Allergic reaction aboard SIA flight: What major airlines do to guard against triggering allergies

SINGAPORE – A Singapore Airlines flight was forced to make an emergency landing in October 2024 after

a passenger suffered a severe shellfish allergy on board

and had to be rushed to hospital.

Dr Doreen Benary, 41, a resident of Manhattan, was flying from Frankfurt to New York City when she “fell violently ill” after allegedly being served a meal containing shrimp. The plane was diverted to Paris, France.

Dr Benary, a paediatrician, was rushed to hospital and then a second medical facility, where she underwent “painful emergency treatment”, according to court documents.

She is suing the airline for negligence, claiming that she had warned flight attendants about the severity of her allergy – specifically, to shrimp. The incident, she said, caused her “great pain, agony and mental anguish”.

This is not SIA’s first incident with an allergy in mid-air. In 2017,

a toddler went into anaphylactic shock and started vomiting

when too many passengers around him started eating in-flight peanut snacks.

The drug epinephrine is the first-line treatment in cases of anaphylaxis or severe allergic reactions.

However, under US Federal Aviation Administration requirements, for instance, easy-to-use auto-injector EpiPens are not required in on-board first aid kits. Some airlines carry epinephrine, but a trained medical professional is required to administer the correct dosage.

Most airlines declare that allergen-free environments on board cannot be guaranteed, but several accommodations for passengers with dietary restrictions are offered.

The Straits Times rounds up the practices of several major full-service airlines to guard against food allergies:

1. Singapore Airlines

Since the 2017 incident, SIA no longer serves peanuts as snacks on flights. It still, however, serves other nuts like cashews and almonds, and signature local meals, like nasi lemak and satay, still contain peanuts.

SIA recommends passengers refer to the in-flight menu page, which can be viewed up to eight days before the flight, although not all ingredients and allergens are listed.

Alternatively, specific special meals, such as A gluten-intolerant (no wheat, rye, barley, and bran in any form), seafood-free or a general allergen-free meal, can be selected at least 24 to 56 hours before flight departure, depending on the destination.

2. Cathay Pacific

Hong Kong-based Cathay Pacific offers complimentary nut packets as a snack on flights. Passengers with nut allergies can request nut-free snacks, subject to availability, by submitting a physician’s statement declaring their nut allergy via a form on its website.

Although special dietary meals can be requested up to 24 hours before flying, Cathay Pacific does not offer meals suitable for certain common allergies such as gluten and dairy, and offers only “gluten-intolerant” and “low-lactose” meals respectively.

Cathay Pacific suggests passengers with severe allergies bring their own meals on board, wear a medical alert bracelet and carry an EpiPen that can be administered by their travel companion. Additionally, for added safety, they may request for priority boarding to wipe down their seat before the flight.

3. ANA

For international flights, Japan’s All Nippon Airways (ANA) is one of the few airlines that offers both an “eight allergen-free meal” and a “28 allergen-free meal”. The eight allergen-free option excludes eight major allergens such as shellfish, eggs and tree nuts, as defined by Japanese food safety guidelines. The 28 allergen-free option goes a step further by excluding 20 additional allergens such as specific fruits, other meats and gelatin.

These meals are prepared in separate facilities to minimise the risk of cross-contamination, and must be requested 24 hours to eight days in advance before departure.

ANA also offers an allergy buffer zone, or a designated area created around the passenger to minimise the risk of exposure to severe allergens. This must be requested, by phone, at least 48 hours before departure. For domestic flights, passengers who require special meals have to contact the airline in advance to make their request.

4. Qantas

Australian carrier Qantas says it no longer offers peanuts as bar snacks on both flights and lounges and is minimising the use of peanut-based products in their meals. Other nut products are still served.

It offers a gluten- and lactose-intolerant special meal service that can be requested up to 24 hours before departure. However, following 2024 changes to the in-flight menu, only the gluten-intolerant option is nut-free; Qantas does not offer allergy-specific options such as nut-free, dairy-free or seafood-free meals.

Travellers who bring their own meals cannot store or reheat them on board due to contamination concerns.

5. Emirates

Emirates serves nuts on all flights, either as a meal ingredient or as an accompaniment to drinks.

Special meals like gluten-friendly and low-lactose options can be requested at least 24 hours before departure. However, Emirates does not offer allergy-specific options such as nut-free, dairy-free or seafood-free meals.

Those with severe allergies are encouraged to bring their own meals on board. That said, Emirates does not provide refrigeration or reheating.

The airline advises passengers to bring their own medications, such as EpiPens, and to consult a doctor before flying.

6. Qatar Airways

Doha-based Qatar Airways does not offer nut-free meals, and serves both peanuts and tree nuts on board. Those with severe allergies must submit a medical form at least 48 hours and no more than seven days before departure. Approved requests may result in a general announcement or seating accommodations, but these are not guaranteed.

Customers who do not submit the form to disclose their allergies and instead declare it at check-in or on board the flight may be denied boarding due to safety considerations. These passengers will be required to sign a waiver before boarding.

Qatar offers gluten-free and non-lactose special meals, which need to be requested at least 24 hours before departure. However, passengers with severe allergies are advised to bring their own food and necessary medication. While seafood-free meals are not explicitly offered, several vegetarian options can be chosen instead.

7. British Airways

British Airways (BA) asks that passengers notify staff about any food allergy so they can inform passengers of any allergens contained in meals. In some instances, this information may also be available on the meal packaging.

Its in-flight meals do not contain peanuts or peanut products, but may contain other nuts. Passengers with nut allergies can request the cabin crew to make an announcement, asking nearby passengers to refrain from eating nuts.

BA offers a range of special meals, such as gluten-free, low-lactose and vegetarian, for those sensitive to seafood. These need to be booked at least 48 hours in advance, or 24 hours if departing from London’s Heathrow Airport – its main base.

While there is no formal buffer zone or cleaning protocol, passengers with allergies are welcome to board early to wipe down their seating area. Carrying an EpiPen and bringing one’s own food is strongly advised, though BA will not reheat personal meals.

8. Lufthansa

German airline Lufthansa does not typically serve peanuts on its flights. It offers several special options, such as gluten- and lactose-intolerant meals, as well as a vegetarian meal for those allergic to seafood. These special meals need to be requested at least 24 hours before departure and are generally offered only on longer-haul flights.

In the event of severe allergic reactions during a flight, the airline states that its trained cabin crew are always equipped to provide emergency medical care.

9. Delta Airlines

Delta from the US offers a formal allergy accommodation process through its Accessibility Service Request form.

Although the cabin is not completely nut-free, if notified of a peanut allergy, the crew will refrain from serving peanut products during the flight. For food, animal or other allergies, passengers can board early to wipe down their seat area, or request a seat change.

Other special meals, like gluten-free and diabetic-friendly meals, can be ordered at least 24 hours before departure, but allergy-specific meals are not available. Travellers are encouraged to bring their own food and carry necessary medication, including EpiPens.

10. United Airlines

United does not serve peanuts in its meals or snacks. Passengers with severe food allergies are advised to notify a flight attendant, who can then ask nearby passengers to avoid consuming foods that may contain allergens.

Special meals include vegan, gluten-friendly, kosher (food that adheres to Jewish dietary laws) and Asian vegetarian options. They can be requested up to 24 hours before departure but are limited and not guaranteed on every flight.

Passengers may also request to board early and wipe down their seat.