Reviewed by Dr John Pillinger, GP
Insect bites often cause one or more red bumps that are usually itchy and sometimes painful. Often there is a small hole in the middle of the bite, perhaps with the end of the sting sticking out. Apart from this local irritation, the bite is not usually dangerous provided the victim is not allergic to insect bites.
Bee and wasp stings are more likely to cause allergic reactions than other kinds of insect bites.
Bee and wasp stings are more likely to cause allergic reactions than other kinds of insect bites.
Which insects cause stings or bites?Stings or bites are caused by midges, horseflies, bees, wasps, ants, some spiders, fleas, lice, etc.
What does a bite look like? There will be one or more swollen red bumps on the skin. In the middle, you will often see a small hole, which might have the insect's sting sticking out of it.If you wake up in the middle of the night having noticed a painful or itchy lump, check to see if other parts of the body are affected. If there is only one bump, or four or five of them close together, you have probably been stung or bitten. Fleas often bite four or five times in the same area so you may find a couple of these clusters on your body. Some children's diseases can also cause bumps and red, swollen skin. If in doubt, consult your doctor.
What are the symptoms of insect bites?The skin becomes red, swollen, itchy and can be painful. These are the most common symptoms. Sometimes bites cause an allergic reaction. Bites can become infected by scratching. Look out for a rash or swelling that gets worse instead of better. If this happens, see a doctor.Call your doctor immediately if you notice any of the following symptoms:
the person has been stung by many insects at the same time
a rash or swelling that gets worse instead of better
if the site is red, tender and swollen
headache
dizziness
nausea (feeling sick)
pains in the chest
choking or wheezing
difficulty breathing. These may be symptoms of allergy and can be life-threatening if the victim goes into shock. See a doctor immediately or dial 999 for an ambulance.
How to treat an insect bite or stingRemove the sting. Use tweezers to prise it out or scrape it off with your fingernail, or a credit card. Do not attempt to press out the sting, as this will only help the poison spread under the skin.Wash the bite with soap and water, then cool off the skin with ice cubes or an ice-pack that has been wrapped in a cloth or thin towel. Rest the affected area and elevate it if possible to prevent excessive swelling. Do this immediately after the victim has been stung. If necessary, use a painkilling cream or gel or an antihistamine to soothe the itch. If you or a member of your family are allergic to insect bites, talk to your doctor or pharmacist before going on holiday. They may tell you to take an antihistamine with you in tablet form or as an injection. If so, make sure you ask how to use it correctly. Anyone who gets a rash or an itch requiring medical treatment, or who may simply feel unwell following a bite or sting should not drive, as there is a risk of passing out. If in doubt, consult your doctor.
Insect bites and allergiesPeople who are allergic to insect bites should carry a card, bracelet or necklace that lets other people know about their allergy. If the doctor has prescribed medication for you to be used in case of an allergic reaction, it is important that both you and your family know exactly how to use it.
How to avoid getting stung
If surrounded by a swarm of bees or wasps, move out of the way SLOWLY. Do not try to wave the insects away. Violent movements will only excite them and make them more aggressive and likely to attack.
Insect repellents are effective.
Never aim a blow at a wasps' or bees' nest or attempt to throw them because the insects will immediately attack.
Stay away from things that attract insects, such as flowers, trees, bushes and piles of wood.
Be extra careful if you are eating or drinking (especially sweet things) outside.
Smells and bright colours attract insects. Avoid scented creams and strong perfumes if you are going to spend time outside.
Long sleeves, long trousers, socks, shoes and gloves help protect you from stings.
Close the windows in the house and the car to keep the insects out.
Look out for insects' nests in your home or garden and have them removed immediately.
Protective gear such as mesh covers for the face can be very effective against the nuisance of the highland midge in summer for example.
Based on a text by Vibeke Manniche, paediatrician, PhD
Monday, August 18, 2008
Stings and insect bites
"In the initial years of our life we forget our health while going after wealth, in the later years of our life we spend our wealth to take care of our health... It's today reality. Health is not everything, BUT without health everything is nothing."
House dust mite allergy
Reviewed by Dr Paul Klenerman, specialist and Professor Brian Lipworth, professor of allergies and respiratory medicine
What is house dust mite allergy? House mite allergy is a hypersensitive reaction to proteins in the excretion of dust mites. The protein attacks the respiratory passages causing hay fever and asthma. It will aggravate atopic dermatitis in people who have a tendency to this problem. House dust mites are found in all homes. They are microscopic organisms that thrive in warm and humid houses with lots of food - human skin. The mites prefer to live in beds and, because we spend about a third of the day in bed, we inhale large quantities of dust mite allergens.
How do you become allergic to house dust mites? The excretion of the mites contains a number of protein substances. When these are inhaled or touch the skin, the body produces antibodies. These antibodies cause the release of a chemical called histamine that leads to swelling and irritation of the upper respiratory passages - typical asthma and hay fever symptoms. The predisposition for allergy is often hereditary. Unlike pollen, dust mites are present all year round causing constant allergy - 'perennial' allergic rhinitis. The excretion from the mites dries out and can be launched into the air when someone walks over a rug, sits down in a chair, or shakes the bed clothes, giving allergic people immediate symptoms.
What are the symptoms of house dust mite allergy?
Hay fever, runny nose, itching, sneezing.
Watering eyes.
Asthma, difficulty in breathing.
Infantile eczema (a skin disease) may get worse.
What makes the symptoms worse?
Air pollution such as tobacco smoke or car fumes.
How does the doctor make the diagnosis? It is often enough to tell the doctor when, where and how you get the symptoms. Skin tests and various blood tests can be used for confirmation.
Good adviceIt is best to do everything possible to avoid hypersensitivity to house dust mites. People who have perennial rhinitis, inflamed mucous membrane of the nose, or are allergic to house dust mites should try to adapt their homes.
Have as little furniture as possible in which mites can live.
Clean walls, woodwork and floors with wet cloths. The floor can be polished.
Only use rugs that can be washed once a week.
Use bedding that can be washed often, cotton sheets, washable bottom sheets and synthetic blankets or duvets. Don't use woollen blankets or quilts.
Make sure your chairs are made of wood or plastic.
If you can, use plastic curtains and dust them daily.
Use wet cloths and a vacuum cleaner with a no bag vortex and allergen filter to clean the house thoroughly, preferably every day, but at least twice a week.
Avoid dust traps like teddy bears, cushions, dried flowers, bric-a-brac and toys.
Wash bedding etc at a temperature of at least 60°C to kill the house dust mites.
Leave bedding, duvets, pillows and mattress hanging outside for an hour every day or as often as practical.
Put duvets and pillows in plastic bags and put them in the freezer for 24 hours at least once a month.
You may want to sleep on a cheap mattress that you can exchange for a new one at least every six months.
Dust mites hate dry and cold air, so try to air the house every day and don't use an air humidifier, which will only make matters worse. If the lower edge of the window is moist when you wake up in the morning, there is too much humidity in the air.
Do not spray the house, it may worsen your symptoms.
Do not touch dusty objects like books and old clothes.
When you are likely to be exposed to substances that give you a reaction, eg when you are house cleaning, you should wear a mask.
Don't allow smoking in the house.
What complications are possible?
You are predisposed to other respiratory diseases.
You are also predisposed to otitis, inflammation of the ear.
You may have trouble sleeping and suffer from chronic fatigue.
Hospitalisation following a severe asthma attack.
Future prospects If you are allergic to house dust mites, it is important that you don't expose yourself to the dust mite allergen because it increases your chances of developing asthma. The best remedy against house dust mites is described under the heading 'Good advice' above. Your symptoms can be controlled by treatment, but you can't escape your hypersensitivity. If severe dust mite allergy is the only form of allergy you suffer from, your doctor may want to try hyposensitisation - a 'vaccination' against the allergen. This tolerance treatment involves regular allergen injections in increased doses over a period of five years, but is not routinely given and is not always successful.
What medicine is given?
Antihistamine tablets or syrup (eg loratidine, cetirizine). These lessen the allergic reaction by blocking the actions of histamine. They relieve hayfever symptoms.
Nasal sprays or drops containing sodium cromoglicate, corticosteroids (eg beclometasone) or antihistamines (eg levocabastine) can be used to reduce nasal inflammation and control symptoms in the nose.
Eye drops containing sodium cromoglicate, nedocromil, or antihistamines (eg azelastine) reduce eye inflammation and can be used if eye symptoms are a particular problem.
If the allergy causes asthmatic symptoms, some of the asthma medication below may be used
Relievers (bronchodilators): these are quick-acting medicines that relax the muscles of the airways. They are used when required to relieve shortness of breath.
Preventers: these act over a longer time and work by reducing the inflammation within the airways. They should be used regularly for maximum benefit. When the dosage and type of preventive medicine is correct, there will be little need for reliever medicines.
RelieversThere are three groups of these.
Beta-2 agonistsBeta-2 agonists cause the airways to relax and widen. Examples of those which act for a short time (3 or 4 hours following a single dose) are salbutamol and terbutaline. These medicines are inhaled from a variety of delivery devices, the most familiar being the pressurised metered-dose-inhaler (MDI). When inhaled, these types of medicines work within minutes to open the airways, making breathing easier.Longer-acting beta-2 agonists include salmeterol and formoterol. Their action lasts over 12 hours, making them suitable for twice daily dosage to keep the airways open.
AnticholinergicOne of the ways in which the size of the airways is naturally controlled is through nerves that connect to the muscles surrounding the airways. The nerve impulses cause the muscles to contract, thus narrowing the airway. Anticholinergic medicines such as ipratropium block this effect, allowing the airways to open. The size of this effect is fairly small, so it is most noticeable if the airways have already been narrowed by other conditions, such as chronic bronchitis.
Theophyllines and aminophyllineTheophyllines and aminophylline are given by mouth and are less commonly used in Britain because they are more likely to produce side effects than inhaled treatment. They are still in very wide use throughout the world. All three types of reliever can be combined if necessary.
PreventersThere are three main groups of these.
CorticosteroidsCorticosteroids (or 'steroids') work to reduce the amount of inflammation within the airways, reducing their tendency to contract. They are usually given as inhaled treatment, although sometimes oral steroid tablets may be required for severe attacks. Although steroids are powerful medicines with many potential side effects their safety in asthma has been well established. It is also important to balance the problems that arise from poorly treated asthma against the improvement in health which occurs when the condition is well treated.
CromonesThere are two kinds of cromones: sodium cromoglicate and nedocromil. They also act to reduce inflammation of the airways. They tend to be best for mild asthma symptoms and are more effective in children than adults. The medicines are given by inhalation and are usually very well tolerated.
Leukotriene receptor antagonistsLeukotriene receptor antagonists are compounds released by inflammatory cells within the lungs and which have a powerful constricting effect upon the airways. By blocking this effect with these antagonist medicines the constriction is reversed. There are two such medicines currently available: montelukast and zafirlukast.Most cases of allergic asthma are best controlled with an inhaled corticosteroid, eg beclometasone, which is taken at regular intervals as a preventative measure. A beta-2 agonist, eg salbutamol, is used in conjunction with this to relieve symptoms when necessary. For patients who have associated perennial or seasonal allergic rhinitis the use of an antihistimine, eg cetirizine, is often useful.
Based on a text by Dr Flemming Andersen
What is house dust mite allergy? House mite allergy is a hypersensitive reaction to proteins in the excretion of dust mites. The protein attacks the respiratory passages causing hay fever and asthma. It will aggravate atopic dermatitis in people who have a tendency to this problem. House dust mites are found in all homes. They are microscopic organisms that thrive in warm and humid houses with lots of food - human skin. The mites prefer to live in beds and, because we spend about a third of the day in bed, we inhale large quantities of dust mite allergens.
How do you become allergic to house dust mites? The excretion of the mites contains a number of protein substances. When these are inhaled or touch the skin, the body produces antibodies. These antibodies cause the release of a chemical called histamine that leads to swelling and irritation of the upper respiratory passages - typical asthma and hay fever symptoms. The predisposition for allergy is often hereditary. Unlike pollen, dust mites are present all year round causing constant allergy - 'perennial' allergic rhinitis. The excretion from the mites dries out and can be launched into the air when someone walks over a rug, sits down in a chair, or shakes the bed clothes, giving allergic people immediate symptoms.
What are the symptoms of house dust mite allergy?
Hay fever, runny nose, itching, sneezing.
Watering eyes.
Asthma, difficulty in breathing.
Infantile eczema (a skin disease) may get worse.
What makes the symptoms worse?
Air pollution such as tobacco smoke or car fumes.
How does the doctor make the diagnosis? It is often enough to tell the doctor when, where and how you get the symptoms. Skin tests and various blood tests can be used for confirmation.
Good adviceIt is best to do everything possible to avoid hypersensitivity to house dust mites. People who have perennial rhinitis, inflamed mucous membrane of the nose, or are allergic to house dust mites should try to adapt their homes.
Have as little furniture as possible in which mites can live.
Clean walls, woodwork and floors with wet cloths. The floor can be polished.
Only use rugs that can be washed once a week.
Use bedding that can be washed often, cotton sheets, washable bottom sheets and synthetic blankets or duvets. Don't use woollen blankets or quilts.
Make sure your chairs are made of wood or plastic.
If you can, use plastic curtains and dust them daily.
Use wet cloths and a vacuum cleaner with a no bag vortex and allergen filter to clean the house thoroughly, preferably every day, but at least twice a week.
Avoid dust traps like teddy bears, cushions, dried flowers, bric-a-brac and toys.
Wash bedding etc at a temperature of at least 60°C to kill the house dust mites.
Leave bedding, duvets, pillows and mattress hanging outside for an hour every day or as often as practical.
Put duvets and pillows in plastic bags and put them in the freezer for 24 hours at least once a month.
You may want to sleep on a cheap mattress that you can exchange for a new one at least every six months.
Dust mites hate dry and cold air, so try to air the house every day and don't use an air humidifier, which will only make matters worse. If the lower edge of the window is moist when you wake up in the morning, there is too much humidity in the air.
Do not spray the house, it may worsen your symptoms.
Do not touch dusty objects like books and old clothes.
When you are likely to be exposed to substances that give you a reaction, eg when you are house cleaning, you should wear a mask.
Don't allow smoking in the house.
What complications are possible?
You are predisposed to other respiratory diseases.
You are also predisposed to otitis, inflammation of the ear.
You may have trouble sleeping and suffer from chronic fatigue.
Hospitalisation following a severe asthma attack.
Future prospects If you are allergic to house dust mites, it is important that you don't expose yourself to the dust mite allergen because it increases your chances of developing asthma. The best remedy against house dust mites is described under the heading 'Good advice' above. Your symptoms can be controlled by treatment, but you can't escape your hypersensitivity. If severe dust mite allergy is the only form of allergy you suffer from, your doctor may want to try hyposensitisation - a 'vaccination' against the allergen. This tolerance treatment involves regular allergen injections in increased doses over a period of five years, but is not routinely given and is not always successful.
What medicine is given?
Antihistamine tablets or syrup (eg loratidine, cetirizine). These lessen the allergic reaction by blocking the actions of histamine. They relieve hayfever symptoms.
Nasal sprays or drops containing sodium cromoglicate, corticosteroids (eg beclometasone) or antihistamines (eg levocabastine) can be used to reduce nasal inflammation and control symptoms in the nose.
Eye drops containing sodium cromoglicate, nedocromil, or antihistamines (eg azelastine) reduce eye inflammation and can be used if eye symptoms are a particular problem.
If the allergy causes asthmatic symptoms, some of the asthma medication below may be used
Relievers (bronchodilators): these are quick-acting medicines that relax the muscles of the airways. They are used when required to relieve shortness of breath.
Preventers: these act over a longer time and work by reducing the inflammation within the airways. They should be used regularly for maximum benefit. When the dosage and type of preventive medicine is correct, there will be little need for reliever medicines.
RelieversThere are three groups of these.
Beta-2 agonistsBeta-2 agonists cause the airways to relax and widen. Examples of those which act for a short time (3 or 4 hours following a single dose) are salbutamol and terbutaline. These medicines are inhaled from a variety of delivery devices, the most familiar being the pressurised metered-dose-inhaler (MDI). When inhaled, these types of medicines work within minutes to open the airways, making breathing easier.Longer-acting beta-2 agonists include salmeterol and formoterol. Their action lasts over 12 hours, making them suitable for twice daily dosage to keep the airways open.
AnticholinergicOne of the ways in which the size of the airways is naturally controlled is through nerves that connect to the muscles surrounding the airways. The nerve impulses cause the muscles to contract, thus narrowing the airway. Anticholinergic medicines such as ipratropium block this effect, allowing the airways to open. The size of this effect is fairly small, so it is most noticeable if the airways have already been narrowed by other conditions, such as chronic bronchitis.
Theophyllines and aminophyllineTheophyllines and aminophylline are given by mouth and are less commonly used in Britain because they are more likely to produce side effects than inhaled treatment. They are still in very wide use throughout the world. All three types of reliever can be combined if necessary.
PreventersThere are three main groups of these.
CorticosteroidsCorticosteroids (or 'steroids') work to reduce the amount of inflammation within the airways, reducing their tendency to contract. They are usually given as inhaled treatment, although sometimes oral steroid tablets may be required for severe attacks. Although steroids are powerful medicines with many potential side effects their safety in asthma has been well established. It is also important to balance the problems that arise from poorly treated asthma against the improvement in health which occurs when the condition is well treated.
CromonesThere are two kinds of cromones: sodium cromoglicate and nedocromil. They also act to reduce inflammation of the airways. They tend to be best for mild asthma symptoms and are more effective in children than adults. The medicines are given by inhalation and are usually very well tolerated.
Leukotriene receptor antagonistsLeukotriene receptor antagonists are compounds released by inflammatory cells within the lungs and which have a powerful constricting effect upon the airways. By blocking this effect with these antagonist medicines the constriction is reversed. There are two such medicines currently available: montelukast and zafirlukast.Most cases of allergic asthma are best controlled with an inhaled corticosteroid, eg beclometasone, which is taken at regular intervals as a preventative measure. A beta-2 agonist, eg salbutamol, is used in conjunction with this to relieve symptoms when necessary. For patients who have associated perennial or seasonal allergic rhinitis the use of an antihistimine, eg cetirizine, is often useful.
Based on a text by Dr Flemming Andersen
"In the initial years of our life we forget our health while going after wealth, in the later years of our life we spend our wealth to take care of our health... It's today reality. Health is not everything, BUT without health everything is nothing."
Hay fever and perennial allergic rhinitis
Hay fever and perennial allergic rhinitis
Reviewed by Professor Brian Lipworth, professor of allergies and respiratory medicine
What is hay fever? Hay fever, otherwise known as seasonal allergic rhinitis, is an allergic reaction to airborne substances such as pollen that get into the upper respiratory passages - the nose, sinus, throat - and also the eyes.
What's in a name?
The name hay fever is misleading because symptoms don't just occur in autumn when hay is gathered and never include fever.
Hay fever is the most common of all the allergic diseases - about 15 per cent of the population in industrialised countries suffer from this condition. Symptoms usually appear in childhood first and then lessen by the age of 30 or 40.Perennial allergic rhinitis is a similar allergy that occurs all year round and is caused by things such as house dust, mites and pets. However the predominant allergen changes from time to time.
Why do you get hay fever?
Frequent sneezing is characteristic of hay fever.
Different microscopic substances get into the nose and cause the body to produce antibodies and release histamine. Histamine irritates the upper respiratory passages, making them swell and producing the typical hay fever symptoms. A tendency to suffer allergies is often hereditary. The most common causes of hay fever are:
tree pollen such as elder, elm, hazel and especially birch (spring hay fever).
grass pollen (summer hay fever).
mugwort and hybrids such as chrysanthemum (autumn hay fever).
house dust mites and mould fungus - particularly associated with perennial allergic rhinitis.
What are the symptoms of hay fever?
Itchy and watery eyes
Frequent sneezing, a bunged up or runny nose
Itching on the roof of the mouth
Coughing
Wheezing or a burning sensation in the throat.
What can cause hay fever?
The pollen to which you are allergic.
Genetic predisposition associated with other atopic diseases, eg eczema or asthma.
How does the doctor make the diagnosis? Often it will be enough to tell the doctor when, where, and how your symptoms occur. Skin tests and specific blood tests can be used to confirm what exactly you are allergic to.
Good advice
If your hay fever is caused by various pollens, try to keep doors and windows shut during the pollen season.
Let someone else mow the lawn.
Check pollen forecasts. Try to avoid outdoor activities if very high.
In the long termHay fever sufferers are more vulnerable to other allergic respiratory diseases, eg asthma, and sleeping difficulties that can lead to chronic fatigue (because of blocked nasal passages and snoring).If you suffer from hay fever you should do whatever you can to avoid substances that provoke hypersensitivity. Otherwise you will increase the risk of developing other, more serious, allergic diseases.Symptoms can be controlled through treatment, but you can't get rid of the allergy itself. However, hay fever is usually more of a nuisance than a harm to health, and the symptoms of many people improve over time.
What medicine can I take? There are numerous medicines that can be used to relieve the symptoms of hay fever. Many of these are now available over-the-counter from pharmacies and your pharmacist will be able to advise on which are most suitable for you. The choice will often depend on which symptoms trouble you the most.
Antihistamine tablets and syrups Antihistamines prevent the histamine your body produces to the allergen from causing the allergic symptoms. They are good at relieving sneezing, itching and runny nose and eye symptoms, but are slightly less effective at reducing a blocked nose. There are two main types:
those that cause drowsiness, such as chlorpheniramine and promethazine
newer medicines that cause less or no drowsiness, such as acrivastine, cetirizine and loratadine. Many people prefer to use the newer medicines because they can usually be taken once daily and allow you to get on with your daily activities without problems. Many antihistamines can be bought over-the-counter, but some, eg terfenadine, are available on prescription only.
Antihistamine nasal sprays and drops Antihistamines that are used directly in the nose are azelastine and levocabastine, both of which can be bought over-the-counter. These can be used to provide rapid relief of sneezing, itching and runny nose, but have no effect on other symptoms such as itchy eyes.They can also be used regularly to prevent nasal symptoms, but are less effective than nasal corticosteroids.
Nasal corticosteroids There are two steroid nasal preparations that can be bought from pharmacies: beclomethasone and flunisolide. Others are also available on prescription only. Nasal steroids reduce inflammation in the nasal passages and are better than oral antihistamines at relieving most nasal symptoms, including a blocked nose. They also relieve eye symptoms. Nasal steroids have to be used regularly to be effective. They are best started a couple of weeks before the pollen season begins.
Nasal cromoglicate Nasal sprays containing sodium cromoglicate are also used to prevent nasal symptoms, ideally starting treatment a couple of weeks before the pollen season. They are less effective than nasal corticosteroids, but are often the first choice for young children.
Nasal decongestants Nose drops and sprays containing decongestants such as xylometazoline can be bought over-the-counter to treat a blocked nose. They should only be used for a few days, otherwise they can cause ‘rebound congestion’ when you stop using them.
Antihistamine eye dropsAntihistamine drops can be useful if eye symptoms are your biggest problem. They include antazoline, azelastine and levocabastine, which you can buy from pharmacies. The drops provide rapid relief from itchy, red, watery eyes.
Cromoglicate eye dropsDrops containing sodium cromoglicate or nedocromil should be used regularly, as with nasal cromoglicate products, to prevent the allergic reaction occurring. Cromoglicate drops can be bought from pharmacies and are also suitable if eye symptoms prevail.
Immunotherapy (desensitising vaccines)This treatment is only used when allergen avoidance and medicines have proved ineffective at treating a severe allergy. Injections of small amounts of the known allergy-causing substance are given to create tolerance to the allergen and prevent the immune system producing too much histamine when it encounters it. This treatment has to take place over a long time and requires strict adherence.
Based on a text by Dr Flemming Andersen
Reviewed by Professor Brian Lipworth, professor of allergies and respiratory medicine
What is hay fever? Hay fever, otherwise known as seasonal allergic rhinitis, is an allergic reaction to airborne substances such as pollen that get into the upper respiratory passages - the nose, sinus, throat - and also the eyes.
What's in a name?
The name hay fever is misleading because symptoms don't just occur in autumn when hay is gathered and never include fever.
Hay fever is the most common of all the allergic diseases - about 15 per cent of the population in industrialised countries suffer from this condition. Symptoms usually appear in childhood first and then lessen by the age of 30 or 40.Perennial allergic rhinitis is a similar allergy that occurs all year round and is caused by things such as house dust, mites and pets. However the predominant allergen changes from time to time.
Why do you get hay fever?
Frequent sneezing is characteristic of hay fever.
Different microscopic substances get into the nose and cause the body to produce antibodies and release histamine. Histamine irritates the upper respiratory passages, making them swell and producing the typical hay fever symptoms. A tendency to suffer allergies is often hereditary. The most common causes of hay fever are:
tree pollen such as elder, elm, hazel and especially birch (spring hay fever).
grass pollen (summer hay fever).
mugwort and hybrids such as chrysanthemum (autumn hay fever).
house dust mites and mould fungus - particularly associated with perennial allergic rhinitis.
What are the symptoms of hay fever?
Itchy and watery eyes
Frequent sneezing, a bunged up or runny nose
Itching on the roof of the mouth
Coughing
Wheezing or a burning sensation in the throat.
What can cause hay fever?
The pollen to which you are allergic.
Genetic predisposition associated with other atopic diseases, eg eczema or asthma.
How does the doctor make the diagnosis? Often it will be enough to tell the doctor when, where, and how your symptoms occur. Skin tests and specific blood tests can be used to confirm what exactly you are allergic to.
Good advice
If your hay fever is caused by various pollens, try to keep doors and windows shut during the pollen season.
Let someone else mow the lawn.
Check pollen forecasts. Try to avoid outdoor activities if very high.
In the long termHay fever sufferers are more vulnerable to other allergic respiratory diseases, eg asthma, and sleeping difficulties that can lead to chronic fatigue (because of blocked nasal passages and snoring).If you suffer from hay fever you should do whatever you can to avoid substances that provoke hypersensitivity. Otherwise you will increase the risk of developing other, more serious, allergic diseases.Symptoms can be controlled through treatment, but you can't get rid of the allergy itself. However, hay fever is usually more of a nuisance than a harm to health, and the symptoms of many people improve over time.
What medicine can I take? There are numerous medicines that can be used to relieve the symptoms of hay fever. Many of these are now available over-the-counter from pharmacies and your pharmacist will be able to advise on which are most suitable for you. The choice will often depend on which symptoms trouble you the most.
Antihistamine tablets and syrups Antihistamines prevent the histamine your body produces to the allergen from causing the allergic symptoms. They are good at relieving sneezing, itching and runny nose and eye symptoms, but are slightly less effective at reducing a blocked nose. There are two main types:
those that cause drowsiness, such as chlorpheniramine and promethazine
newer medicines that cause less or no drowsiness, such as acrivastine, cetirizine and loratadine. Many people prefer to use the newer medicines because they can usually be taken once daily and allow you to get on with your daily activities without problems. Many antihistamines can be bought over-the-counter, but some, eg terfenadine, are available on prescription only.
Antihistamine nasal sprays and drops Antihistamines that are used directly in the nose are azelastine and levocabastine, both of which can be bought over-the-counter. These can be used to provide rapid relief of sneezing, itching and runny nose, but have no effect on other symptoms such as itchy eyes.They can also be used regularly to prevent nasal symptoms, but are less effective than nasal corticosteroids.
Nasal corticosteroids There are two steroid nasal preparations that can be bought from pharmacies: beclomethasone and flunisolide. Others are also available on prescription only. Nasal steroids reduce inflammation in the nasal passages and are better than oral antihistamines at relieving most nasal symptoms, including a blocked nose. They also relieve eye symptoms. Nasal steroids have to be used regularly to be effective. They are best started a couple of weeks before the pollen season begins.
Nasal cromoglicate Nasal sprays containing sodium cromoglicate are also used to prevent nasal symptoms, ideally starting treatment a couple of weeks before the pollen season. They are less effective than nasal corticosteroids, but are often the first choice for young children.
Nasal decongestants Nose drops and sprays containing decongestants such as xylometazoline can be bought over-the-counter to treat a blocked nose. They should only be used for a few days, otherwise they can cause ‘rebound congestion’ when you stop using them.
Antihistamine eye dropsAntihistamine drops can be useful if eye symptoms are your biggest problem. They include antazoline, azelastine and levocabastine, which you can buy from pharmacies. The drops provide rapid relief from itchy, red, watery eyes.
Cromoglicate eye dropsDrops containing sodium cromoglicate or nedocromil should be used regularly, as with nasal cromoglicate products, to prevent the allergic reaction occurring. Cromoglicate drops can be bought from pharmacies and are also suitable if eye symptoms prevail.
Immunotherapy (desensitising vaccines)This treatment is only used when allergen avoidance and medicines have proved ineffective at treating a severe allergy. Injections of small amounts of the known allergy-causing substance are given to create tolerance to the allergen and prevent the immune system producing too much histamine when it encounters it. This treatment has to take place over a long time and requires strict adherence.
Based on a text by Dr Flemming Andersen
"In the initial years of our life we forget our health while going after wealth, in the later years of our life we spend our wealth to take care of our health... It's today reality. Health is not everything, BUT without health everything is nothing."
Food allergies
Reviewed by Professor Brian Lipworth, professor of allergies and respiratory medicine
What are food allergies? A food allergy is an abnormal hypersensitive reaction that occurs after eating a normal amount of a certain food. The reaction is repeated every time the food in question is eaten. Although food allergies are rare, they most commonly occur in children under the age of four. The most frequent food allergies are to milk, eggs, fish, nuts, citrus fruit and tomatoes. Children with food allergies often have several different recurrent symptoms. These include severe children's eczema (or skin rash), vomiting and diarrhoea (for no apparent reason), asthmatic bronchitis or asthma and allergic cold.
How do food allergies begin? A hypersensitive reaction towards food is usually a type 1 allergic reaction to something in the diet. Almost one third of the population omit certain foods from their diet or their family's diet because they believe they will cause an allergic reaction. But in fact, only about one third of children suffer allergic reactions towards food, and most of them will outgrow this before they reach the age of three. Among adults, only about 1 per cent suffer from an allergy to a particular food.
How to avoid food allergies Type 1 allergic diseases are to some extent inherited. For this reason, it is advisable to talk to your general practitioner or allergy specialist before you get pregnant.
What should I do if I suspect my child has a food allergy?
If you are in any doubt contact your doctor.
Do not put your child on a strange restricted diet that could result in malnutrition.
A change in a child's bowel movements is not a sign of food allergy.
It is completely normal for a child's bowel movements to change if their diet is changed.
Most importantly: relax. Don't assume that your child is suffering from a food allergy until this has been confirmed by an allergy specialist.
Can allergies be treated? If your child suffers from a food allergy the treatment will be a diet that eliminates the food that causes the reaction. Based on a text by Dr Flemming Andersen
What are food allergies? A food allergy is an abnormal hypersensitive reaction that occurs after eating a normal amount of a certain food. The reaction is repeated every time the food in question is eaten. Although food allergies are rare, they most commonly occur in children under the age of four. The most frequent food allergies are to milk, eggs, fish, nuts, citrus fruit and tomatoes. Children with food allergies often have several different recurrent symptoms. These include severe children's eczema (or skin rash), vomiting and diarrhoea (for no apparent reason), asthmatic bronchitis or asthma and allergic cold.
How do food allergies begin? A hypersensitive reaction towards food is usually a type 1 allergic reaction to something in the diet. Almost one third of the population omit certain foods from their diet or their family's diet because they believe they will cause an allergic reaction. But in fact, only about one third of children suffer allergic reactions towards food, and most of them will outgrow this before they reach the age of three. Among adults, only about 1 per cent suffer from an allergy to a particular food.
How to avoid food allergies Type 1 allergic diseases are to some extent inherited. For this reason, it is advisable to talk to your general practitioner or allergy specialist before you get pregnant.
What should I do if I suspect my child has a food allergy?
If you are in any doubt contact your doctor.
Do not put your child on a strange restricted diet that could result in malnutrition.
A change in a child's bowel movements is not a sign of food allergy.
It is completely normal for a child's bowel movements to change if their diet is changed.
Most importantly: relax. Don't assume that your child is suffering from a food allergy until this has been confirmed by an allergy specialist.
Can allergies be treated? If your child suffers from a food allergy the treatment will be a diet that eliminates the food that causes the reaction. Based on a text by Dr Flemming Andersen
"In the initial years of our life we forget our health while going after wealth, in the later years of our life we spend our wealth to take care of our health... It's today reality. Health is not everything, BUT without health everything is nothing."
Pet allergies
Reviewed by Dr Paul Klenerman, specialist and Professor Brian Lipworth, professor of allergies and respiratory medicine
What is a pet allergy? The proteins from the hair, saliva or urine of household pets cause an allergic reaction that attacks the eyes and the airways, like hay fever, and can result in asthmatic symptoms. It may also cause atopic dermatitis or a nettle rash.It is often difficult to avoid the allergens that can come from other people's pets or be transported by people who have been in contact with animals. School classes can be overloaded with pet allergens.Most often the allergies are to cats or dogs, but rats, mice, guinea pigs, hamsters, pet birds, horses, cows or poultry can be involved.
Why are we allergic to pets?Pet allergens are proteins, which when in contact with the skin or breathed in, cause an allergic reaction that provokes the body into producing histamine. The histamine produces swelling and irritation of the upper airways and causes typical hay fever and asthmatic symptoms. The tendency toward allergic reactions is often hereditary.People who have had asthmatic bronchitis as children in a household with pets, especially a cat, are at a high risk of developing allergies towards cats as they get older.Pets are very important in modern life. When moving house or flat, the chances of the former owners having had a pet are high. It may take months, and in a modern insulated flat years, before the level of allergens are so low that an allergic reaction is not a possibility.If pet allergies are suspected, the new house owner should try to stay away from home for a fortnight to see whether the symptoms disappear. A doctor or specialist could be asked to conduct an allergy test to confirm the diagnosis.
What are the signs of pet allergy?When touching the fur or feathers of pets; objects containing pet allergens; or breathing in pet allergens; the following reactions may result:
hay fever (seasonal allergic rhinitis). Sneezing and a running or blocked nose.
eye symptoms such as itching and watering eyes.
asthma. Coughing and wheezing. (Children with asthma).
children's eczema. Itchy skin disease with red patches.
nettle rash. An itchy reddish rash.
What makes the symptoms worse?
Polluted air, tobacco smoke and car fumes may precipitate asthma.
Any other allergens in the environment (eg pollens).
How does the doctor make the diagnosis?Often it is enough for the doctor to know when and where the patient got their symptoms. Skin tests and blood samples can confirm the diagnosis.
What should I do? If you have allergic symptoms, you should avoid things that provoke them and it is advisable to ensure that in your house:
there are no pets.
there are as few pieces of furniture as possible.
the walls, wood and floors are as clean as possible. The floor should be polished. If necessary clean the walls, woodwork and floors regularly.
only carpets that can be cleaned every week are used.
only sheets that can be washed regularly, like cotton sheets, washable mattresses and synthetic blankets and pillows should be used. Do not use woolen or cotton blankets.
only plastic or wooden chairs should be used . Do not have upholstered furniture.
hang plastic curtains if possible. Dust them every day.
use moist rags and a vacuum cleaner that has a vortex with no bag and an allergen filter to clean the house thoroughly, at least twice a week.
avoid objects that attract dust like teddy bears, pillows, dried flowers, bric-a-brac and toys.
What else can I do?
Do not touch objects that are very dusty, such as books and old clothes.
If you are exposed to allergy provoking elements you should wear a mask. Even better, make people without allergies do the cleaning!
Do not allow smoking in your house.
But what if I still want pets?You have to be aware that there is a huge possibility that you may have to find another home for your pet. If you are in this situation, you should contact the RSPCA and ask them for advice.There are low allergen producing animals, such as furless cats, which may sometimes be OK. (But you may be allergic to cat spit and not cat fur? If you want a black and white cat to stroke, how much fun is a cat without fur?)You should still decorate your house as mentioned above. Even if the animal is only visiting you so that you can check if you are able to live with it, it may still take half a year or more before you develop symptoms. Dogs and cats should be bathed at least once a month in plain water. Remember to dry the animals properly afterwards. It has been proved that a monthly 'cat wash' lowers the level of allergens in the house.But what about fish or turtles? This may sometimes work but then you may be allergic to the food they eat.Rabbits and guinea pigs do not produce so much hair but their urine may cause trouble. They should not live in the house but outside and be cared for by a person without allergies. It is possible to buy anti-allergen filters and special air filtering systems (HEPA). Talk to your doctor or an organization for patients with asthma or allergies before you buy these devices.Keep animals out of bedrooms and public rooms. It would be preferable to keep them outside of the house. Every time you touch a pet, wash your hands thoroughly.
What complications are possible?
Greater susceptibility to other illnesses of the airways.
Ear infections.
Difficulties sleeping and insomnia.
Worsening of asthma, and maybe even the possibility of a severe asthma attack.
What are my prospects?Pet owners should know it is important to avoid their allergens because of the increase in the risk of developing, or worsening, asthma. The symptoms can be controlled with medication but the allergy itself cannot be removed.For people who have only one allergy, it may be possible to have a tolerance treatment. This desensitisation treatment is a vaccination against the allergen. Exposure to the allergens several times in a period of up to five years will be necessary.
What medication is given?
Antihistamine tablets or syrup (eg loratidine, cetirizine). These lessen the allergic reaction by blocking the actions of histamine. They relieve hayfever type symptoms.
Nasal sprays or drops containing sodium cromoglicate, corticosteroids (eg beclometasone) or antihistamines (eg levocabastine) can be used to reduce nasal inflammation and control symptoms in the nose.
Eye drops containing sodium cromoglicate, nedocromil, or antihistamines (eg azelastine) reduce eye inflammation and can be used if eye symptoms are a particular problem.
If the allergy causes asthmatic symptoms, some of the asthma medication below may be used
Relievers (bronchodilators): these are quick-acting medicines that relax the muscles of the airways. They are used when required to relieve shortness of breath.
Preventers: these act over a longer time and work by reducing the inflammation within the airways. They should be used regularly for maximum benefit. When the dosage and type of preventive medicine is correct, there will be little need for reliever medicines.
RelieversThere are three groups of these.
Beta-2 agonists These medicines cause the airways to relax and widen. Examples of those which act for a short time (3 or 4 hours following a single dose) are salbutamol and terbutaline. These medicines are inhaled from a variety of delivery devices, the most familiar being the pressurised metered-dose-inhaler (MDI). When inhaled, these types of medicines work within minutes to open the airways, making breathing easier.Longer-acting beta-2 agonists include salmeterol and formoterol. Their action lasts over 12 hours, making them suitable for twice daily dosage to keep the airways open.
Anticholinergics One of the ways in which the size of the airways is naturally controlled is through nerves that connect to the muscles surrounding the airways. The nerve impulses cause the muscles to contract, thus narrowing the airway. Anticholinergic medicines block this effect, allowing the airways to open. The size of this effect is fairly small, so it is most noticeable if the airways have already been narrowed by other conditions, such as chronic bronchitis.
Theophylline These medicines are given by mouth and are less commonly used in Britain because they are more likely to produce side effects than inhaled treatment. They are still in very wide use throughout the world. All three types of reliever can be combined if necessary.
PreventersThere are three main groups of these.
Corticosteroids Corticosteroids (or 'steroids') work to reduce the amount of inflammation within the airways, reducing their tendency to contract. They are usually given as inhaled treatment, although sometimes oral steroid tablets may be required for severe attacks. Although steroids are powerful medicines with many potential side effects their safety in asthma has been well established. It is also important to balance the problems that arise from poorly treated asthma against the improvement in health which occurs when the condition is well treated.
Cromones There are two medicines in this group: sodium cromoglicate and nedocromil. They also act to reduce inflammation of the airways. They tend to be best for mild asthma symptoms and are more effective in children than adults. The medicines are given by inhalation and are usually very well tolerated.
Leukotriene receptor antagonists Leukotrienes are compounds released by inflammatory cells within the lungs and which have a powerful constricting effect upon the airways. By blocking this effect with these antagonist medicines the constriction is reversed. There are two such medicines currently available: montelukast and zafirlukast.Most cases of allergic asthma are best controlled with an inhaled corticosteroid, eg beclometasone, which is taken at regular intervals as a preventative measure. A beta-2 agonist, eg salbutamol, is used in conjunction with this to relieve symptoms when necessary. For patients who have associated perennial or seasonal allergic rhinitis the use of an antihistimine, eg cetirizine, is often useful.
Based on a text by Dr Flemming Andersen
What is a pet allergy? The proteins from the hair, saliva or urine of household pets cause an allergic reaction that attacks the eyes and the airways, like hay fever, and can result in asthmatic symptoms. It may also cause atopic dermatitis or a nettle rash.It is often difficult to avoid the allergens that can come from other people's pets or be transported by people who have been in contact with animals. School classes can be overloaded with pet allergens.Most often the allergies are to cats or dogs, but rats, mice, guinea pigs, hamsters, pet birds, horses, cows or poultry can be involved.
Why are we allergic to pets?Pet allergens are proteins, which when in contact with the skin or breathed in, cause an allergic reaction that provokes the body into producing histamine. The histamine produces swelling and irritation of the upper airways and causes typical hay fever and asthmatic symptoms. The tendency toward allergic reactions is often hereditary.People who have had asthmatic bronchitis as children in a household with pets, especially a cat, are at a high risk of developing allergies towards cats as they get older.Pets are very important in modern life. When moving house or flat, the chances of the former owners having had a pet are high. It may take months, and in a modern insulated flat years, before the level of allergens are so low that an allergic reaction is not a possibility.If pet allergies are suspected, the new house owner should try to stay away from home for a fortnight to see whether the symptoms disappear. A doctor or specialist could be asked to conduct an allergy test to confirm the diagnosis.
What are the signs of pet allergy?When touching the fur or feathers of pets; objects containing pet allergens; or breathing in pet allergens; the following reactions may result:
hay fever (seasonal allergic rhinitis). Sneezing and a running or blocked nose.
eye symptoms such as itching and watering eyes.
asthma. Coughing and wheezing. (Children with asthma).
children's eczema. Itchy skin disease with red patches.
nettle rash. An itchy reddish rash.
What makes the symptoms worse?
Polluted air, tobacco smoke and car fumes may precipitate asthma.
Any other allergens in the environment (eg pollens).
How does the doctor make the diagnosis?Often it is enough for the doctor to know when and where the patient got their symptoms. Skin tests and blood samples can confirm the diagnosis.
What should I do? If you have allergic symptoms, you should avoid things that provoke them and it is advisable to ensure that in your house:
there are no pets.
there are as few pieces of furniture as possible.
the walls, wood and floors are as clean as possible. The floor should be polished. If necessary clean the walls, woodwork and floors regularly.
only carpets that can be cleaned every week are used.
only sheets that can be washed regularly, like cotton sheets, washable mattresses and synthetic blankets and pillows should be used. Do not use woolen or cotton blankets.
only plastic or wooden chairs should be used . Do not have upholstered furniture.
hang plastic curtains if possible. Dust them every day.
use moist rags and a vacuum cleaner that has a vortex with no bag and an allergen filter to clean the house thoroughly, at least twice a week.
avoid objects that attract dust like teddy bears, pillows, dried flowers, bric-a-brac and toys.
What else can I do?
Do not touch objects that are very dusty, such as books and old clothes.
If you are exposed to allergy provoking elements you should wear a mask. Even better, make people without allergies do the cleaning!
Do not allow smoking in your house.
But what if I still want pets?You have to be aware that there is a huge possibility that you may have to find another home for your pet. If you are in this situation, you should contact the RSPCA and ask them for advice.There are low allergen producing animals, such as furless cats, which may sometimes be OK. (But you may be allergic to cat spit and not cat fur? If you want a black and white cat to stroke, how much fun is a cat without fur?)You should still decorate your house as mentioned above. Even if the animal is only visiting you so that you can check if you are able to live with it, it may still take half a year or more before you develop symptoms. Dogs and cats should be bathed at least once a month in plain water. Remember to dry the animals properly afterwards. It has been proved that a monthly 'cat wash' lowers the level of allergens in the house.But what about fish or turtles? This may sometimes work but then you may be allergic to the food they eat.Rabbits and guinea pigs do not produce so much hair but their urine may cause trouble. They should not live in the house but outside and be cared for by a person without allergies. It is possible to buy anti-allergen filters and special air filtering systems (HEPA). Talk to your doctor or an organization for patients with asthma or allergies before you buy these devices.Keep animals out of bedrooms and public rooms. It would be preferable to keep them outside of the house. Every time you touch a pet, wash your hands thoroughly.
What complications are possible?
Greater susceptibility to other illnesses of the airways.
Ear infections.
Difficulties sleeping and insomnia.
Worsening of asthma, and maybe even the possibility of a severe asthma attack.
What are my prospects?Pet owners should know it is important to avoid their allergens because of the increase in the risk of developing, or worsening, asthma. The symptoms can be controlled with medication but the allergy itself cannot be removed.For people who have only one allergy, it may be possible to have a tolerance treatment. This desensitisation treatment is a vaccination against the allergen. Exposure to the allergens several times in a period of up to five years will be necessary.
What medication is given?
Antihistamine tablets or syrup (eg loratidine, cetirizine). These lessen the allergic reaction by blocking the actions of histamine. They relieve hayfever type symptoms.
Nasal sprays or drops containing sodium cromoglicate, corticosteroids (eg beclometasone) or antihistamines (eg levocabastine) can be used to reduce nasal inflammation and control symptoms in the nose.
Eye drops containing sodium cromoglicate, nedocromil, or antihistamines (eg azelastine) reduce eye inflammation and can be used if eye symptoms are a particular problem.
If the allergy causes asthmatic symptoms, some of the asthma medication below may be used
Relievers (bronchodilators): these are quick-acting medicines that relax the muscles of the airways. They are used when required to relieve shortness of breath.
Preventers: these act over a longer time and work by reducing the inflammation within the airways. They should be used regularly for maximum benefit. When the dosage and type of preventive medicine is correct, there will be little need for reliever medicines.
RelieversThere are three groups of these.
Beta-2 agonists These medicines cause the airways to relax and widen. Examples of those which act for a short time (3 or 4 hours following a single dose) are salbutamol and terbutaline. These medicines are inhaled from a variety of delivery devices, the most familiar being the pressurised metered-dose-inhaler (MDI). When inhaled, these types of medicines work within minutes to open the airways, making breathing easier.Longer-acting beta-2 agonists include salmeterol and formoterol. Their action lasts over 12 hours, making them suitable for twice daily dosage to keep the airways open.
Anticholinergics One of the ways in which the size of the airways is naturally controlled is through nerves that connect to the muscles surrounding the airways. The nerve impulses cause the muscles to contract, thus narrowing the airway. Anticholinergic medicines block this effect, allowing the airways to open. The size of this effect is fairly small, so it is most noticeable if the airways have already been narrowed by other conditions, such as chronic bronchitis.
Theophylline These medicines are given by mouth and are less commonly used in Britain because they are more likely to produce side effects than inhaled treatment. They are still in very wide use throughout the world. All three types of reliever can be combined if necessary.
PreventersThere are three main groups of these.
Corticosteroids Corticosteroids (or 'steroids') work to reduce the amount of inflammation within the airways, reducing their tendency to contract. They are usually given as inhaled treatment, although sometimes oral steroid tablets may be required for severe attacks. Although steroids are powerful medicines with many potential side effects their safety in asthma has been well established. It is also important to balance the problems that arise from poorly treated asthma against the improvement in health which occurs when the condition is well treated.
Cromones There are two medicines in this group: sodium cromoglicate and nedocromil. They also act to reduce inflammation of the airways. They tend to be best for mild asthma symptoms and are more effective in children than adults. The medicines are given by inhalation and are usually very well tolerated.
Leukotriene receptor antagonists Leukotrienes are compounds released by inflammatory cells within the lungs and which have a powerful constricting effect upon the airways. By blocking this effect with these antagonist medicines the constriction is reversed. There are two such medicines currently available: montelukast and zafirlukast.Most cases of allergic asthma are best controlled with an inhaled corticosteroid, eg beclometasone, which is taken at regular intervals as a preventative measure. A beta-2 agonist, eg salbutamol, is used in conjunction with this to relieve symptoms when necessary. For patients who have associated perennial or seasonal allergic rhinitis the use of an antihistimine, eg cetirizine, is often useful.
Based on a text by Dr Flemming Andersen
"In the initial years of our life we forget our health while going after wealth, in the later years of our life we spend our wealth to take care of our health... It's today reality. Health is not everything, BUT without health everything is nothing."
House dust mite allergy
Reviewed by Dr Paul Klenerman, specialist and Professor Brian Lipworth, professor of allergies and respiratory medicine
What is house dust mite allergy? House mite allergy is a hypersensitive reaction to proteins in the excretion of dust mites. The protein attacks the respiratory passages causing hay fever and asthma. It will aggravate atopic dermatitis in people who have a tendency to this problem. House dust mites are found in all homes. They are microscopic organisms that thrive in warm and humid houses with lots of food - human skin. The mites prefer to live in beds and, because we spend about a third of the day in bed, we inhale large quantities of dust mite allergens.
How do you become allergic to house dust mites? The excretion of the mites contains a number of protein substances. When these are inhaled or touch the skin, the body produces antibodies. These antibodies cause the release of a chemical called histamine that leads to swelling and irritation of the upper respiratory passages - typical asthma and hay fever symptoms. The predisposition for allergy is often hereditary. Unlike pollen, dust mites are present all year round causing constant allergy - 'perennial' allergic rhinitis. The excretion from the mites dries out and can be launched into the air when someone walks over a rug, sits down in a chair, or shakes the bed clothes, giving allergic people immediate symptoms.
What are the symptoms of house dust mite allergy?
Hay fever, runny nose, itching, sneezing.
Watering eyes.
Asthma, difficulty in breathing.
Infantile eczema (a skin disease) may get worse.
What makes the symptoms worse?
Air pollution such as tobacco smoke or car fumes.
How does the doctor make the diagnosis? It is often enough to tell the doctor when, where and how you get the symptoms. Skin tests and various blood tests can be used for confirmation.
Good adviceIt is best to do everything possible to avoid hypersensitivity to house dust mites. People who have perennial rhinitis, inflamed mucous membrane of the nose, or are allergic to house dust mites should try to adapt their homes.
Have as little furniture as possible in which mites can live.
Clean walls, woodwork and floors with wet cloths. The floor can be polished.
Only use rugs that can be washed once a week.
Use bedding that can be washed often, cotton sheets, washable bottom sheets and synthetic blankets or duvets. Don't use woollen blankets or quilts.
Make sure your chairs are made of wood or plastic.
If you can, use plastic curtains and dust them daily.
Use wet cloths and a vacuum cleaner with a no bag vortex and allergen filter to clean the house thoroughly, preferably every day, but at least twice a week.
Avoid dust traps like teddy bears, cushions, dried flowers, bric-a-brac and toys.
Wash bedding etc at a temperature of at least 60°C to kill the house dust mites.
Leave bedding, duvets, pillows and mattress hanging outside for an hour every day or as often as practical.
Put duvets and pillows in plastic bags and put them in the freezer for 24 hours at least once a month.
You may want to sleep on a cheap mattress that you can exchange for a new one at least every six months.
Dust mites hate dry and cold air, so try to air the house every day and don't use an air humidifier, which will only make matters worse. If the lower edge of the window is moist when you wake up in the morning, there is too much humidity in the air.
Do not spray the house, it may worsen your symptoms.
Do not touch dusty objects like books and old clothes.
When you are likely to be exposed to substances that give you a reaction, eg when you are house cleaning, you should wear a mask.
Don't allow smoking in the house.
What complications are possible?
You are predisposed to other respiratory diseases.
You are also predisposed to otitis, inflammation of the ear.
You may have trouble sleeping and suffer from chronic fatigue.
Hospitalisation following a severe asthma attack.
Future prospects If you are allergic to house dust mites, it is important that you don't expose yourself to the dust mite allergen because it increases your chances of developing asthma. The best remedy against house dust mites is described under the heading 'Good advice' above. Your symptoms can be controlled by treatment, but you can't escape your hypersensitivity. If severe dust mite allergy is the only form of allergy you suffer from, your doctor may want to try hyposensitisation - a 'vaccination' against the allergen. This tolerance treatment involves regular allergen injections in increased doses over a period of five years, but is not routinely given and is not always successful.
What medicine is given?
Antihistamine tablets or syrup (eg loratidine, cetirizine). These lessen the allergic reaction by blocking the actions of histamine. They relieve hayfever symptoms.
Nasal sprays or drops containing sodium cromoglicate, corticosteroids (eg beclometasone) or antihistamines (eg levocabastine) can be used to reduce nasal inflammation and control symptoms in the nose.
Eye drops containing sodium cromoglicate, nedocromil, or antihistamines (eg azelastine) reduce eye inflammation and can be used if eye symptoms are a particular problem.
If the allergy causes asthmatic symptoms, some of the asthma medication below may be used
Relievers (bronchodilators): these are quick-acting medicines that relax the muscles of the airways. They are used when required to relieve shortness of breath.
Preventers: these act over a longer time and work by reducing the inflammation within the airways. They should be used regularly for maximum benefit. When the dosage and type of preventive medicine is correct, there will be little need for reliever medicines.
RelieversThere are three groups of these.
Beta-2 agonistsBeta-2 agonists cause the airways to relax and widen. Examples of those which act for a short time (3 or 4 hours following a single dose) are salbutamol and terbutaline. These medicines are inhaled from a variety of delivery devices, the most familiar being the pressurised metered-dose-inhaler (MDI). When inhaled, these types of medicines work within minutes to open the airways, making breathing easier.Longer-acting beta-2 agonists include salmeterol and formoterol. Their action lasts over 12 hours, making them suitable for twice daily dosage to keep the airways open.
AnticholinergicOne of the ways in which the size of the airways is naturally controlled is through nerves that connect to the muscles surrounding the airways. The nerve impulses cause the muscles to contract, thus narrowing the airway. Anticholinergic medicines such as ipratropium block this effect, allowing the airways to open. The size of this effect is fairly small, so it is most noticeable if the airways have already been narrowed by other conditions, such as chronic bronchitis.
Theophyllines and aminophyllineTheophyllines and aminophylline are given by mouth and are less commonly used in Britain because they are more likely to produce side effects than inhaled treatment. They are still in very wide use throughout the world. All three types of reliever can be combined if necessary.
PreventersThere are three main groups of these.
CorticosteroidsCorticosteroids (or 'steroids') work to reduce the amount of inflammation within the airways, reducing their tendency to contract. They are usually given as inhaled treatment, although sometimes oral steroid tablets may be required for severe attacks. Although steroids are powerful medicines with many potential side effects their safety in asthma has been well established. It is also important to balance the problems that arise from poorly treated asthma against the improvement in health which occurs when the condition is well treated.
CromonesThere are two kinds of cromones: sodium cromoglicate and nedocromil. They also act to reduce inflammation of the airways. They tend to be best for mild asthma symptoms and are more effective in children than adults. The medicines are given by inhalation and are usually very well tolerated.
Leukotriene receptor antagonistsLeukotriene receptor antagonists are compounds released by inflammatory cells within the lungs and which have a powerful constricting effect upon the airways. By blocking this effect with these antagonist medicines the constriction is reversed. There are two such medicines currently available: montelukast and zafirlukast.Most cases of allergic asthma are best controlled with an inhaled corticosteroid, eg beclometasone, which is taken at regular intervals as a preventative measure. A beta-2 agonist, eg salbutamol, is used in conjunction with this to relieve symptoms when necessary. For patients who have associated perennial or seasonal allergic rhinitis the use of an antihistimine, eg cetirizine, is often useful.
Based on a text by Dr Flemming Andersen
What is house dust mite allergy? House mite allergy is a hypersensitive reaction to proteins in the excretion of dust mites. The protein attacks the respiratory passages causing hay fever and asthma. It will aggravate atopic dermatitis in people who have a tendency to this problem. House dust mites are found in all homes. They are microscopic organisms that thrive in warm and humid houses with lots of food - human skin. The mites prefer to live in beds and, because we spend about a third of the day in bed, we inhale large quantities of dust mite allergens.
How do you become allergic to house dust mites? The excretion of the mites contains a number of protein substances. When these are inhaled or touch the skin, the body produces antibodies. These antibodies cause the release of a chemical called histamine that leads to swelling and irritation of the upper respiratory passages - typical asthma and hay fever symptoms. The predisposition for allergy is often hereditary. Unlike pollen, dust mites are present all year round causing constant allergy - 'perennial' allergic rhinitis. The excretion from the mites dries out and can be launched into the air when someone walks over a rug, sits down in a chair, or shakes the bed clothes, giving allergic people immediate symptoms.
What are the symptoms of house dust mite allergy?
Hay fever, runny nose, itching, sneezing.
Watering eyes.
Asthma, difficulty in breathing.
Infantile eczema (a skin disease) may get worse.
What makes the symptoms worse?
Air pollution such as tobacco smoke or car fumes.
How does the doctor make the diagnosis? It is often enough to tell the doctor when, where and how you get the symptoms. Skin tests and various blood tests can be used for confirmation.
Good adviceIt is best to do everything possible to avoid hypersensitivity to house dust mites. People who have perennial rhinitis, inflamed mucous membrane of the nose, or are allergic to house dust mites should try to adapt their homes.
Have as little furniture as possible in which mites can live.
Clean walls, woodwork and floors with wet cloths. The floor can be polished.
Only use rugs that can be washed once a week.
Use bedding that can be washed often, cotton sheets, washable bottom sheets and synthetic blankets or duvets. Don't use woollen blankets or quilts.
Make sure your chairs are made of wood or plastic.
If you can, use plastic curtains and dust them daily.
Use wet cloths and a vacuum cleaner with a no bag vortex and allergen filter to clean the house thoroughly, preferably every day, but at least twice a week.
Avoid dust traps like teddy bears, cushions, dried flowers, bric-a-brac and toys.
Wash bedding etc at a temperature of at least 60°C to kill the house dust mites.
Leave bedding, duvets, pillows and mattress hanging outside for an hour every day or as often as practical.
Put duvets and pillows in plastic bags and put them in the freezer for 24 hours at least once a month.
You may want to sleep on a cheap mattress that you can exchange for a new one at least every six months.
Dust mites hate dry and cold air, so try to air the house every day and don't use an air humidifier, which will only make matters worse. If the lower edge of the window is moist when you wake up in the morning, there is too much humidity in the air.
Do not spray the house, it may worsen your symptoms.
Do not touch dusty objects like books and old clothes.
When you are likely to be exposed to substances that give you a reaction, eg when you are house cleaning, you should wear a mask.
Don't allow smoking in the house.
What complications are possible?
You are predisposed to other respiratory diseases.
You are also predisposed to otitis, inflammation of the ear.
You may have trouble sleeping and suffer from chronic fatigue.
Hospitalisation following a severe asthma attack.
Future prospects If you are allergic to house dust mites, it is important that you don't expose yourself to the dust mite allergen because it increases your chances of developing asthma. The best remedy against house dust mites is described under the heading 'Good advice' above. Your symptoms can be controlled by treatment, but you can't escape your hypersensitivity. If severe dust mite allergy is the only form of allergy you suffer from, your doctor may want to try hyposensitisation - a 'vaccination' against the allergen. This tolerance treatment involves regular allergen injections in increased doses over a period of five years, but is not routinely given and is not always successful.
What medicine is given?
Antihistamine tablets or syrup (eg loratidine, cetirizine). These lessen the allergic reaction by blocking the actions of histamine. They relieve hayfever symptoms.
Nasal sprays or drops containing sodium cromoglicate, corticosteroids (eg beclometasone) or antihistamines (eg levocabastine) can be used to reduce nasal inflammation and control symptoms in the nose.
Eye drops containing sodium cromoglicate, nedocromil, or antihistamines (eg azelastine) reduce eye inflammation and can be used if eye symptoms are a particular problem.
If the allergy causes asthmatic symptoms, some of the asthma medication below may be used
Relievers (bronchodilators): these are quick-acting medicines that relax the muscles of the airways. They are used when required to relieve shortness of breath.
Preventers: these act over a longer time and work by reducing the inflammation within the airways. They should be used regularly for maximum benefit. When the dosage and type of preventive medicine is correct, there will be little need for reliever medicines.
RelieversThere are three groups of these.
Beta-2 agonistsBeta-2 agonists cause the airways to relax and widen. Examples of those which act for a short time (3 or 4 hours following a single dose) are salbutamol and terbutaline. These medicines are inhaled from a variety of delivery devices, the most familiar being the pressurised metered-dose-inhaler (MDI). When inhaled, these types of medicines work within minutes to open the airways, making breathing easier.Longer-acting beta-2 agonists include salmeterol and formoterol. Their action lasts over 12 hours, making them suitable for twice daily dosage to keep the airways open.
AnticholinergicOne of the ways in which the size of the airways is naturally controlled is through nerves that connect to the muscles surrounding the airways. The nerve impulses cause the muscles to contract, thus narrowing the airway. Anticholinergic medicines such as ipratropium block this effect, allowing the airways to open. The size of this effect is fairly small, so it is most noticeable if the airways have already been narrowed by other conditions, such as chronic bronchitis.
Theophyllines and aminophyllineTheophyllines and aminophylline are given by mouth and are less commonly used in Britain because they are more likely to produce side effects than inhaled treatment. They are still in very wide use throughout the world. All three types of reliever can be combined if necessary.
PreventersThere are three main groups of these.
CorticosteroidsCorticosteroids (or 'steroids') work to reduce the amount of inflammation within the airways, reducing their tendency to contract. They are usually given as inhaled treatment, although sometimes oral steroid tablets may be required for severe attacks. Although steroids are powerful medicines with many potential side effects their safety in asthma has been well established. It is also important to balance the problems that arise from poorly treated asthma against the improvement in health which occurs when the condition is well treated.
CromonesThere are two kinds of cromones: sodium cromoglicate and nedocromil. They also act to reduce inflammation of the airways. They tend to be best for mild asthma symptoms and are more effective in children than adults. The medicines are given by inhalation and are usually very well tolerated.
Leukotriene receptor antagonistsLeukotriene receptor antagonists are compounds released by inflammatory cells within the lungs and which have a powerful constricting effect upon the airways. By blocking this effect with these antagonist medicines the constriction is reversed. There are two such medicines currently available: montelukast and zafirlukast.Most cases of allergic asthma are best controlled with an inhaled corticosteroid, eg beclometasone, which is taken at regular intervals as a preventative measure. A beta-2 agonist, eg salbutamol, is used in conjunction with this to relieve symptoms when necessary. For patients who have associated perennial or seasonal allergic rhinitis the use of an antihistimine, eg cetirizine, is often useful.
Based on a text by Dr Flemming Andersen
"In the initial years of our life we forget our health while going after wealth, in the later years of our life we spend our wealth to take care of our health... It's today reality. Health is not everything, BUT without health everything is nothing."
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