SEASONAL ALLERGIES

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

Allergies are your body’s reaction to a foreign substance, called an allergen. Usually, these allergens are harmless and don’t cause a reaction. However, if you have an allergy to a particular allergen, your immune system will identify it as harmful and make protective antibodies, called histamines. Histamine is what causes your allergy symptoms.

Allergic reactions vary from person to person and range from minor irritations to a life-threatening emergency called anaphylaxis.

Allergies can affect anyone, although you are more likely to have or develop allergies if your biological parents have allergies. More boys develop allergies than girls, however this reverses after puberty as the female hormone oestrogen is known to exacerbate sensitivity to allergens. Obesity has also been identified as a major risk factor for allergic diseases.

WHAT CAUSES SEASONAL ALLERGIES?

Various substances can cause allergies. Some common allergy triggers include:

AIRBORNE ALLERGENS, such as pollen, animal dander, dust mites and mould
CERTAIN FOODS, especially peanuts, tree nuts, wheat, soy, fish, shellfish, eggs and milk
INSECT STINGS, such as from a bee or wasp
MEDICINES, especially penicillin or penicillin-based antibiotics, sulphur containing medications
LATEX or other substances you touch, which can cause allergic skin reactions

ALLERGY SYMPTOMS

Allergic reactions depend on what allergen is involved, and can affect your airways, sinuses and nasal passages, skin, and digestive system. Your symptoms can range from mild to severe.

ALLERGY COMPLICATIONS

Having an allergy raises the risk of certain other health conditions, including:

ANAPHYLAXIS: If you have severe allergies, that raises your risk of this serious allergic reaction. Foods, medicines, latex and insect stings are the most common triggers of anaphylaxis.
ASTHMA: If you have an allergy, you’re more likely to have asthma. Asthma is an immune system reaction that affects the airways and breathing. Often, asthma is triggered by exposure to an allergen in the environment. This is known as allergy-induced asthma.
INFECTIONS of the sinuses, ears or lungs. Your risk of getting these conditions is higher if you have hay fever or asthma.

ALLERGIES IN SOUTH AFRICA

Allergies are very common, and allergic diseases are on the rise worldwide. While a third of South Africans will suffer an allergic reaction at least once during their lifetime, 40% of allergy sufferers in South Africa are children.

AIRBORNE ALLERGIES

Pollen and house dust mite allergens are the most common triggers of allergic rhinitis and asthma. However, not all pollen is allergenic. The most allergenic pollen in South Africa comes from the plants that are not indigenous but have been introduced; like plane trees and oak trees from the Northern Hemisphere. Grasses are also highly allergenic and release millions of windborne pollen grains in spring, causing seasonal allergies which affect 20-30% of South Africans.

Trees with big bright flowers like those from jacaranda or acacia trees, which are large, sticky and insect pollinated, are NOT allergenic. Fynbos is also rarely allergenic. Most fynbos plants are pollinated by insects, birds or small mammals like mice or bats. The pollen is not easily airborne and is not windblown like grass and so is not as easily inhaled.

FOOD ALLERGIES

2 or 3 out of every 100 South African children have a food allergy, so most schools will have several learners with a potentially life-threatening food allergy.

The South African Directorate of Food Control (Department of Health) recognises eight foodstuffs and their derivatives as common allergens:

Cow’s milk
Peanuts
Tree nuts (almonds, Brazil nuts, cashew nuts, hazelnuts, macadamia nuts, pecan nuts, pistachio nuts, walnuts)
Soya
Significant cereals (wheat, rye, barley, oats, crossbred hybrids)
Eggs
Shellfish (crustaceans, molluscs)
Fish

INSECT STING ALLERGY

In South Africa, bee-sting hypersensitivity is the most common form of stinging insect allergy. It is estimated that only 1 % of the population has a systemic allergy to bee stings, but this allergy can be life-threatening. If you are part of the 1% with a bee sting allergy, you must carry emergency treatment with you at all times and wear a Medic Alert bracelet / necklace.

MEDICINE ALLERGY

Worldwide, adverse drug reactions (e.g. a reaction to antibiotics) affect about 10% of the population. However, as HIV infection is associated with high rates of drug allergy reactions, this number may be higher in South Africa due to our high HIV prevalence rate.

LATEX ALLERGIES

Latex is the sap from the rubber tree used in the manufacture of gloves and other rubber products. It largely affects healthcare workers and other occupations who have repeated exposure to products containing latex. Statistics from four South African hospitals show a latex allergy prevalence of 9–20%.

IDENTIFYING ALLERGIES

If you think you have allergies, and your symptoms last longer than a week or two or tend to come back during certain times of the year, make an appointment with an allergist. The allergist will perform tests to ascertain exactly what it is you are allergic to so that a specific management protocol can be developed for you.

PREVENTING ALLERGIES

Preventing allergic reactions depends on the type of allergy you have, but the following behaviour changes can help:

MANAGING & TREATING ALLERGIES

Avoiding allergens often doesn’t completely end allergic reactions. Over-the-counter and prescription allergy medications may be necessary. These are available as nasal sprays, pills, liquids, eye drops and topical ointments or skin creams.

ANTIHISTAMINES: These are the most common medications for the relief of allergy symptoms. They work by blocking the chemical, histamine, that causes the symptoms of allergy.
CAUTION: Some antihistamines tend to cause drowsiness and may not be suitable for use if you are going to be driving or doing any activity that requires full alertness or alternatively you can request ones with non-sedative properties.
DECONGESTANTS: These are usually available as nasal sprays that can relieve congestion (stuffiness) in the nose or sinuses.
CORTICOSTEROIDS: These medications help relieve symptoms by reducing inflammation. Steroids can be found in some nasal sprays and skin creams but are also available in tablet or inhaler form. Your doctor may need to prescribe you a steroidal medication that can help manage your symptoms.
CAUTION: Long-term corticosteroid use can cause cataracts, osteoporosis, muscle weakness, thinning of the skin, stomach ulcers, increased blood sugar (glucose) levels, delayed growth in children and can also worsen high blood pressure. Talk to your healthcare provider if you are going to be using corticosteroids for a long period of time.
MAST CELL-STABILISERS: These medications block mast cells from releasing histamine. Your doctor may prescribe these when you cannot use antihistamines or when antihistamines are not working effectively to relieve your symptoms. Mast cell stabilisers do not provide immediate relief of symptoms but require at least a few days’ use to be effective.
LEUKOTRIENE INHIBITORS: These tablets block the other chemicals that help to cause allergy symptoms.
CAUTION: Your doctor will have to prescribe these medications as they are sometimes known to cause, or aggravate, psychological conditions like anxiety and depression.
IMMUNOTHERAPY: Immunotherapy is a treatment that involves administering small doses of an allergen to help your body become used to it over time. Successful immunotherapy can prevent allergy symptoms from returning. Immunotherapy is usually given as a series of injections at a healthcare facility or immunology clinic over a few years.
CAUTION: Immunotherapy needs to be carefully monitored by a healthcare professional, as it can cause side-effects, such as swelling and pain at the site of injection, or even anaphylaxis.
EMERGENCY EPINEPHRINE: If you have a severe, life-threatening allergy, you’ll most likely have to carry an emergency epinephrine autoinjector. This is the first-line treatment for anaphylaxis.
In many cases, a combination of therapies works best e.g. antihistamine pills alongside nasal sprays. It’s important to work with a healthcare professional to develop the best management plan for your allergies.

SEASONAL ALLERGIES

SEASONAL ALLERGIES

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

WHAT CAUSES SEASONAL ALLERGIES?

ALLERGY SYMPTOMS

ALLERGY COMPLICATIONS

ALLERGIES IN SOUTH AFRICA

IDENTIFYING ALLERGIES

PREVENTING ALLERGIES

MANAGING & TREATING ALLERGIES

FURTHER READING