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24 Why are we so allergic?

You see them plastered up in every school wall, in every kindergarten kitchen. Anaphylaxis Action Plans outlining the procedures for the common — peanut or egg, to the not so common — anaphylaxis to cold. Is there a greater awareness of allergies and better diagnosis, or are allergies on the rise?

Why are we so allergic?

She was born a red, blotchy baby who would always cry after her breastfeed — which is perhaps not so unusual. But when she was about nine months old, she had a severe and life-threatening allergic reaction to her mother’s breastmilk. If this wasn’t enough, Bethany’s little body was constantly covered in weeping eczema, and her face sloughed off.
“She was bathed and wet wrapped four times daily in the early days and we made little progress with our little girl who was failing to thrive,” her mother, Linda, recalls. “In utter desperation I made a private appointment with an Auckland allergy specialist and had an accurate diagnosis. Life began to look up as we gave her regular medication to help with the allergic reactions and systematically trialled one food at a time.”
Bethany has a list of food allergies almost as long as she is. While beef has been a no-no, now she has to avoid it in its living form.
“We live in a rural town in the Waikato and I am responsible for a farm that Bethany has visited regularly with me over the years. The last reaction to cows happened within one hour of being in contact with a calf. She had ocular oedema and we were close to giving the EpiPen, however the steroid and antihistamine and Ventolin helped enough. She stayed swollen for three days post contact with the calf.”
On top of being at risk of anaphylaxis to eggs, milk and peanuts, Bethany has to avoid spinach, silver beet, winter melon, bok choy, apple, watermelon, honey dew melon, buckwheat, millet, vanilla bean, boney fish (cartilaginous fish is ok) pear, sulphites on dried fruits, methylcellulose, guar gum, tapioca,yeast, and carob!
Bethany started school last year, which was very stressful, says Linda.
You probably wouldn’t have known a little girl like five-year-old Bethany Sunderland a decade ago. But each year, more and more children are presenting with complicated allergic conditions.
Plastered on school walls and in the kitchens of early daycare centres are action plans for the common food allergies, like peanut allergy, to the lesser known allergies, such as anaphylaxis to cold.
With at least one third of our population affected by allergic disease, it appears as though we are an allergy nation. But has there been an increase in allergies, or is it that we are more aware and better at diagnosing?
According to results from the world’s largest epidemiological study on allergic disease, The International Study of Asthma and Allergies in Childhood, there is a definite increase — the number of children with allergic conditions rose worldwide in the 1990s.
The study, published in the British medical journal Lancet in 2006, involved 56 countries including New Zealand, and interviewed 500,000 children aged six or seven and 13 or 14 about their symptoms. It found rates of asthma, eczema and hay fever increased between 1991 and 2003, with the younger age group most susceptible.
The New Zealand data, taken from almost 11,000 children in the younger age group, found an increase in hay fever and eczema, but decreases in asthma. The drop in asthma suggests asthma reached a plateau in the first part of the decade.
[[x-head] So, why?
“I don’t think anyone knows what’s causing a rise in allergies,” says Dr Jan Sinclair, paediatric immunologist at Auckland’s Starship Hospital. “I think that’s the difficulty, really. There are a lot of hypotheses and epidemiological factors, but I don’t think we have a simple answer.”
Genetics are probably still your biggest risk factor in developing allergies, she says. “Then something has changed in the way that people interact with their environment to encourage the immune system to skew off down a particularly allergic pathway. There are lots of things that probably contribute to that, for example family size.
“Some studies have associated the oldest child being more at risk than the youngest child, exposure to particular sorts of organisms in early childhood being either protective or non-exposure to particular organisms putting you at more risk. But it’s not going to be one answer,” she says.

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Regulars

2 Editorial
4 Giveaways
5 Feedback

6-10 Allergy Update

• The EpiPen and Pharmac saga continues
• Increasing evidence of allergy cost
• ACC covers anaphylaxis
• New asthma trial underway


12-16 Ask the Expert

Your allergy questions answered


18-23 Real people

• Mission impossible — but not quite
• Winning the battle

30 Hay fever

The hayfever and sinusitis link

40 Asthma
Breathless: is your asthma under control?


42-44 On the skin

Wrapped for eczema success

46-47 Healthy home

Pillow talk: dust mite combat

52 Directories

Allergy New Zealand, useful contacts and acknowledgements

53 Subscribe and win

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56-60 Food for thought

• Wheat-free, not taste-free. Four pages of delicious recipes
• Soy allergy

64-65 Parting shot

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