Inside this issue (and check out our new style):

• Is kiwifruit the new peanut? New Zealand scientists look for an answer
• How healthy is your home? What you need to know when choosing a ventilation system
• Cold allergy: it's no fiction
• Dealing with eczema at school
• Afternoon tea delights: mouth-watering recipes

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Is kiwifruit the new peanut?

Kiwifruit is a substantial export earner for New Zealand, and this vitamin-packed fruit has been hugely popular in the UK and Europe. But in recent years, the prevalence of kiwifruit allergy appears to have increased in these countries and reactions have been particularly severe in some children. In the meantime, research into what makes the kiwifruit so allergenic is happening right here in the land of kiwi. Inga Stünzner reports.
Kiwifruit: the new peanut?

It’s nutritious, it’s tasty, it’s practically New Zealand’s national emblem, but for a growing number of people — particularly children — it could be life-threatening.
Eight-year-old Henry is one of these children – he had a severe reaction to kiwifruit when he had his first taste at the age of eight months. After just one small bite, which he immediately spat out, he started scratching his forehead and rubbing his eyes before breaking out in hives all over his face.

“His nose started streaming and he started sneezing so I put him in the bath to wash any residue off his hands and fingers,” his mother, Beth, says. “By this time his right eye was very red and nearly closed for half an hour from puffiness, and then he vomited and brought up his entire meal.”

Because Henry is also allergic to fish, eggs and milk, Beth was able to dose him with the antihistamines she already had on hand. The allergic reaction subsided, but it was the beginning of what their allergy specialist believes will be a life-time of avoidance of this fruit.

Henry is just one of an apparently increasing number of children who are developing allergies to kiwifruit. This increase seems to generally be in line with the increase in prevalence of other food allergies in New Zealand, such as peanut, according to allergy specialist, Dr Vincent St Aubyn Crump, of the Auckland Allergy Clinic.

“The reason that it doesn’t seem to be increasing more than these other food allergies could be that our kiwifruit eating practices haven’t changed that much over the years,” he says.

This does not appear to be the case for the UK, which is probably explained by an increase in the consumption of kiwifruit.

Kiwifruit was first introduced into the UK diet in the late 1960s, and consumption has increased steadily since then, with over 31,000 tons of the fruit being imported into the country in 2002, mainly from New Zealand. In a poll, one in 10 children said it was their favourite.

In the 1970s very little allergy to kiwifruit was reported. However reactions were increasingly seen in the 1980s, predominantly in adults.

“Through the late 1990s and early 2000s we were aware of an increasing number of very young children attending our large paediatric allergy clinic, with a diagnosis of kiwifruit allergy,” says Dr Jane Lucas, a paeditrician and clinical research fellow at the University of Southampton.

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Starting school with eczema

Starting school or daycare is stressful at the best of times, but it can be particularly daunting if your child has eczema. How is your child going to avoid triggers, who will supervise the moisturising regime, how will they cope after a bad night of scratching? Jane Morgan offers some practical advice

Perhaps the biggest wrench of the parent or carer of a child with eczema is passing on the care of that child to the ‘big school’. It is something that we all have to endure and this is an attempt to make that transition from home or daycare to school as easy as possible.

Due to the very nature of the condition eczema can vary in its severity from a small patch of dry skin to extreme cases that require regular hospital admissions.

You are about to pass on the care of your child to a teacher who may have experienced eczema but may not have experienced the level of the condition that your child has. The only way to build an understanding of this is by talking to the class teacher and the Principal. You have cared for your child on a one-to-one basis, and the class teacher cannot possibly be expected to maintain that level of care. However, they can be instrumental in making sure that you maintain your child’s skin in the best condition possible and ensure that their skin does not deteriorate unnecessarily.

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Allergic to cold: the real deal

When you mention allergy people usually think of allergies to foods, pollen, pets, drugs and insect stings. Few are even aware that it’s possible to be allergic to cold. But cold urticaria, as it’s properly called, is very real and for a significant number of sufferers it can result in anaphylaxis. The good news is that for most people, it is manageable and, as Inga Stünzner discovers, there is no need to move to the tropics.

When Cherie Bouzaid explains to people that her seven-year-old son Mason is allergic to the cold, she is often met with scepticism.

“It definitely is an effort to convince people that being allergic to the cold is a real allergy. I’ve had people look at me in disbelief and at times have felt like a completely over-protective mother,” she says.

Mason first started showing signs of his allergy as a toddler when he would break out in red, itchy hives after going for a swim at the beach or getting wet under the garden hose. Now he takes special care not to get cold — which may seem impossible considering the Bouzaids live in notoriously cold Dunedin.

Keeping him warm on a normal winter’s day, however, is not too difficult for the most part, Cherie explains. It means keeping him completely covered from the freezing air when he goes outside, and avoiding a lot of cold activities. Occasionally his face and hands will still break out in welts in the cold wind.

“If he has a reaction, then we have to get Mason warm by taking off cold wet items of clothing and replacing them with anything dry and warm and, also important, just like any other allergy, we give him a dose of antihistamine, which helps a lot.”
Mason also carries an adrenaline auto-injector, which he also needs for his peanut allergy.

Dunedin gets a couple of good doses of snow a year and Mason is allowed to play in it, but he is wrapped up and the time he is allowed to stay outside is limited.

At other times, it can be more of a problem. “We took Mason to the ice skating rink last year and even though he was well wrapped up, his face and neck broke out in hives and we had to leave immediately and warm him up,” Cherie says.

But it hasn’t stopped Mason from doing what most other kids age his age enjoy doing. He plays Ripper Rugby in winter, and although the cold mornings on the field cause his exposed skin to break out in hives, his family are investing in long johns this year so he can keep up his sport.

The biggest risk for Mason, as is the case with many people with cold urticaria, is swimming.

“Our allergy specialist Dr Broome in Christchurch has advised me that if Mason ever falls off a boat or floating device into cold water, he could go into anaphylactic shock. This makes holidays and picnics difficult when we spend the day at the lake. Mason is very understanding and sensible, but he does look longingly at the other children swimming and jet skiing.”

Cherie says school trips to the beach are a concern. Although the teachers keep Mason away from the water or any cold activity, they ask so many questions about his allergy that she is not sure they believe her.

She gets a similar reaction from the parents of Mason’s friends.

“Mason has been invited to go to the lakes or ice skating with friends or holiday programmes and I thank them but refuse their offers and explain why. His friends’ mothers are quite amazed when they hear of this allergy – they seem polite at the time but maybe they think I’m totally nuts. It is not a common allergy and not talked about.”

Dr Jan Sinclair, paediatric allergist and immunologist at Auckland’s Starship Hospital sees about half a dozen children a year with cold urticaria.

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