All the manifestations of the allergy do not have same gravity. Which are the minor but awkward symptoms which can be treated in self medication? Some brief replies.

Worries related to the allergy
The allergy represents the abnormal reaction of your organization vis-a-vis a foreign element. Whereas there do not exist true attacks, it engages of the “inappropriate” defense reactions which result in ignitions, sneezes, an eczema. The product considered to be dangerous can be very diverse: acarina, pollens, shellfish, or being contained in dust, the hairs of animals.

The allergy can be immediate (as of the first exposure to the allergen, it is the most frequent case) or delayed (during the second exposure to the allergen. These cases are generally reserved for the allergy of contact).

When can one resort to self medication?
On a side, one can be tried to say that vis-a-vis a weak specific embarrassment (nasal flow, salvos of sneeze, small itchings.), self medication can be a solution. Moreover, your pharmacist is an interlocutor health who will be able to direct you towards a doctor in case of doubt;
Other, the coexistence of the allergic rhinitis and asthma, the possible existence of cross allergies (which can handicap the effectiveness of the behaviors of ousting) and the natural evolution of certain allergies plead in favor of a doctor visit, at least initially.
Self medication in question
The drugs high-speed motorboats of the allergy are the antihistamines, some are delivered only on regulation, others are sold freely by your pharmacist. In the form of tablets, they act on many symptoms. It is generally recommended to use them as of the appearance of the first manifestations of the allergy, even in a preventive way if you know that you will be in contact with the allergen.

Will know that all these drugs do not have the same effects exactly. If the traditional antihistamines have some side effects not to neglect (in particular the risk of somnolence), the antihistamines known as of second generation target the release of the allergy best and do not have these awkward side effects.

Beside the compressed forms, one finds eye lotions, adapted to the ophthalmic symptoms of the allergy and in particular to ocular itchings.

Errors not to be made
To avoid very taken of risk, it is necessary to be sure that your symptoms are indeed the reflection of an allergy. A coloured and thick nasal flow could not be allergic and you will have to take other measures. If it is about a food allergy, the visible symptoms such as red plates can be moderate whereas the abdominal pains, unusual nauseas or digestive problems can be more important. If you encounter difficulties of breathing or swellings of the face and neck, it is necessary to consult urgently.

For the children, it is absolutely necessary to consult to draw aside a diagnosis of asthma. Finally for the infants, will never resort to self medication. The consultation in the pediatrist or your general doctor is essential.

For what are used they?
The tests have as an interest to simulate in a visible way, on the skin, the conflict generated by allergic sensitizing inside the organization.

The tests come following the clinical survey carried out by the expert. So sometimes the diagnostic orientation is evoked by the simple private clinic: typical hay cold, asthma with the hairs of animals or the acarina, urticaria food or medicamentous, in many cases several factors intriquent and complicate the step. More and more often, the doctors are in front of this type of situation and must refine their diagnosis.

Technique of the tests
The tests most usually applied to the cabinet of the expert are the épidermiques stamps (patch-tests) and tests (prick-tests).

Stamps

They are used for the research of the allergies of contact like for that of certain food allergies. They consist of the application of a series of stamps coated with the substance which one suspects being responsible for the allergy to different concentrations, or of several substances tested at the same time. These stamps are stuck on the skin of the patient and are left in place a few hours or a few days. The goal is to obtain a local effect similar to the symptom dominating of the patient.

A very great number of professional eczemas find their explanation thus. Potassium bichromate of cements (masons), solvents and dyes chemical (various industries), materials as various as of the shampoos or lacquers (hairdressers) paintings (body), etc the allergy to latex, rare but very handicapping, is thus easily highlighted.

The child can profit from this technique as of more the young age, for eczemas of contact: products of toilet, detergents and softeners, soaps but also in the event of food eczema of origin. A certain number of aggressive agents are thus uncovered: milk, certainly, but also the egg white, certain vegetables, of the food dyes. The increasing complexity of certain food like the exotic mixtures of fruits, the introduction of dyes, fixers, gelling and others makes often delicate this type of diagnosis. Can one think that the introduction into the genetically modified protein organization will contribute to thicken even certain mysteries?

Épidermiques tests

The épidermiques tests consist in introducing the allergens by a tiny puncture of less than one millimetre of depth. The reaction awaited in the minutes which follow is a more or less broad papule resembling a puncture of nettle.

It is there too the field of the food allergies at the origin of crises of urticaria and especially that of the respiratory problems like asthma and the seasonal rhinitis due to pollens. The studied agents are very numerous, to start with ten families of acarina. Then come dust from house, bakery, of wood or cereals, the many atmospheric moulds, pollens and the hairs of animals, the chemical food and derivatives.

The diagnosis of allergy was largely facilitated by the development of the batteries of test cutaneous. All these tests can be refined by a blood control. Certain allergens should be required besides only by one blood test and of the reactions observed in laboratory. It is the case of drugs: antibiotics, aspirine for the principal ones. It is also the case of venoms of hyménoptères.

Eczema atopic is a skin disease to allergic tendency which can appear as of the three months age in the infant. For still unexplained reasons, this affection is in full explosion in Europe, where it reaches 20 to 25% of the children. Hereditary, it is without gravity but appears extremely unpleasant at the time of the pushes. It starts important itchings which end up damaging the skin. This one thickens, becomes red and pruriginous, with a risk of superinfection. The doctor is then brought to prescribe local treatments containing cortisone (dermocorticoïdes), very effective at the time of the pushes. Moreover, to fight the cutaneous dryness, it is advisable to apply hydrating and emollient creams to the whole of the body.

Out of relay of the traditional treatments

In the event of severe eczema, hydrotherapy can take over traditional treatment, in order to limit the catch of drugs, in particular in the child whose organization is more fragile. “The water cures are indicated in the event of eczemas difficult to stabilize, for which have is brought to use the dermocorticoïdes too regularly”, explains Dr. Didier G, dermatologist council of the thermal spa of Avène-the-Baths. One notices an improvement as of the first cure, with a stabilization which can last several months. For all this period, one notes a very clear reduction in medicamentous consumption. The following year, a second cure is sometimes indicated in order to consolidate the results.

The children can be accommodated as of the six months age for one three weeks duration stays, dealt with by the Social security after agreement preliminary. The basic care consists of baths to clean, relieve congestion and alleviate the skin, of showers general or located, to mass and pickle the skin, and of pulverizations to the properties anti-inflammatory drugs and antiprurigineuses. This external care is supplemented in-house by the drink cure (feeding-bottle with thermal spring for the babies).

Water and nature

In addition to the virtues of water and care, the effectiveness of a cure is also explained by the environment and the changes usually of life. The green framework encourages with the relaxation and rest, as much of the child that parents, often very distressed by the disease. It is a well come bracket. The fact of daily meeting the dermatologist and a team accustomed to the problems of pleasing skin to put all the questions remained hitherto without answer. One learns with better knowing the affection, with the dédramatiser. “One also learns with better looking after the skin of the child and with applying the creams well”, the specialist continues.

The thermal springs with dermatological indication act from their specific mineral composition. These minerals and trace elements confer properties to them anti-inflammatory drugs, alleviating and lenitive. Used since millenia in an empirical way, they are today the subject of studies scientifiques* which make it possible to affirm that the thermal spring is indeed an active ingredient with whole share. Eczema, psoriases, after-effects of burns, prurits belong to its great indications.

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Today, did the assumption of responsibility of the allergic children in school improve?

Caroline Morice: The reception of the children is much easier than ten years ago. That is in particular related to the improvement of the diagnosis. Previously, a child who presented the symptoms of the allergy (vomiting, eczema…) was not immediately identified like allergic. Now, one more quickly detects the cause, food accused and the level of severity. It is then easier to organize an assumption of responsibility. And of many efforts were made in favor of the reception of the children at the school. Among those, it is necessary to quote the Project of Individualized Reception (FEEDS), initiated in 1999. This one put a little time to set up itself, but it is usually used today. In all the cases, the dialogs lead much more quickly today.

Precisely, you evoke the Project of Individualized Reception, intended for all the provided education for children suffering of health issues. Concretely, up to what point this can FEEDS help the allergic children?

Caroline Morice: The Project of Individualized Reception (FEEDS) is made with the request express parents near the school doctor, it is not a question of an automatic process. FEEDS then will be written at a meeting between the parents, the establishment, and the representatives of the municipality, under the coordination of the school doctor. In all the cases, the family must ask her specialist treating a recent and complete assessment allergologic, with a precise regulation of the mode of mode and possibly the various precautions to be adopted in community (contact with certain materials, reactions with the animals…).

What is also important, it is that the doctor gives in a language simple, nonmedical, the signs of alarm of a crisis and the protocol emergency to apply in this case. At the beginning, this step posed problem, because the school is not a place of care, and the mistresses can with difficulty manage several children, each one with different treatments. It is true that this protocol must remain held with the children for whom it is essential. In all the cases, FEEDS it must allow to organize installations necessary within the school, which should result in not having recourse to this emergency protocol.

To divide See also our files: Food allergies
Allergies to the school and on vacation
Children, first victims of the allergies
Canteens, what is nine?

Food allergies: no the school buissonnière!
(Page 2 out of 3)

For is the parents, the fact of signing one FEEDS really one more?

Caroline Morice: This FEEDS represents real advanced. Its advantage is to take into account the specificity of each child. It is not presented as a rigid framework, with rules to be followed by pathology, but it is worked out on a case-by-case basis. Admittedly, it is also based on the good will of each one. But this action in dialog is certainly more effective. If it spent time to be set up, it is used more and more today. Thus, in 2001 there were 59.000 FEEDS, of which 8.000 concerned allergic children. And this figure is in constant increase. For all the parents who sign one FEEDS, we advise to remain in of liaison with the mistress or the professor in the first times, in order to know if all occurs well. Because often, the first weeks are most important. It is there that there can be problems and especially reserves. But last this course, the things occur very well.

But doesn’t the reception at the time lunching it pose problem?

Caroline Morice: The reception in school restoration of the dependant childrens of the municipalities in class of nursery schools and elementary is not a legal requirement, a fortiori the reception of the allergic children. It should be stressed that there exists a great disparity according to the communes. It is true that according to the sites the possibilities are not the same ones: it is for example easier to manage an allergic child when it is about a self-service. In the same way, when the schools have a cooker which prepares the meals: it can indicate which ingredients are used in the menus and arrange them consequently. But when they are external people receiving benefits, the management of the allergic children can prove more problematic.

All the children are not allergic in the same way. Some for example will be allergic to certain easily identifiable food, such as fish or garden peas. They will be able without problem lunch with the canteen. It will simply be necessary to manage to avoid accused food. In other cases, there will be children allergic to eggs, but with a low sensitivity. They will be able to very eat punctually sauces containing of the minor amounts of egg. It will simply be necessary to replace a hard-boiled egg in entry by another dish. And to replace a cake serves some by a fruit for example. In the majority of the cases, the presence with the canteen requires only small installations.

And when the child suffers from a more important allergy?

Caroline Morice: It is necessary indeed to take into account the children suffering from polyallergies (milk, eggs…) or the children who have thresholds of very low sensitivities. For them, it is generally not possible to adapt the been useful meals. The municipality can possibly propose to prepare dishes, but it is a responsibility which requires important installations. She can also sub-contract with a company which has specific meals for allergic. But it poses the problems of the price and diversity. The basket meal is the solution most often adapted. It is preferable other than the children of the canteen, as certain municipalities do it. But the protocol which surrounds this basket is often too heavy. Thus, not to take any risk, the municipality forces the parents to also provide covers, the plate, glass salt and the water of the children! For the parents who must already prepare the meal, it is also necessary to set up a whole logistics! The precaution principle is sometimes thorough to the extreme.

What would you advise with parents who learn that their child is allergic?

Caroline Morice: Initially, it is important to establish a rigorous diagnosis. Then, an assessment should be remade regularly. Because in many children, the allergies disappear while growing. And the best possible one should be lived, while dédramatisant. The parents are often more anxious than the children. If I can add a council, the family must endeavor to keep her own dietary habits. Because is not to render service to the child to only eat like him, to gum the differences and the interdicts. When it is outside, it will have to face this difference. It should not live in the illusion. In addition, it is important to try to maintain in the mode of the child a large culinary variety. Lastly, a last council: not to hesitate to consult an association where necessary. It is not a question to become militant, but one should not hesitate to turn to an association, even for a specific request. Because the parents will be able to meet qualified people having already faced a great number of situations. Birthday in buddies, school camp… they can help them to find a solution adapted!

The food allergies touch 3 to 5% of the children but continuously appear to gain ground. There remains difficult today still to know why such individual will be allergic, while such other will remain insensitive. The hereditary factor brings a beginning of explanation: 80% of the allergic children present family antecedents. Scientific studies also noted that the simple fact of moving away a newborn from his/her mother during the first hours which follow its birth its risk of hay cold increases. The same phenomenon is observed for the newborns by Cesarean or in the mothers who took a antibiotique1 during their pregnancy.

Cow’s milk, a powerful allergen

The intestinal flora plays the part of “barrier” by controlling the ignitions of the intestinal mucous membranes in reaction to the antigens. Exposed to proteins that he does not recognize, the immune system on-reacts. The allergy appears by digesting troubles (vomiting, diarrheas, pains abdominal), eczema, urticaria, even a shock anaphylactic. Vis-a-vis the food allergies, the breast-feeding is often presented as being best preventions because of the small quantities of proteins than it contains. The baby can thus forge his immunological tolerance gradually. But after its weaning, or as of the first days if the mother does not want or cannot nurse, the cow’s milk constitutes one of principal food of the children. Its high content in proteins (casein, lactoglobuline and lactalbumine) makes it highly allergenic.

Substitutes

The “milk” of soya
Soya, which has “milk” only the name since it does not contain lactose, was often presented like an alternative to the cow’s milk. But the proteins of soya preserve a strong antigenic capacity and the risks of allergy crossed with cow’s milk proteins are not negligible. “It is thus impossible to today recommend the recourse to this type of food to decrease occurred of various allergies” underlined the pr. Jacques Sarles, pediatrist at the hospital of children of Timone (Marseilles) during the Talks with Bichat 2002.

Milks hypoallergenic
It is actually about a trade description which does not have lawful reality. Their proteins are also of animal origin (casein or proteins soluble) but their allergenic potential was decreased by the action of water (hydrolisation). Studies showed an important reduction of the allergic demonstrations in the children, but, even reduced, the risk continues to exist. The hypoallergenic preparations are thus not advised with the already sensitized children with proteins of the cow’s milk.

The probiotiques ones
These cultures of bacteria, potentially beneficial for the development of the intestinal flora, could contribute to the prevention of the allergic risks. A study published in 2001 in Lancet2 by the team of Dr. Marko Kalliomaki provides some interesting elements. A group of expectant mothers, having antecedents or close relations suffers from eczema, of allergic rhinitis or from asthma, received from Lactobacillus GG 2 to 4 weeks before the birth. The experiment continued with the administration at the newborns for 6 months. At 2 years, the atopic frequency of eczema was 2 times more important in the group untreated than in that which had received the probiotiques ones. “Before passing to the practice one should not however neglect the fact that the harmlessness of probiotic is perhaps not total in particular at the newborn” specifies Jacques Sarles.

Mathieu Ozanam

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The cutaneous allergy revêt of the very diverse aspects. One of its most banal forms is urticaria. Who among us did not meet it? After having consumed shellfish, fish, strawberries, eggs, milk… the skin inflates suddenly by places, becomes red and determines a brutal desire for being scraped.

Park with urticaria!
Actually, the lesions resemble more or less the reactions observed after a puncture of nettle (“Latin urtica”), which gave its name besides to the disease.

At sensitized people, an urticaria can also occur after the administration of antibiotics containing penicillin, anti-inflammatory drugs, aspirine or after having breathed of pollens, the hairs of animals, or having undergone an insect bite.

At the same person, the reaction always occurs in the same circumstances. Another characteristic of urticaria is that once appeared the lesions “move” readily to reach other body zones.

Acute urticarias are due to the release of a molecule supporting the ignition, histamine, following the conflict between the foreign substance allergisante and the organization.

Edema of Quincke, a form of allergy sometimes mortal
Another variety of allergy is represented by the edema of Quincke. In this rather particular form of urticaria, fortunately much rarer, the allergic reaction does not occur in the skin itself but in subcutaneous fabrics. It involves a swelling of the face, in particular around the eyes and of the mouth, which can be dangerous because it can cause an edema of the pharynx sometimes responsible for asphyxiation.

Lastly, it should be known that certain people present authentic allergies to the sun, which appear in varied forms. At the time of the first rays of the sun, or after an exposure prolonged to this one, an eruption of the urticaria type develops which can extend on the skin and to join general signs (faintness). The cause is an intolerance with the ultra-violets. There too, an excessive production of histamine is at the origin of the cutaneous ignition.

There are eczema and eczema
Another very widespread kind of cutaneous allergy is consisted eczema. However, this term indicates actually several allergic diseases, makes some rather different. Most frequent of them are represented by the eczema atopic of the infant and the allergic eczema of contact of the adult. It also happens that affections of the skin like the psoriasis, become complicated other cutaneous deteriorations resembling those found in eczema following the administration of drugs allergisants.

One speaks then “about eczematization” of the lesions. Lastly, the dermatologists also described a particular form of cutaneous allergic reaction, near to the eczema, which rises from a “internal sensitizing” of the organization to an infectious hearth present in its center.

Antihistamines, desensitizing…
To protect itself, the first gesture to be made is of course to draw aside the substance allergisante. But the identification of the culprit is often difficult in spite of a quasi police investigation. Also, of the treatments they are often proposed to the patients with an aim of avoiding the allergic reaction (desensitizing) or of limiting its width while fighting against the exaggerated histamine formation. The drugs antihistamines quickly decrease the redness and the swelling of the skin; most recent of them induce somnolence less and less.

Desensitizing consists in injecting minor amounts of the allergen under the skin to accustom little by little the organization to its presence. This method thus functions a little on the opposite principle of a vaccine. Better and better controlled, it is used to prevent the allergies to the insect bites (wasps…) and the certain food allergies, in particular most serious of them.

… and corticoids
Although nonspecific of the allergy, corticoids bring also an invaluable help in the combat against the cutaneous allergies because they make disappear the ignition. Used, in general, in the form of cream, they are classified in various stages according to their power of action on the cutaneous diseases. But, they have many side effects and owe, for this reason, being employed with parsimony.

Many international studies showed a true boom of the allergies in the children, and an increase in asthma and problems respiratory. And the situation would be even more alarming in the cities. What is it in Paris? It is what a study seeks to determine, which supervises more than 4000 Parisian new-born babies since 2003. The goal is to measure the emergence of the respiratory diseases by taking of account the behavioral and environmental factors (as well inside the hearths as outside the house).

Chronic whistles

With semi course of the study, the main issue highlighted is the chronic whistle. 21% of the babies suffer from it, that is to say small Parisian on 5. this whistle appears especially in the children who have bronchial antecedents of problems, respiratory infections, problems of eczema. It will be noted that 20% of whistling are reached in a chronic way. These whistles are far from being pain-killers: they can be the precursory signs of one asthma at the adulthood. Moreover, the fact of having asthmatic parents is him also a factor which supports these whistles.

Among the other respiratory symptoms revealed by this monitoring, one will note that 23% of the babies have dry coughs and 4% of the respiratory embarrassments.

Infections with the allergies.

Apart from these whistles, the investigation concerned others turbid more or less widespread. Thus, the “traditional” cold touched nearly 60% of the babies and nearly 30% knew a bronchiolite. But what is most worrying, it is that 4% knew more than 3 bronchiolites and that 12% had more than three otitises. Difficult to determine the factors supporting these infections. In the field of the allergies, 17% of the children know atopic dermatites, nearly 9% have allergic rhinitides and nearly 3% know food allergies.

Various causes

The purpose of the study is to seek the causes of these respiratory problems, in particular while being focused on a sub-group of 200 children, to carry out thorough environmental measurements. Because the scientists suspectent already several pollutants to be responsible for these respiratory problems:

Fumes exhaust automobile;
Tobacco;
Nitrogen dioxide released by the gas heating and boiling apparatuses;
The volatile organic compounds (which are in the adhesives, varnishes, inks, cosmetics, products domestic…) ;
Moulds;
Acarina;
Endotoxines released by the bacteria (often related to the presence of animals in the house).
First reports: one finds the chemical pollutants with rather homogeneous concentrations in all the Parisian residences. Only certain products are found on higher levels according to the places: alkanes and paradichlorobenzenes, of the products related to do-it-yourself; the hexanal and propionaldéhyde, related them to the presence of pieces of furniture in agglomerate, or the presence of a coating vitrified on the ground, especially if it dates of more than one year. With regard to the acarina and the moulds, one finds equivalent mean levels in the apartments.
Then certainly, for the moment the scientists did not cross yet the data between the respiratory problems and the levels of pollution. And the study will still continue until the 6 years of the children.
Data which will be essential to dam up the respiratory disorders and to make it possible to the children to breathe in Paris and in all the cities!

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The allergic rhinitis, ignition of the higher air routes, occurs when a sensitized person is in the presence of an allergen. It concerns today more than 25% of the teenagers and adults of less than 50 years. One distinguishes two types from them: the rhinitis known as persistent, present throughout the year, is due to allergens which one permanently finds in the environment (acarina, hairs of animals, moulds), and seasonal rhinitis allergic, especially related to pollens of the trees, graminaceous and herbaceous, which appears each year at the same season.

Two types of rhinitis, the identical symptoms
When in spring, allergic to pollen enters a field, its reaction can be immediate and in general rather violent, characteristic of the seasonal allergic rhinitis. It can start with sneezing, often with salvos, 10,15 times after. Its nose starts to run “like a fountain”, with clear secretions. Then, the nose is stopped (two nostrils at the same time), and starts to scrape furiously. At the same time, the eyes start to cry, breathing becomes difficult and whistling, and cough appears. At half of allergic to pollen, all these symptoms are associated with a conjunctivitis.

In the most severe cases, this scene can end in an asthma attack and in rare cases, at the time of a direct contact with the skin (often in a little wet medium), of the very allergic people can also develop an urticaria, associated with the rhinitis.

For a persistent allergic rhinitis, the symptoms are identical, but often present at low noise: it is the nose slightly stopped all the year, which runs a little, and which requires the permanent presence of a handkerchief in the pocket… These signs can however be of variable intensity, according to the allergen, of the quantity present in the air, and of the degree of sensitizing of the person. The rhinitis started by an allergy to the hairs of animals is for example often as explosive as a seasonal allergic rhinitis. As for the acarina, the allergic crisis of rhinitis can also end in an asthma attack. It will occur more readily the morning, because the particles of allergen being of size more important than pollens, they longer take to arrive in the bronchi, and the crisis is shifted.

Different calendars
The seasonal allergic rhinitis, primarily related to pollens, generally does not appear before the age of 3-4 years, and really starts between 6 and 12-15 years. For the persistent rhinitis, there is no really given age: it can start at the adulthood, and even with the retirement! It is enough sometimes to a change of residence, of environment.

In general, this pollinic allergic rhinitis returns every year about at the same period, at the beginning of spring. But for certain pollens like the pollen of cypress, there can be one year variations on the other, in particular according to the weather.

It should not be forgotten that there exist also differences according to the areas: in the area of Lyon for example, the Ambrosia causes very virulent allergies, which occur as from September.

Not to confuse with other affections
At the time of an allergic rhinitis, the nose is stopped, it runs rather forwards and scrapes furiously. Contrary, a completely stopped nose, with secretions which go towards the throat, will have rather to make think of a sinusitis.

During a traditional cold, the nose stops on a side then other, burns, and secretions are viscous. In a child, it is often more difficult to make the difference between a cold and an allergic rhinitis; the characteristic sign to detect an allergic rhinitis is then to look at if it scrapes the nose with the palm or the fingers. Because all is summarized with a short phrase: the cold makes badly with the nose, whereas the allergic rhinitis scrapes.

To differentiate a cold from a rhinitis
Cold
Allergic rhinitis

Causes
virus
allergens

Release
viral contamination
contact with allergens

Signs being able associated beings
Muscular pains, headaches
Irritated eyes and larmoyants, tinglings of the nose

Duration
1 week
a few days in a few months

When one recognizes the symptoms of an allergic rhinitis, they should not be neglected, because a light rhinitis can worsen. Many treatments exist, speech with an health professional, doctor or pharmacist.

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Nose which pricks and which itch, sneezes, permanent feeling to have the stopped ears, eyes bouffis with the alarm clock which cry with the least ballade in the fields… Spring is not part of pleasure, and if the symptoms of the allergic rhinitis are without gravity, they remain difficult to support with the daily newspaper. Painful to spend its time to this moucher at the time of a dinner between friends, to have the eyes irritated and inflated at a professional meeting, or to sneeze every 5 minutes during a course or during an examination!!!

Practical advices
The hay cold which you undergo since of the years is not a fate, do not hesitate to speak about it with your doctor. He will initially seek to eliminate another cause from rhinitis and nasal flow by carrying out a detailed examination of your throat and your nose, and he will also seek signs of allergy being able to be located at other places of your body (eczema, asthma,…). A thorough interrogation will help it to evaluate your antecedents: you had other signs of allergy, your parents or your grandparents are they allergic, etc

Finally, it can be resulted in proposing to you tests carried out by an allergist within the framework of an allergic assessment in order to seek which are precisely the substances who start you these symptoms.

In the case of seasonal allergic rhinitides, a preventive medication by antihistamines can be to you prescribed: often such a treatment will make it possible to avoid the appearance of the symptoms completely, and in all the cases, it will decrease them in an important way. This one must be started at the beginning of the period during which usually your hay cold occurs.

For the annual rhinitides per, it is imperatively necessary to deal with the environment: to avoid the fitted carpet, to treat all the textile elements with acaricides in the rooms and to use covers treated in the event of allergy to the acarina. To avoid the animals, and at least to prohibit the entry in the rooms to them. According to the nature of the substance allergisante, to take the necessary measures to reduce its contact and its inhalation. The use of a filter anti-pollen in the car can also decrease the exposure to the allergen.

Whatever the allergic type of rhinitis, the symptomatic medicamentous treatment calls upon cures of antihistamines or corticoids in pulverization by nasal way associated or not. Desensitizing – mainly prescribed today by sublingual way – is the only treatment which acts durably on the cause of the allergy, making it possible to modify the evolution of the disease favorably.

Of course, the first of the things is to avoid as much as possible the contact with the substances responsible for your allergic rhinitis… not always simple!!!

A permanent irritation
The signs are known goods of those which undergo this disease. A nose which starts to run permanently, with a clear flow as of the water (one speaks about rhinorrhée aqueous) and which obliges to fill its pockets with handkerchiefs. Often, there exist also signs on the level of the eyes: whimperings, tinglings, itchings, feeling to have the irritated and inflated eyelids.

A feeling to have the stopped ears is also often associated, related to the thickening of the wall of the Eustachian tubes, these small channels which go from the throat to the middle ear and which have as a role to balance the pressure between the interior and the outside of the tympanum.

The repetition of these irritations ended up having an effect on the walls of the nose, which they make more fragile and more sensitive to the infections.

30% of the adult population reached
Often neglected by the patients who are not considered truly sick, the allergic rhinitis is a reaction of the walls of the nose to the presence of an external substance able to start a reaction of allergy. This substance (then called allergen) involves an answer of certain immunizing cells which automatically produce a too great quantity of antibody (Immunoglobulins of the type E or IgE) on the level of the nasal mucous membrane, i.e. lining of the nose. This production is also accompanied by a dilation by the blood-vessels and local emission by irritating substances. As this reaction locally takes place on all zone ORL, it is the nose but also all the bodies which are connected to him which will be touched: the back gorges, the middle ear and the eyes.

30% of the population present every year an allergic rhinitis, which testifies at the people reached, of a predisposition allergic or a sensitizing to certain particular allergens.

Pollens, dust and animals: first culprits

In very many cases, in fact pollens start these crises: it is then about seasonal allergic rhinitides, or “hay cold”. Indeed, pollens are especially present according to the areas between February and September. All pollens are not allergisants: to have this characteristic, those must indeed contain proteins which will be recognized by the allergic person and to start a reaction… and the presence of this type of proteins can vary considerably from one area to another, including for pollens of the same species of trees!!

In addition, pollens allergisants are only those which are disseminated by the wind and which can thus be breathed by allergic people: those which are disseminated by the insects are not sources of crises of hay colds. Among the plants giving pollens more allergisants, one can quote the graminaceous ones (grass of the meadows), the armoise, the ambrosia and the nettle, the cypresses, the birches, the oaks and the plane trees.

When the allergenic product is present permanently in the environment, the symptoms are present throughout the year, and one speaks then about perannuelle allergic rhinitis. This one is primarily due to “domestic” elements: hairs of pets, feathers; dust of house (of which famous acarina), cockroaches, etc

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You sneeze and you mouchez yourselves as soon as arrives spring? Or perhaps does your nose run throughout the year without you for being caught cold as much? You are probably reached of an allergic rhinitis. In 30 years, the frequency of these allergies doubled and it is estimated today that 10 to 15% of the inhabitants of the industrialized countries suffer with various degrees from this disorder. This recrudescence does not seem as well related to external pollution, as with the containment growing of the dwellings. The insulation of the dwellings causes to increase the density of the domestic allergens, such as the maintenance products or the acarina, inside the residences.

An aberrant immunity
Like all the allergies, the allergic rhinitides are related to an abnormal immunizing response of the organization with a substance (allergen) on which the person became sensitive. During this first phase of sensitizing, the individual produces particular antibodies, IgE, which recognize the allergen in question precisely.

These antibodies will be fixed on certain cells of the mucous membranes, nasal in particular. Then, at the time of a new contact with the allergen, this one will be able to meet the cells carrying these IgE (mastocytes) and to stimulate them, causing the release of inflammatory factors. It is this inflammatory reaction which involves the characteristic disorders: nasal flow aqueous, tinglings, sneezes, sometimes associated with a whimpering and a loss of the sense of smell.

The affection generally begins in childhood or at the beginning from the adulthood, and can disappear with ageing. It is not serious in oneself, but can become very génante, involving insomnia and tiredness.

Pollens or cockroaches?
There exist two forms of allergic rhinitis:

Seasonal rhinitides (traditional “hay cold”) very often due to an allergy to pollens;
The perannuelles rhinitides persist all the year and are generally dependant on domestic allergens like the acarina, the cockroaches or the hairs of pets.
However, the polysensiblisations are frequent and a person can have very well a perannuelle allergy to the hairs of cat and an allergy to pollens. In the children, the allergic rhinitis can also be related to food allergens.

All the chronic rhinitides are far, however to be allergic. More half of them are related to another cause. The rhinitis vasomotrice is in particular often related to the abuse certain drugs (nasal vasocontrictor, in particular).

Why certain people they are affected allergic rhinitides?

Besides this affection translates a ground allergic (or atopic), as testifies rather frequent association to it to the rhinitis to other allergic diseases, such as asthma or eczema. The origin of this allergic predisposition is certainly multifactorielle, with a hereditary genetic component. Thus the people having one or the two parents reached of an allergic disease have more risk to develop, themselves, an allergy in the form of a rhinitis in particular.

Publicity
Like the skin or the nasal mucous membrane, conjunctive, fine membrane which recovers the eye, is in permanent contact with the allergens present in the atmosphere (acarina, hairs of animals, feathers, pollen…), on the eyelids (cosmetic) or in the eyes (eye lotion). At the people having an allergic ground, these allergens can involve an inflammatory reaction of conjunctive, similar to the reaction responsible for the allergic rhinitides.

Often associated rhinitis and conjunctivitis
When the allergen is spread in the air, allergic rhinitis and conjunctivitis are often associated besides, causing nasal flow, sneezes and whimpering. The conjunctivitis can be also isolated, in particular when it is related to a product directly in contact with the eye. In this case, the demonstrations are limited to the eyes, which are red, picotent, itch and cry. The light is difficult to support (photophobia). Often the eyelids red and are inflated, sometimes stuck the morning. However the intensity of the signs is very variable from one person to another.

These symptoms are related to a reaction of the antibodies against the antigen (allergen) against which the person developed a sensitivity. In the event of allergy to pollens the graminaceous ones, grass or trees, the episodes are seasonal workers, being repeated each year in spring, the end of the summer and the beginning of the autumn. The conjunctivitis is generally associated, in this case, with a rhinitis, it is traditional “the hay cold”. When they are acarina or hairs which start the episodes, the conjunctivitis can reproduce throughout the year. In the child, there exist spring conjunctivites, form particular allergic conjunctivitis which evolves/moves by seasonal pushes.

If the diagnosis is easy when the conjunctivitis joins a rhinitis, which transforms the allergic one into true fountain, it is much more delicate when it is insulated, especially if it acts of a first episode. The conjunctivites infectious, viral, in particular, very frequent, give identical signs. It is often the evolution which leads to suspecter the allergy, when the conjunctivitis does not cure or repeats. In this case, like front any suspicion of allergy, it is necessary to make carry out a complete assessment by a doctor allergist.

Hunting for the allergens
The first treatment is the ousting of the allergen, when it is possible. To remove the make-up temporarily is a requirement in front of any red eye. The cure of the conjunctivitis and its reappearance during a new application makes it possible to identify the responsible substance. The presence of an allergy of this type must result in being vigilant in the choice of its cosmetics.

The ousting is much more difficult, even impossible, when the allergen in question is a pollen, for example, or the acarina. In this last case, it is essential to reduce dust to the minimum, by avoiding fitteds carpet, carpet, blankets wool, and by maintaining a hygiene rigorous. A desensitizing can also be tried, in condition of having identified the cause of the allergy well.

The allergy can be secondary with the treatment
If the signs of ignition of the eye are intense or persistent, it is essential to consult an ophthalmologist before taking drugs. Eye lotions containing antihistamines or of relieving congestion can relieve the symptoms, without curing the allergy. In the most severe cases, corticoid eye lotions are effective, but cannot be used in a prolonged way. These products should be employed only under medical control, because they can worsen the infections, to even involve the loss of the eye in the event of ocular herpes. It is essential to throw any started eye lotion and not to keep it in its medecine-chest to possibly use it at the time of a forthcoming episode.

Lastly, it is important to know that the molecules contained in the ophthalmic eye lotions and pomades can, they also, to cause allergic conjunctivites. This possibility, rather frequent, must be evoked each time an ocular treatment involves irritation and itchings, or that the treated affection does not cure, in spite of the drugs. The stop or the change of treatment will then be enough to improve the symptoms quickly.

Publicity
In 1991, researchers of the whole world took part in the international study on the infantile asthma and allergies (baptized ISAAC). It aimed at determining the proportion of people touched by asthma, the hay cold and the eczéma1. More than ten years later, the team of Innate Ahser of the University of Auckland (New Zealand) repetition in order to determine the evolution of these diseases.

More and more of allergic children
The researchers thus followed nearly 200.000 older children from 6 to 7 years and more than 300.000 of 13-14 years resulting of more than 50 countries of which South Africa, Brazil, Iran, Canada, New Zealand or the United Kingdom. And the results confirm what one feared… The tendencies to increase are more frequent than the declines and more frequently concern young people.

This boom of the allergies relates to in priority eczema for young people and the hay cold for the two studied age groups. But whereas the preceding studies had underlined the increase in asthma at the 13-14 years, the tendency seems to be reversed.

Only the areas of the Asia-Pacific and India present an increase in the three diseases.

Assumptions but few answers
The authors think that these new data can have direct consequences as well on the health policies of the various countries as on the comprehension of these diseases. But on this last point, the assumptions have hardly varied for several years: the modifications of the environment of the children, in particular the urbanization, increase susceptibility to develop allergies.

External but also domestic atmospheric pollution would affect the pulmonary sensitivity and/or the development of the children, thus supporting pathologies respiratoires2. In parallel, a too clean environment could by a lack of infectious requests prevent the maturation of the immune system of the newborn and thus more easily expose it to allergies.

Several studies support this thesis hygienist, in particular those showing that the children placed in crib have more infections but less allergy, contrary to the babies born by Cesarean not having been in contact with the vaginal germs…

Not an asthma but of asthmas!
Since 1995, Fernando Martinez estimated that asthma did not hide only one disease but several entities différentes3. This assumption is taken again by the pr. Sally Wenzel of the University of Colorado4, which tries more specifically to characterize several types of asthma. This step would make it possible tomorrow to better identify each syndrome, to better seize the mechanisms of them and consequently to better deal with them.

The leading article of Lancet even ventures to wonder whether, finally, asthma is not the demonstration of various affections rather than a clean pathological entity. Absurdity, do you think? Not so sure! Until the 19th century, the fever was regarded a disease and not as a symptom. Could it be that asthma knows same retrogradation from here 20,30 or 50 ans5?

Does your child have plates of dry skin? He regularly becomes red and scrapes himself? And if it were about dermatite atopic? At the time of the Dermatological Days of Paris, in December 2003, the prevention and the treatments of this skin disease were in the middle of the debates…

When the skin sees red!

The dermatite atopic key approximately 15 to 20% of the babies. It is to say if this affection is important. It is about a form of eczema which in general declares 3 to 6 months after the birth but which is not caused by the contact with a product involving an allergy. Rednesses, itchings, skin dries… are not easier to live for baby who scrapes himself, awakes the night… and his/her parents with! In some cases, seepages can exist, and crusts to appear.

Not enough of microbes!

One does not know really the origin of this problem of skin. Apparently, there exists a strong genetic component: if the two parents are touched, the risk for the child to develop a atopic dermatite borders the 50%. On the possible causes, the assumption which seems to be confirmed is the excess of hygiene! Our children would grow in too clean environments, too sterile! Seldom in contact with bacteria, their immune system not having “anything to put itself under the tooth” would run off the line a little bit and cause cutaneous ignitions. This assumption is confirmed by the fact that the babies placed earlier in crib, having brothers and sisters or living in the countryside are less prone to the dermatite.

How to prevent?

To prevent the atopic dermatite, that does not want to say to let play his/her children in mud! Because to comply with the rules of hygiene makes it possible to avoid many infections! The simplest solution is to put them in contact with “friendly” bacteria such as those which colonize our digestive tract naturally. For example, the leavens present in yoghourts could limit the risks of dermatite. On this subject, lira our article To prevent the atopic dermatite by the ingestion of bacteria. It would be even more effective than it is the mother who eats yoghourts, as of the end of the pregnancy!

Effective cures

For the parents whose children are touched by the atopic dermatite, not concern! This disease attenuates gradually then generally disappears towards 3 or 4 years. Admittedly, it can perdurer at the adulthood in a little less than 10% of the cases. With regard to the treatment, only a doctor will be able to help you to choose more adapted. In general, it will prescribe you corticoids, which gives good performances to prevent the crises. But of new drugs, appeared in 2003, are very promising. It acts local immunosuppresseurs. They would make it possible to treat the crises and to limit their frequency. But one still misses retreat on their long-term effects. Finally searchs for new drugs should succeed.

Certain infants do not have a chance. Because their body present by places of the red plates, which involve strong itchings and are covered with a thickened, very dry skin with squames or, on the contrary, oozing. They are victims of eczema.

In the toddlers, this cutaneous allergy prevails more readily on the level of the face, often on the level of the knobs. After 2 years, one preferentially meets it on the level of the folds of the elbows and the knees, but certain children suffer from lesions on the level of the hands, the arms or on wider body zones. They are scraped much, often to blood, perspire, and their daily life is faded. This the more so as the plates tend, in these predisposed children, to reappear with the least stress. It is thus not rare that some of these young patients tend to be isolated from the other children and that their parents adopt a protectionist behavior.

An increased probability to be asthmatic
Extremely fortunately for these small patients and their family, the eczema of the child rarefies after 3-4 years. At the adulthood only the most severe forms of the disease persist indeed.

But eczema, in general, is observed in children having of the family antecedents of allergy. For this reason, the eczematous children thus risk thereafter, once their cured cutaneous lesions, to become more frequently than the other asthmatic ones, because this disease is it also of allergic origin. With adolescence, they will be able to as develop more often as the other young people of the rhinitides of allergic origin (hay cold…).

To differentiate from the eczema of contact
Affection of the child with strong hereditary component, this eczema atopic (atopic wants to say allergic) should not be confused with the eczema of contact. This other form of eczema is generally seen in adults and appears by the appearance of an eruption on the skin after the wearing of jewels imagination out of nickel, the use of cosmetics or substances like formaldehyde. One finds in the two diseases a phenomenon of sensitizing to a foreign agent (allergen) but the concerned mechanisms are not completely the same ones.

The eczema of the child is a true allergy, secondary with the racing of the production of certain antibodies, the immunoglobulins E, in answer to allergens of the food (milk, eggs, soya…) or contained in the atmosphere (microscopic pollens, animals like the acarina, dust). Some of them cross the cutaneous barrier, from where the attack of the skin.

The eczema of contact of the adult corresponds, him, rather with a local reaction developed afterwards repeated contacts of the skin with a sensitizing substance. The aspect of the sick skin is a little different: one notes the appearance on the level of the zone reached of multiples small blisters which contain a liquid and can break.

An often disappointing treatment
The eczema of contact cures with the disappearance of the agent in question. Remain that, in practice, this gesture of good sense is not always simple to realize because the allergen can be met in a professional framework.

In the eczema of the child, one will be able, when the allergen is known, to try to remove it, for example by modifying the food of the child or while attacking the source of the allergy (removal of a stuffed mattress of acarina). But, there too, it is often easier to say than to make! A desensitizing could be tried in certain cases, but these children are often sensitive to several substances what complicates this approach.

Also, very often, the treatment will only aim it at correcting the cutaneous lesions, thanks to creams and oils of bath improving the hydration of the skin and possibly, under strict medical control, with the use of corticoids in local form. In order to prevent the appearance of repetitions to the stop of the treatment, the stop of corticoids will be always progressive. It will also be necessary to take care to avoid superinfections of the skin, thanks to a good personal hygiene. Lastly, in the event of too strong itchings, the administration of a drug antihistamine will be able to bring a relief.

The digestive tract has a very rich local immunological system on the level of the mucous membrane, supplemented by a very important ganglionic drainage. This system protects the organization from the viral, bacterial and parasitic antigens by an effective immunizing response which aims at eliminating them. The immune system must also admit food proteins to accept their passage through the mucous membrane. A food contains many proteins indeed. Among them, much prove to be allergens. A food can thus contain forty different allergens.

A predisposition to the allergy
The natural tolerance with foreign food proteins is a completely original biological characteristic. In certain children, there exists a family ground called “atopic”. The atopie is a genetic predisposition to work out antibodies of the class of IgE against the natural allergens (proteins of the environment) coming into contact with the organization by the natural ways: skin and mucous membranes (respiratory, digestive).

Mother’s milk and ignition
The food allergens are the first allergens natural to come into contact with the organization. Indeed, one knows that the food allergens pass, with the state of traces, in the mother’s milk. These very small quantities of food proteins are undoubtedly used with the immune system of the baby to set up his immunological tolerance. In the case of a ground atopic, there is probably a racing of the processes and the creation of a food allergy. It is possible that the food allergy is also supported by the existence of an ignition of the intestinal mucous membrane under the influence of varied factors (viral infections, reaction to the stress, destruction of the intestinal flora, irritation of the digestive mucous membrane, presence of a parasitosis or an intestinal candidose and any cause of increase in the intestinal permeability to proteins of food).

Symptoms
The infant can sensitize himself with food very early, even in utero during the pregnancy. The food allergy of the infants often reaches the digestive tract (vomiting, diarrheas, pains abdominal). It can cause a total atrophy villositaire with persistent diarrhea as it is the case in intolerance with the gluten. In the larger child, the symptoms are very diverse: shock anaphylactic, urticaria, edema of the lips and the atopic language, dermatite, diarrhea, vomiting, colics, eczema, asthma, infections ORL with repetition, etc the share of the food allergy in the shocks anaphylactic for example is from 3 to 15%. In asthma, it would be responsible for 8% of the crises. In the atopic dermatites (eczemas), some advance the figures from 30 to 50%. The more severe the atopic dermatite is, the more it is probable that a food allergy is in question.

The principal food in question
If the food allergies can in theory relate to all food, a score, according to pr. D.A. Monneret-Vautrin, of food in France are most often in question. Certain allergens are responsible for 90% of the cases of allergies: eggs, fish of sea, peanuts or groundnuts, hazel nuts and drupacées (almond, nut, apricot, cherry, quince, fishing, apple, pear, plum, olives), cow’s milk, celeriac, celery salt and others ombellifères (anise, angelica, carrot, chervil, coriandre, cumin, fennel, parsley, green pepper), shellfish (spider crab, crab, shrimp, crayfish, lobster, crawfish, lobster). Other food is more rarely causes some (10% of the cases): exotic fruits (pineapple, banana, fruit of passion, kiwi, khaki, litchi, mango, coconut, papaw), leguminous plants (broad beans, beans, pea, chick-pea, soya), flour of corn, moulds, ox, potato, nut, coconut, chicken, pig, mustard with a possible inductive role of the mustard cataplasms in childhood.

The other allergens are exceptional: garlic, lamb, artichoke, squid, coffee, sweet chestnut, chocolate, red cabbage, chive, scallop, squid, spices and condiments, snail, strawberry, royal jello, rabbit, bay-tree, lilicées, yeast of baker, onion, orange, pigeon, pistachio, pollens, radish, grape, kidneys, buckwheat, sesame, tomato…

Before the age of 1 year, the principal allergens are the egg, the groundnut and the cow’s milk. Between 1 and 3 years, the principal allergens are the egg (31%), the groundnut (18%), milk (12,5%), the fish (12,5%), the groundnut oil, mustard.

Certain risk factors were highlighted: the great diversification of the food, generalized employment and food protein crescent added with the industrial preparations because of their properties, etc agribusiness industry introduces indeed without stop of new ingredients into its preparations.

Some are potentially allergisants:

New cereals;
Varied dry fruits (peanuts, hazel nuts, nut, pistachios, almonds);
Various exotic fruits (khaki, kiwi, litchi, etc);
Varied seeds (poppy, sesame, etc);
Varied proteinic food additives (alpha-amylase, carmine of cochineal, caseinates, gums vegetable, lysozyme, etc);
Presence of protein traces in plant oils (groundnut, nut, sesame, soya, sunflower);
Modified proteins allergisantes (textured soya, surimi of fish, etc).
The development of the allergy to latex is at the origin of allergies crossed with certain plants. The allergy to the dyes and other food additives is often suspectée but difficult to show. The principal accused food additives are especially azo dyes of synthesis like licensed blue (E131), the érythrosine (E127), the red cochineal has (E124) and the tartrazine yellow (E1O2).

The role of the chemical conservatives is as for him badly known. More sensitizing are probably those containing sodium métabisulfites (E222 with E227). The sulphites are so widespread in food industry and pharmaceutical that their calling into question is not always possible.

The food diagnosis of allergy
The diagnosis is difficult. It requires the recourse to an immuno-allergist specialized in food allergy which will decide strategy of assumption of responsibility.

An eruption urticarienne after the meals can be for example an element of presumption. The food risk of allergy is of 20% when none of the two parents is allergic. This risk is of 40% when one of the parents is allergic and goes up to 60% when the two parents are atopic. The food newspaper keeping where the ingestion of all food is noted scrupulously can help the doctor. The cutaneous tests, the proportioning of IgE specific, the tests of provocation (or modes of exclusion) in general make it possible to pose the diagnosis.

The problem of the “masked” allergens is important. The examples are increasingly numerous: there are caseinates in the chicken stock, of the lyzozyme of egg white in certain cheeses (Gruyere, Emmenthaler cheese) for example. The groundnut oil contained in certain dietetic milks was at the origin of dermatites atopic. Currently, adapted milks do not contain any more. Observations of children sensitized in utero with groundnut revealed that the pregnant mothers ate great quantities of peanuts, sitting in front of television.

Treatment
The absolute ousting of responsible food must be recommended. It requires a vigilance of every moment when it is of eggs, milk, groundnut or soya. When an allergy to many food is proven, the recommended mode must be established by a dietetician experienced in order to avoid nutritional deficiencies, in particular vitamin.

The pharmacological treatment comprises an antihistamine and a drug protecting the digestive mucous membrane from the risk of local histamine release (cromoglycate disodic: Nalcron). In the event of serious allergic accidents, corticoids and adrenalin are necessary. When the child presents an high-risk of shock or acute asthma, it is necessary to fill a contract with reception personalized for the school such as it is envisaged by the circular of July 22nd, 1993, n°93-248.

Many unknown factors persists on the natural history of the food allergy. It is not possible to currently forecast the evolution of it: the allergy to proteins of the cow’s milk often cures around 5 years; the allergy to groundnut often persists all the life. Many factors all, not listed, are combined so that at the end of one to three years, in a random way, the child is cured, or in the process of cure, or in a stable condition, or on the contrary in a state of sursensibilisation.

More and more attends, the allergy of the child requires an early and total assumption of responsibility not to become a handicap difficult to live. At the time of the national day of the allergy, Doctissimo gives a progress report on these infantile diseases.

According to the World Health Organization (WHO), the allergy is the 4th chronic disease and the respiratory allergies are in the forefront of the chronic diseases of the child. In France, the proportion of touched child is estimated today at 9% for the asthme1, 10 to 20% for the dermatite atopique2 (eczema) and oscillates between 20 and 40% 3 at the European general population for the allergic rhinitis. Currently, more than 5% of the older children of less 15 years suffer from an allergy alimentaire4. The diagnosis of the allergy as of more the young age is essential to establish a follow-up and an assumption of responsibility adapted and personalized which will facilitate the daily newspaper of the child and will help it to fight its disease on the long run. The point at the time of the national day of the allergie5,6.

Diagnosed early, the child is better neat
Occurring sometimes as of more the young age, the allergy can take multiple forms. Before declaring his child “allergic”, there exist various signals to be supervised: symptoms, factors releases, periodicity… This information will be essential with the doctor allergist to diagnose the allergy and to identify the source of it. Several symptoms can contribute to identify an allergic ground:

The persistence and strong repetition of certain diseases like the bronchiolites, the conjunctivites, the rhinitides, the laryngitides, the sinusitises;
The clinical demonstrations of the allergy are more or less severe and can touch various parts of the body of the child. They can be cutaneous, respiratory and ocular, digestive and oral, or finally general (eczema atopic and urticaria, allergic rhinitis and asthma, oral and digestive reactions, edema of Quincke (or angio-edema) and shock anaphylactic).
If the manifestations of the allergy are sometimes perceived like a simple embarrassment at the time of childhood, they can also develop while growing and become a true handicap. Essential stage in the follow-up of the allergic patient, the early diagnosis of the allergy and the identification of the responsible allergen will allow a real assumption of responsibility necessary to fight it and decrease the evolutionary risks by them. These demonstrations are not always related to an allergic ground. Only a diagnosis carried out by a doctor allergist will be able to make it possible to confirm it. Interrogation, tests cutaneous, blood testings, tests of provocation… the diagnosis must be carried out as of the first signs and particularly in the children at the risk of atopie (heredity).

Allergy and heredity

The independent factor of risk predisposing with the development of an asthma or an allergy remains the existence of a family predisposition.

The risk to become allergic is of:

80%, if the two parents are reached same pathology allergic – 40 to 60% if the two parents are allergic;
20 to 40% if one of the parents is allergic;
5 to 15% if no relative is allergic.
Source: Polonovski J-M., allergic Rhinitis, Impact Boarding school, 1999, p.109-11

The assumption of responsibility of the allergy, essential to avoid its aggravation (appearance of new allergies, development of an asthma or progression of the symptoms) depends on this first stage.

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To treat and accompany the allergic child
The allergic child requires an early assumption of responsibility to prevent and treat the allergic demonstrations and the allergy, to avoid their evolution or the development of new allergies, to facilitate the daily newspaper of the child in order to ensure a normal life to him.

First treatment of the allergy, the mode of ousting consists to decrease or eliminate the contacts with the allergen and the other factors starting (passive smoking, pollution, etc).
The medicamentous treatments make it possible to improve quality of life of the allergic child and to reduce his clinical demonstrations. The symptomatic treatments most frequently used are the antihistamines, corticoids, the antileucotrienes and adrenalin.
Desensitizing (or immunothérapie allergenic) is the only treatment which can modify the evolution of the allergic disease. It improves quality of life of the child, decreases the recourse to the symptomatic treatments and would prevent the risks of appearance of new allergies.
Therapeutic education consists in helping the child and his parents to apprehend his disease. There exist today Schools dedicated to therapeutic education often located or associated with a hospital. The schools of asthma, the schools of the atopie and the schools of the food allergy make it possible to tackle all the questions that the child allergic and his parents are posed to the daily newspaper by the organization of interactive workshops.
The allergic child should not be put or visible treaty differently well off manner because integration is an essential stage of its good development. The control of its environment and the dialog with the daily newspaper are the guarantors of a “normal” childhood. For that, discover our councils to help it at the school, on vacation or to the house and go at the time of the demonstrations organized at the time of the national day of March 23rd.

Appointment with the allergists on March 23rd, 2010

At the time of the 4th French Day of the Allergy, the allergists mobilize themselves in about fifty French cities. Their objective: to help the parents with better managing the allergy of their child to the daily newspaper.

How to know if my child is allergic? Which tests can one practice and at which age? Which are the primary symptoms? Will it be allergic all its life? Which are the treatments? Which practical solutions with the daily newspaper? … All these questions will be tackled the March 2010 during the briefings animated a little everywhere in France by the specialists in the allergy. A decoding of the question and moments of exchange will be with the program of these free meetings, opened with all. All information on the organization of the 4th French day of the allergy is available on Internet site: www.asthme-allergies.org

The evolution of our lifestyle and our food on which has occurred of food allergies is not any more a doubt. But what one suspects less easily is than ascribable climate warming with the man contributes to the increase in the allergens aerosols.

The summer will be hot… for the allergic ones!
The increase in the carbon dioxide concentrations1 (CO ²) associated with climate warming could increase the frequency of the allergies to pollens in the next years. Such are the conclusions of a report of the researchers of Université of Harvard. The scientists are mainly interested in grass pollens with lice, the most abundant allergen in the United States during the end of the summer and the beginning of the autumn. “We inquired into the direct impact of an increase in CO ² concentrations into the production of pollen in an experimental group of grass with lice in order to evaluate the future possible hazards of hay cold and other respiratory diseases, and to develop strategies of prevention” Dr. Peter Wayne declares.

Carbon dioxide increased by 29% since the preindustrial time and a doubling is envisaged during the 50 or 100 next years. This gas is mainly resulting from the combustion of fossil energies. But in addition to the warming of planet and a disturbance of the cycle of water on a world level, an increase in atmospheric CO ² involves a faster and vaster development of the plants.

Result: the production of pollen is increased by 61% in atmospheres enriched in CO ² compared to ambient CO ². “Although these discoveries suggest an increase in the incidence of the hay colds and respiratory diseases connected, it is difficult to judge threat for the public health of this problem” moderates Dr. Wayne. But these researchers underline the need for decreasing the CO ² stack disposals. Let us recall however that the principal country pollutant is also the only one which refuses to reduce its emissions: the United States.

Allergens and viruses support asthma
The preceding ones études2 showed that many allergens could be at the origin of asthma. Same manner, the viral respiratory infections exacerbate the crises during childhood. But few studies until had now inquired into sensitizing and the exposure to certain allergens associated with a viral infection in exacerbation with the asthma attacks in real situation.

With this intention, of the researchers anglais3 followed 60 patients accommodated for an important asthma attack to the hospital of Manchester over one year. Compared with two groups (of the stable cases of asthma and the patients not suffering from respiratory diseases), the patients presented more case of sensitizings to various allergens (cat, dog, acarina, etc) and more case of viral infections.

These statistically significant differences made it possible to determine that the allergens and the viruses act in concert to worsen asthma. To reduce the serious consequences of asthma could thus pass by the reduction of these two risk factors.

The bonds between asthma and rhinitis appear today increasingly narrow, bringing into play similar immunological mechanisms. Thus, the last discoveries made it possible to determine that asthma is very often of origin allergic (three times out of four in the child). With nearly 20% of the population suffering from asthma and/or allergies, these diseases seem today priorities of public health identified by the World Health Organization.

Is the boom of the allergies in our Western companies the other side of the coin of our comfort?

Domestic allergens and habitat: dangerous connections
The pr. Pauli1 recalls thus that “Several studies showed an increase in the prevalence of asthma and diseases allergic like the rhinitides and eczema, in many countries. The rise in the temperature inside the dwellings, the reduction in ventilation and the more frequent presence of pets probably involved a more important exposure to pneumoallergenes of the domestic environment”. According to this allergist, the exposure to these allergens would have consequences for the genetically predisposed people. She would constitute a factor supporting sensitizings and, in certain cases, the bronchial appearance of hyper reactivity (HRB) and asthma attacks.

Biological pollution of the habitat thus gathers the acarina, the allergens of animals, moulds and those rarer like the ficus or food for fish. For each one of these allergens, the interior environment influences via moisture, the lack of ventilation, the presence of animals or cockroaches, overpopulation in the habitat or a bad hygiene. The ousting of the allergens of the interior environment makes it possible to improve the life of the patients. An adviser in environment can within this framework play large a rôle2.

Important geographical disparities
But from one place to another, the frequency of the allergies vary considerably. Sensitizings with the cockroaches are not very important in France compared to the United States. In the Scandinavian countries, the acarina have more evil to develop but the reactions to the pets are in the foreground.

The external allergens include mainly the moulds and pollens with in the foreground the graminaceous ones. More on these geographical and seasonal variations, discover our heading “Parks with the allergens!”

Finally in professional environment, of many irritating substances, allergens or chemical substances are often factors of asthma or professional rhinitis. National observatories allowed to count the principal ones: flour, isocyanates (used in the manufacture of the plastics), the latex, some disinfecting or produced used in the medium of the hairstyle.

Noxious or protective factors
Various studies made it possible to stress that the allergic asthma and diseases are higher in the rich Western countries, with high level of industrialization, that in the countries in the process of development with a strong rural population. The increase in pathologies related to the atopie in the child mainly was allotted to an elevated level atmospheric pollution, in particular automobile. Certain domestic chemical pollutants (nitrogen dioxide, carbon dioxide and passive smoking) involve a hypersensitizing of the allergens and a lowering of the threshold of reaction of the already sensitized people.

Certain allergists and researchers advance the thesis “hygienist”. Because of a too clean environment, the lack of infectious requests would prevent the maturation of the immune system of the newborn. Several studies plead in favor of this assumption: the children placed in crib have more infections but less allergy, the babies born by Cesarean not having been in contact with the vaginal germs have more allergies.

The bonds between the appearance of asthma and certain food (salt, magnesium, grease, vitamin C.) were also the object of studies, just like of other less obvious factors (social status, physical exercise.). The purpose of the creation of an observatory of the quality of the interior air is to better target the industrial pollutants in the interior environment and to describe the potential sources of pollution. More on this subject, discover our article “pollution invades in our houses”.

But certain environmental factors could have a protective role by involving a primary prevention in the children at the risk born allergic parents. Infections during early childhood, the exposure to bacterial toxins in rural environment or the modification of the dietary habits interfering with the flora of the digestive tract would decrease the risk to develop allergies. But such assumptions will have nevertheless to be confirmed before being the object of recommendations.

In 1991, researchers of the whole world took part in the international study on the infantile asthma and allergies (baptized ISAAC). It aimed at determining the proportion of people touched by asthma, the hay cold and the eczéma1. More than ten years later, the team of Innate Ahser of the University of Auckland (New Zealand) repetition in order to determine the evolution of these diseases.

More and more of allergic children
The researchers thus followed nearly 200.000 older children from 6 to 7 years and more than 300.000 of 13-14 years resulting of more than 50 countries of which South Africa, Brazil, Iran, Canada, New Zealand or the United Kingdom. And the results confirm what one feared… The tendencies to increase are more frequent than the declines and more frequently concern young people.

This boom of the allergies relates to in priority eczema for young people and the hay cold for the two studied age groups. But whereas the preceding studies had underlined the increase in asthma at the 13-14 years, the tendency seems to be reversed.

Only the areas of the Asia-Pacific and India present an increase in the three diseases.

Assumptions but few answers
The authors think that these new data can have direct consequences as well on the health policies of the various countries as on the comprehension of these diseases. But on this last point, the assumptions have hardly varied for several years: the modifications of the environment of the children, in particular the urbanization, increase susceptibility to develop allergies.

External but also domestic atmospheric pollution would affect the pulmonary sensitivity and/or the development of the children, thus supporting pathologies respiratoires2. In parallel, a too clean environment could by a lack of infectious requests prevent the maturation of the immune system of the newborn and thus more easily expose it to allergies.

Several studies support this thesis hygienist, in particular those showing that the children placed in crib have more infections but less allergy, contrary to the babies born by Cesarean not having been in contact with the vaginal germs…

Not an asthma but of asthmas!
Since 1995, Fernando Martinez estimated that asthma did not hide only one disease but several entities différentes3. This assumption is taken again by the pr. Sally Wenzel of the University of Colorado4, which tries more specifically to characterize several types of asthma. This step would make it possible tomorrow to better identify each syndrome, to better seize the mechanisms of them and consequently to better deal with them.

In 2010, about half of the world population could be concerned by the allergy. In France, it is already the case for a person on five! In a case on two, they are respiratory problems. Far from being alleviating, these diseases can really handicap the quality of life of the patients. According to a study led on more than 3.600 patients in France, in the United Kingdom, in Germany, in Italy, in Spain and in the United States, the embarrassment caused by this disease is not always lived in the same way.

The nasal congestion remains most awkward
The embarrassment during spring and of the summer is prevalent in all the countries, but it is in France that it is most important (92%) far in front of the United Kingdom (67%) or Germany (80%). The embarrassment is present all the year at the United States, in the United Kingdom, in France and Germany at a person on approximately four, whereas 64% of the Spaniards and 49% of the Italians state to suffer only in spring.

This seasonal variation is found in the origin of the symptoms. The allergic allergies in the open air, or rhinitides seasonal, are causes it number one of symptoms in the five countries, follow-up of the allergies in interior, or allergic rhinitides perennial. The allergies due to the allergens external such as pollens of trees, graminaceous or herbaceous are most frequent in all the countries: 94% in the USA, 90% in the United Kingdom, 82% in Italy, 80% in France, 73% in Germany and 63% in Spain. The allergens of interiors (moulds, dust, acarina) arrive only in second position, more assigning the Americans (68%) and the French (63%) that the Italians (34%). The Americans (35%) and the French (30%) are still most sensitive to the animals far in front of the Spaniards (27%).

More severe symptoms the morning
Although the patients suffer throughout the day, the morning is the worst moment for the majority of them. Thus, allergic Italian and Spanish most frequently indicated the morning as being the moment of the day when the symptoms of the allergy were most severe (with the alarm clock or other hours of the morning).

In France, 58% of the questioned people answered that the morning was the moment of the day when the symptoms of the allergy were strongest, 48% percent in Germany and 46% percent the United Kingdom. Lastly, 39% of probed in Spain announce severe symptoms to the alarm clock. In Italy and France, approximately a third of the people gave the same answer. The symptoms include/understand the nasal obstruction, the itching of the eyes, the sneezes, of the whimperings, of the cephalgias, a cough, itchings of the nose, ears or palate… The French and the Spaniards hold the record of the sneezes.

These difficult alarm clocks could be explained by circadian variations (biological changes whose rate/rhythm is fixed over one day) or by more important concentrations of pollens the morning.

Weeks wasted by the allergy!
But these symptoms and their impact are not confined at the first hours of the day. Badly rested, the allergic subjects have evil to concentrate or to feel energetic or justified. In the USA and the United Kingdom, a person on three expresses her frustration to feel “apart from the true life”. They are the French who complain to be the most tired (59%).