Asthma and allergies often go hand-in-hand

2017-04-26 06:00
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WORLD Asthma Day is set to take place on Tuesday, May 2, and this year’s theme is ‘Asthma: Better Air, Better Breathing’.

World Asthma Day is an awareness-raising event organised globally by the Global Initiative for Asthma (GINA) and locally by the National Asthma Education Programme (NAEP).

NAEP is a non-profit organisation that aims to disseminate impartial information about asthma diagnosis and treatment to health professionals and the South African public and this year they will be focusing on asthma and allergies.

Basic facts and figures

. Asthma is a common condition affecting about 15% of children and 1 in 20 adults.

. It is twice as common in boys as girls.

. It is a long-standing chronic condition.

. It is variable, with different severities, but all asthma can be well controlled.

. It is not curable, but can be controlled by proper medication.

. Contrary to common belief, exercise is good for asthmatics.

Avoiding risk factors that cause asthma symptoms is an important strategy for improving control. However, in many areas in South Africa, people with asthma may be exposed to conditions such as outdoor or indoor asthma triggers.

People who have allergies, especially allergic rhinitis (hay fever/sinus), eczema and severe food allergies, have a greater chance of developing asthma. Asthma and allergies often go hand-in-hand.

There are several types of asthma, but allergic asthma is a type that is triggered by an allergy.

What is an allergy?

An allergy is when someone has a bad reaction to something in the environment that other people can tolerate. We get allergies when our body’s defence system hurts us instead of protects us.

Allergens are the substances that may cause these reactions.

Examples include pollens from trees, grasses and weeds, animal allergens from cats or dogs, house-dust mites, insect parts and insect stings, food and food additives, fungal spores and even certain medicines such as aspirin or penicillin.

People make contact with the allergens by breathing, eating and touching them. Once in the body, the allergens encounter special cells of the body’s immune system. They line the areas of our bodies that are in contact with the outside world, the skin, nose, lungs and digestive systems.

The surface of some allergy cells are covered with a substance called Immunoglobulin E (IgE) which detects the allergen.

When the IgE and allergen meet, a series of complex reactions occur causing allergic damage, especially swelling and inflammation.

What can be done about allergies and asthma?

People must avoid all things known to trigger their asthma. This may differ from person to person. Viral infections are the most common precipitants of acute asthmatic attacks in allergic people.

Non-allergic triggers such as cigarette smoke and preservatives such as sulphur dioxide are also common triggers. People with asthma should also know what they are allergic to. The common allergens include house-dust mites, dogs or cats, grasses and cockroaches. A rarer trigger in very young children may be certain foods such as cow’s milk.

A doctor will be able to provide you with excellent advice about avoidance programmes. In addition to avoidance procedures, there are very effective medicines to treat asthma.

In the vast majority of cases, people who have asthma are able to lead a normal, active and happy life with full involvement in sport and all other activities.

Exposure to the following may increase your risk of developing an asthma attack if you are sensitive to that particular allergen. You should only avoid an allergen if it has been proven by blood or skin tests that you are allergic to it.

Indoor allergies

The most common indoor allergens in South Africa are animal danders, moulds, house-dust mites and cockroaches.

Animal dander

These are minute portions of saliva, skin or hair of cats, dogs, rabbits, hamsters or even mice. They are harmless in and of themselves but, unfortunately, they are strong allergens.

If you are allergic to these, contact with an allergen will result in an allergic reaction, asthma or hay fever. If you can avoid contact you will get better.

If you are allergic to animals, you should not own them and if you visit friends who own pets, always take your reliever medication with you. If pets are already part of your family, you must try and keep them outdoors. In particular, keep them out of your bedroom and carpeted, upholstered living rooms where their hair and fur may collect in large amounts.

See that they are bathed and brushed regularly.

Mould

Moulds like dark, damp places. You will often see mould growing in showers and dank basements, but look carefully and you may find them in pot plant soil, in mattresses, behind cupboards and under carpets laid on concrete floors.

If you are allergic to moulds, they should be removed as far as possible, and clothes and cupboards must be aired.

House-dust mites

These are microscopic, busy, innocuous creatures which live mainly in our mattresses, bedding and in carpet dust. They love warm, humid settings. Hundreds can be found in just a pinch of house dust.

They harmlessly feed off the scales of our skin which we shed continuously.

However, not only are their body parts strong allergens, their minute droppings can also cause allergic sensitisation. Large amounts can cause serious allergic attacks. Mites grow more readily where humidity is high, so larger amounts are found in coastal regions and houses situated in humid areas.

If you are allergic to house-dust mites, you should try and reduce the amount in your home. You can decrease numbers by vacuuming with a special vacuum cleaner (with a HEPA filter), cleaning with damp cloths (instead of feather dusting) and mopping instead of sweeping.

The most important thing is to cover mattresses and pillows with special mite-proof covers. Washing sheets and bedding in very hot water also kills them. Fluffy toys and deep carpets should be removed.

Special mite sprays are available and may complement the measures outlined above, however they should not be used alone.

Cockroaches

Did you know that cockroach eggs, droppings and bodies are all common allergens? If you are allergic to them and live in a house where cockroaches are found, they should be exterminated.

Outdoor allergens

South Africa has one of the largest floral kingdoms in the world. All plants produce pollen at different times of the year and the levels of pollen in the air depend on the season and wind.

Pollen

Not all pollens cause allergic symptoms. People with pollen allergies will get asthma attacks when exposed to pollens. These patients typically suffer from seasonal asthma and hay fever, particularly in spring, when a particular grass, weed or tree is flowering.

Which pollens are important?

The pollens that are wind dispersed are often allergenic, whereas the sticky heavier pollens, produced by brightly coloured flowers and dispersed by insects or birds, are often not allergenic. The grass pollens are by far the most important pollens.

Because they are small they are able to be breathed in to the airways of the lungs. Because the grass flowering seasons in South Africa are very long (from August to April) grass allergic patients may have symptoms almost the whole year round.

Tree pollens, by contrast, are released for short periods (usually only a few weeks per year in early spring) and typically cause well-defined seasonal asthma.

How does one test for pollen allergy?

Pollen allergy can be diagnosed the same way as indoor allergens by either skin prick tests or by blood tests for IgE. These tests are very reliable for the identification of the grass, tree or weed-sensitive patient.

It is important, however, that antihistamine medicines should be discontinued a few days before skin tests are performed since antihistamines can block the reaction of skin tests.

What is the treatment for pollen allergy in asthmatics?

Avoidance is the most effective treatment strategy for pollen allergy. Pollen allergens are difficult to avoid completely, but simple measures such as keeping windows closed, avoiding grass cuttings and avoiding direct exposure to flowering trees or flowers should be attempted.

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