One week rainy, the next already a heatwave – these are sharp fluctuations that signal the arrival of the spring season. The phone in the allergy clinic does not stop ringing. But this year, alongside the familiar seasonal allergy wave, another phenomenon stands out: More and more parents are arriving with children who suffer from a runny nose and cough that have worsened in recent weeks, that is, since the beginning of the campaign against Iran.
Many thought it was a passing cold, but exposure to the dusty air in crowded shelters, together with the seasonal bloom, has led to a significant outbreak of allergy and allergic asthma.
What is actually the difference between allergy and asthma?
Allergy and asthma are two different diseases, but they are closely related.
Allergic rhinitis is a reaction of the immune system to inhaled allergens such as pollen, house dust mites or animals, and it is expressed in a daily runny nose, repeated sneezing and itching in the eyes, and sometimes also in the palate and ears.
When the same immune response occurs not only in the mucous membranes and upper airways but also in the lower airways, symptoms typical of allergic asthma develop such as cough, wheezing, shortness of breath and a feeling of pressure in the chest.
In fact, in more than 60% of asthma cases there is an allergic background. Therefore, untreated allergy is not only a nuisance, but may be a preliminary stage in the development of asthma, and it is therefore very important to diagnose it in time.
Why is there worsening during the transition season?
Allergic rhinitis can be divided into two main types: Seasonal and perennial.
Seasonal allergy is caused by exposure to pollen that usually originates outside the home, such as the flowering of pecan, olive, cypress and grasses.
In contrast, perennial allergy usually results from allergens inside the home, such as house dust mites, animal fur and molds. There are patients who suffer from a combination of the two forms.
Shelters and parking garages are usually closed spaces, sometimes humid and not ventilated, and therefore they are fertile ground for the development of house dust mites and molds. In addition, staying in a closed space may itself be a trigger for an asthma attack.
This year it seems that the prolonged stay in shelters, together with the spring season, has led to an unusual increase in visits to allergy clinics. There is a significant rise in the number of children who are developing allergy for the first time and even allergic asthma. This is a much more prominent phenomenon compared to previous years, in which each factor usually acted separately.
It should be noted that psychological stress may also be a significant trigger for worsening symptoms.
A cold, allergy or asthma – how do you know?
Not every “cold” is really a cold. The difference begins with the pattern: Do the symptoms return every year in the same weeks? While a regular cold passes within 7 to 10 days, an allergy tends to return consistently.
There are also less recognized signs. Itching in the palate and ears is a classic allergic symptom that many do not associate. In children, a persistent nighttime cough that returns every spring is often an expression of allergic asthma, and not a bacterial infection.
Quite a few parents arrive after rounds of antibiotics that did not help. Some patients also suffer from recurrent sinusitis or nasal polyps, inflammatory conditions that often originate from the same immune mechanism.
When symptoms return season after season, impair sleep or functioning, and when a child coughs at night for weeks, there is no reason to wait. Early diagnosis is especially important in children.
Untreated allergy may progress to asthma disease, and uncontrolled asthma may affect growth, sleep quality and functioning at school.
Simple diagnostic and treatment methods
Diagnosis is carried out by a specialist doctor in allergy and immunology, and is based on three principles: The clinical picture, skin tests and in certain cases also a blood test for specific IgE antibodies.
Treatment is built in layers. For immediate treatment there are new-generation antihistamines and steroid nasal sprays.
When there is lung involvement, inhalers of bronchodilators, steroids or a combination of them are added.
For those who suffer from recurrent attacks that cannot be controlled, there are now advanced biological drugs for severe asthma, most of which are included in the health basket, and they completely change the picture.
To treat the root of the problem, it is recommended to consider immunotherapy, a treatment that teaches the immune system to develop tolerance to the allergen over time. In Israel there is also a daily sublingual treatment against house dust mites, for children and adults.
How do you prepare for the transition season?
First of all – do not wait. If there is a recurring pattern, and especially if the child began to suffer from a runny nose at the beginning of the war and has still not stopped, this is the time for an examination by an allergy doctor.
The Israeli spring is short and beautiful. With proper diagnosis and treatment, it is possible to enjoy it.
The author is a senior physician in the angioedema, clinical immunology and allergy unit, Sheba Medical Center Hospital
Source:
www.jpost.com
