own advocate so you can ensure your safety. IATA recommends taking the following precautions before and on the day of your travel:12
Before travel
Consult your physician about the potential risks of traveling and make sure to carry prescribed medications like EpiPen in your carry-on, along with a written emergency plan. The U.S. Transportation Security Administration limits passengers to two injectors, which should be kept in the original box with a visible prescription label.
Carry a prescription for your auto-injector and an emergency plan signed by your doctor to ease airport security checks.
When booking, contact the airline directly about their policies for allergen-sensitive passengers.
Despite routine cleaning, keep in mind that airlines cannot ensure allergen-free cabins.
Allergen-sensitive minors should not travel alone.
Check your travel insurance coverage for anaphylaxis and severe allergic reactions.
Day of travel
Arrive early at the airport to confirm seating requests and early boarding preferences. At the gate, remind the agent of your allergy issues.
Inform the passengers sitting close to you or the cabin crew about your severe allergies. If it’s your child who has allergies, try to seat them away from other passengers. You can also request back- or front-row seats during reservations to limit your or your child’s proximity to other passengers.
Bring sanitizing wipes to clean your seating area.
Notify cabin crew about your allergies, so they can respond quickly in case a reaction does occur. However, many airlines don’t broadcast these announcements to other passengers.
Bring your own non-perishable food on board. Make sure to check with the airline if it has restrictions on food that can be carried in transit. For travels within the U.S., you can bring fresh fruit in a resealable bag.
Additional Travel Safety Tips for People With Food Allergies
In addition to the in-flight safety precautions recommended by IATA, here are more tips to help ensure safer travels wherever you go, especially if you or a loved one has food allergies:13,14,15,16
Choose your airline carefully — Some resources to help you decide include FoodAllergy.org’s Airlines and Allergies project, which lists the best and worst airlines for people with food allergies.17 The Allergy & Asthma Network also partnered with the American Association of Respiratory Care (AARC) to evaluate major airlines on their policies regarding asthma, pet and food allergies and other respiratory diseases.18
Carefully select the time of your travel — Airplanes are typically cleaned thoroughly at the end of the day, so booking the first flight of the next day can reduce allergen exposure from previous flights. Additionally, choose direct flights to minimize your exposure to crowded spaces and potential allergens.
Avoid pillows and blankets provided by the airline, as they are often not cleaned between flights.
If you carry an epinephrine injector, insert a tracker in its case and set alerts to notify you if you forget it at home or misplace it during your travels, ensuring you’re never without your medicine.
Bring your own towels for the kitchen and bathroom, and consider bringing your own utensils, toiletries, blanket, pillow and pillowcase.
Research local medical facilities in advance to know where emergency care is located and how quickly you can access it if needed.
Look up local restaurants, grocery stores and accommodations to identify safe food options and allergy-aware establishments. Don’t hesitate to ask how your food was made and keep reminding the staff about your allergies.
If you’re planning to dine out, carry a personalized “chef card” detailing your allergies, prepared in both English and in the language of the country you’re traveling to. This helps the kitchen staff prepare a safe meal for you.
Prepare and cook your own food — Whether you have allergies or not, this practice not only ensures safety from allergens but also helps you avoid the harmful ingredients present in processed foods, prepacked meals or restaurant foods, including harmful fats like linoleic acid and added sugar.
