[note 1] Management is by avoiding eating the causal nuts or foods that contain them among their ingredients, and a prompt treatment if there is an accidental ingestion.

Food allergies in general usually have an onset of symptoms in the range of minutes to hours for an immunoglobulin E (IgE)-mediated response, which may include anaphylaxis.

[6] Symptoms may include rash, hives, itching of mouth, lips, tongue, throat, eyes, skin, or other areas, swelling of lips, tongue, eyelids, or the whole face, difficulty swallowing, runny or congested nose, hoarse voice, wheezing, shortness of breath, diarrhea, abdominal pain, lightheadedness, fainting, nausea, or vomiting.

[7] Non-IgE-mediated responses occur hours to days after consuming the allergenic food, and are not as severe as IgE-mediated symptoms.

[7] Potentially life-threatening, the anaphylactic onset of an allergic reaction is characterized by respiratory distress, as indicated by wheezing, breathing difficulty, and cyanosis, and also circulatory impairment that can include a weak pulse, pale skin, and fainting.

This can occur when IgE antibodies are released[8] and areas of the body not in direct contact with the food allergen show severe symptoms.

Tests can reveal the presence of immunoglobulin E (IgE), an antibody that responds to allergens and triggers the release of chemicals which cause the symptoms.

[16] Foods that almost always contain tree nuts include pesto, marzipan, Nutella, baklava, pralines, nougat, gianduja, and turrón.

Other common foods that may contain tree nuts include cereals, crackers, cookies, baked goods, candy, chocolates, energy/granola bars, flavored coffee, frozen desserts, marinades, barbecue sauces, and some cold cuts, such as mortadella.

[2] Treatment for accidental ingestion of tree nut products by allergic individuals varies depending on the sensitivity of the person.

[29] The Culinary Institute of America, a premier school for chef training, has courses in allergen-free cooking and a separate teaching kitchen.

Nevertheless, there are no labeling laws to mandatory declare the presence of trace amounts in the final product as a consequence of cross-contamination, except in Brazil.

[29][33] The European Union requires listing for those eight major allergens plus molluscs, celery, mustard, lupin, sesame and sulfites.

[32] FALCPA applies to packaged foods regulated by the FDA, which does not include poultry, most meats, certain egg products, and most alcoholic beverages.

These products are regulated by the Food Safety and Inspection Service (FSIS), which requires that any ingredient be declared in the labeling only by its common or usual name.

This concerns labeling for ingredients present unintentionally as a consequence of cross-contact or cross-contamination at any point along the food chain (during raw material transportation, storage or handling, due to shared equipment for processing and packaging, etc.).