Shellfish allergies are, in some ways, one of the easier "big eight" most common food allergies to live with --- seafood isn't nearly as pervasive an ingredient as, for example, dairy or soy. But because shellfish allergies tend to be so severe, it's vital for people with them to be vigilant about the risk of anaphylaxis, and this is never more true than in restaurants, since shellfish can be far more difficult to avoid away from home than in a grocery store. Read on to learn which cuisines and dishes are riskiest and what precautions those with shellfish allergies should take when eating out.
Basic Restaurant Safety:
First of all, whenever you go to any restaurant, make sure you're prepared for emergencies. That means taking your rescue medication (epinephrine plus, if applicable, any asthma medication) with you and making your server and the chef aware of your allergies --- before you arrive, if possible. They should know about the risks of cross-contamination and assure you that your food will be cooked in a shellfish-free area, on grills or pans that have not been used to cook shellfish. For more information on safe dining, see Tips for Eating Out with Food Allergies.
Some types of restaurants are riskier than others because of cross-contamination issues or because a high percentage of dishes on the menu may include shellfish. These include seafood restaurants and sushi bars (which may store fish and shellfish in very close proximity, or which may use the same knives on both types of seafood), Cajun restaurants, and Chinese restaurants that specialize in seafood. Be wary, too, of sharing tapas with friends, as many traditional tapas include shellfish and sharing dishes could be a major cross-contamination risk.
The two safest types of restaurants for shellfish allergies are strict kosher restaurants and dedicated vegan or vegetarian restaurants, which forbid shellfish. German cuisine and Eastern European cuisine are other common cuisines which use less shellfish than many (though both do include fish). Even when eating at a restaurant without visible shellfish on the menu, however, be sure to discuss your allergies, as shellfish may be used in stocks or as a garnish.
Shellfish at Major Chain Restaurants:
Before eating at a chain restaurant, be sure to check their website, as many now include information for the most common food allergens, including shellfish. While checking the website is no substitute for talking to onsite staff about your allergies and about cross-contamination concerns, website information can give you a good idea of whether you'll be able to find suitable options at a given restaurant, or whether some options that look safe really are.
Shellfish in American Cuisine:
In addition to dishes like fried shrimp, surf'n'turf, or steamed mussels that clearly indicate shellfish, several traditional American dishes are made with shellfish. Cioppino, a soup originating in San Francisco, is made from seafood and other shellfish. New England boiled dinners and Low Country boil both usually include shellfish; ask before ordering. Cajun specialties like gumbo and jambalaya are usually made from shellfish, and seafood muffaletta sandwiches may be found in coastal areas. Finally, ask about the possibility of small shrimp being used to garnish salads.
Shellfish in Latin American Cuisine:
Shellfish is not as prevalent in Mexican and Central American restaurants as in some other cuisines, but some restaurants do serve enchiladas or tacos with shrimp fillings, or shrimp versions of traditional Snapper Veracruz. Ask about cross-contamination before ordering. Brazilian and Peruvian cookery features more shellfish, especially ceviche (fish or shellfish "cooked" by marinating it in citrus juice). Be wary of any Latin American dish with "mariscos" in the name, as this is the Spanish word for "seafood."
Shellfish in French and Western European Cuisine:
Shrimp, prawns, lobster, and other shellfish feature prominently in French food and in the cuisine of the Mediterranean, so before eating at a Continental restaurant, it's wise to call ahead and make sure they can accommodate your allergies. You should know that any French dish served "a l'Americaine" comes with a topping of lobster; likewise, "crevettes," on a French or Continental menu always indicate shrimp. Italian cuisine may feature mussels or shrimp but will often include safe options on the menu. Greek cuisine, likewise, features a lot of fish but comparatively little shellfish beyond octopus.
Shellfish in Middle Eastern and Indian Cuisine:
Shellfish is not a prominent part of Middle Eastern cooking, especially Lebanese (one of the more common types of Middle Eastern restaurants you're likely to find in many parts of America). However, you may find mussels or other steamed shellfish on the menu. Indian restaurants vary greatly depending on which part of the country their cuisine is from. Many Indian restaurants are vegetarian and therefore safe. Cuisine from Goa, with its strong Portuguese influence, is more likely than others to contain shellfish.
Shellfish in East Asian Cuisine:
Most popular East Asian cuisines -- Vietnamese, Thai, Chinese, Japanese, and Malaysian -- include shellfish as a major part of their menus, so always ask before going to one of these restaurants. Hong Kong hot pots frequently include shellfish, though vegetarian and meat-based varieties do exist. In addition to asking about shellfish in the dishes themselves, be aware of the possibility of shellfish in condiments, stocks, and other hidden sources. Chinese dried shrimp, Thai kapi and nam prik, and Vietnamese mam tom are among the condiments and sauces that always include shellfish.
Maubourguet, Patrice, Ed. Dir., et al. Larousse Gastronomique. Rev. Ed. New York: Random House, 2001.