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Proactive-Allergy Care

Proactive Allergy Care
16, Jun 2021

Proactive-Allergy Care

By Dr Tom Marrs, Consultant in Paediatric Allergy of

In London, we have some of the highest rates of allergies and allergic disease. This season, many people are sneezing, congested and itching their eyes with tree pollen. Since lockdown, the necessary increase in hand hygiene is aggravating eczema and sensitive skin. We are also seeing an increase in cat and dog allergies as many families have bought pets.

Children in England have one of the highest prevalence figures for allergy worldwide. Currently, one in 14 children have IgE-mediated ‘immediate’ food allergy at some point in their life, equating to two in each class. 1% of children live with long-term peanut allergy. Even 15 years ago, as many as one in 4 children in the UK had eczema and one in 7 had asthma. These rates are likely to have been rising.

People with allergies have “hypersensitivity” reactions to proteins which are normally harmless. Such proteins are known as allergens and common examples include peanut, egg, milk, cat dander, house dust mite, tree and grass pollens. Although reactions can be unsafe, sensible avoidance advice and treatment of reactions can prevent life-threatening responses. Fatalities are very rare.

Fortunately, there has also been a revolution in allergy treatment options. The mainstay of advice used to be avoidance alone, and this is still the most important principle for preventing reactions in children with established allergies. However, there are now important new options for allergy care.

Firstly, babies can be protected from developing food allergy by introducing allergens into their diet. For instance, eating more than one teaspoon of peanut butter per week protects from peanut allergy. However, some children have already developed peanut allergy, have reacted to another food or have established eczema and therefore need testing before considering this prevention treatment. Families who are concerned about the risk of their child reacting may need extra support to plan a safe strategy.

Secondly, immunotherapy treatments are available for a wide range of pollen, dust and pet allergies. For children who are especially sensitive to peanut, the first peanut immunotherapy product is being launched in the UK later this year. Immunotherapy is different to prevention because it aims to ‘dampen down’ an established allergy by taking tiny (milligram) quantities of the relevant allergen on a daily basis. It cannot cure the allergy however aims to reduce symptoms of the allergy through daily treatment. The aim is that hay fever becomes more manageable, dust allergy does not drive on-going congestion and that peanut immunotherapy allows low-dose accidental peanut consumption to go unnoticed.

It is a pleasure to bring these options to families who will benefit from expertise in diagnosing, testing and improving quality of life. Remote consultations are normal and there are even options for home testing which are available in older children. The other good news is that this high-quality evidence-based advice and management is available in your local area from the team at the New Malden Diagnostic Centre!

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