People think they’ll only get a sore tummy … but some can die
hile we’re no closer to seeing a decline in the number of kids being diagnosed with asthma and food allergies, new research is providing hope we may soon have a better understanding of their triggers — and how to better prevent allergies developing.
Today one in nine, or around 2.5 million, Australians are estimated to have asthma, up from one in 10 a decade ago. And in children the figure has been estimated as high as one in five. Food allergies are also overrepresented in children, with an Australasian Society of Clinical Immunology and Allergy report finding up to 10 per cent of infants have a proven allergy.
And allergic diseases are considered to be one of the fastest growing chronic diseases in Australia, with a prediction by ASCIA that by 2050 the number of patients could increase by 70 per cent. But new research is providing better insights into their possible causes, with hopes we’ll be better able to prevent and treat them within years.
Paediatric allergist Dr Richard Loh from the National Allergy Strategy says the high numbers in Australia, now also being seen in developing countries like India and China, are concerning. But we’re gaining a better understanding of the impacts of multiple contributing factors.
This includes advice once given by allergists not to introduce eggs, a food that can cause allergies, before the age of two and peanuts before the age of three, which while given with the best of intentions, Dr Loh says probably contributed to the increase in allergy sufferers. Sarah Foster with her sons PJ, Max and Billyy who ha ve all experiencedp food allergies.
What’s now known is that introducing these foods before 12 months can reduce the risk of allergies. It’s a message the NAS, in partnership with ASCIA, will soon begin promoting among child health services and parents.
And an established school of thought is what’s known as the hygiene hypothesis — the idea that our obsession with cleanliness is thought to contribute by not allowing children to build their immunity up naturally.
Vitamin D deficiencies are also being looked to as a possible factor, as are theories on changes in infants gut bacteria, with probiotics a growing research area.
“There’s a lot of research on the gut organisms showing they’re a bit different now and we’re probably too clean. The bacteria in babies’ guts is not the same as it was 30 years ago and that change is affecting how the immune system responds to foods and dust mites and pollen,” Dr Loh says.
Acknowledging the changing advice can be frustrating for parents. He urges avoiding “Dr Google” and finding reputable sources of information, adding the NAS is working to update pharmacists, nurses and GPs to avoid parents being given conflicting advice.
Allergy and Anaphylaxis Australia CEO Maria Said has seen an increase since she joined the charity in 1993, saying there’s “been a real surge” in both the numbers of children affected and the number of hospitalisations for anaphylaxis. Although she says it was prevalent in the 1990s, patients often selfmanaged by avoiding foods and she has concerns some adults who have never seen a specialist may be without emergency medication. But while awareness has also increased so too have waiting times for specialists, which for food challenges can be up to two years in some areas.
“It’s a triage system, if someone has had an anaphylaxis they’ll hopefully see a specialist sooner. But then people on the waiting list for mild or moderate reactions who might next time have an anaphylaxis are without emergency medication,” she says.
“We want people to be properly diagnosed because the prescription of an epi-pen is life changing, it’s quite a challenge, the specialists are doing the best they can but at the end of the day consumers are left waiting and needing support and direction.”
Asthma Australia CEO Michele Goldman says it’s a similar story for the airways disease, saying while knowledge has increased, there are still many unanswered questions. For Sarah Foster, food allergies in her three sons Max, 12, Billy, 11, and PJ, eight, took her by surprise, with no family history. It has been important for the boys to learn to manage the allergies. She says: “Max broke out in a rash when I first introduced eggs which kept getting worse. I took him to an allergist who diagnosed an egg allergy. I got Billy tested before I started solids and it showed he had a tree nut allergy.
And PJ broke out in hives when he was given cow’s milk and was diagnosed with allergies to egg, dairy and nuts. He’s outgrown all but the
What’s known is there’s a genetic component — a child has a 25 per cent chance of developing asthma if one parent has it and 50 per cent if both do.
Children exposed to tobacco smoke are also at higher risk. Those with food allergies and hay fever are also more prone to asthma, and where one isn’t properly managed, it can flare up the other.
Ms Goldman says while great progress has been made in managing asthma in young children by parents, school and childcare teachers, adolescents are a group of concern as they often slip into complacency once they’re instructed to self-manage their asthma. nuts and Max outgrew the egg allergy.
PJ has had two anaphylactic reactions. One last year on a plane, we don’t know what to, there were no declared allergens in what he ate. Another a year before was to eggs.
We always carry four Epi-pens and have them at home and at school and the kids are trained to use them.
In the beginning a specialist didn’t issue an Epi-pen for Max, back in 2009, which was really difficult. My child had just been diagnosed with a life-threatening allergy but we didn’t have anything to manage it. But my GP said absolutely he needed one. That’s changed over time, they’re now prescribed more and instructions are to give the Epi-pen and give it early.
In the 11 years I’ve had a child with a life-threatening allergy the information and support that’s come out in that time is amazing.
It’s really important the kids learn to live in the real world and to manage these on their own. We have them ask if there are nuts in foods and to check the ingredients themselves, we help them but they need to learn to do it themselves. I think it’s really important the community is aware how serious it is. People think they’ll only get a sore tummy or feel unwell, but unfortunately people can die.”