Human immune system has come under a lot of debate over last few decades, thanks to the deadly human immune deficiency syndrome (HIV) virus. While it is good to see the debate raging over the impact of HIV, what is totally ignored is the impact our immune system is having due to allergies.
World Health Organization (WHO) defines allergy as an “immunologically mediated hypersensitivity.” In simple words an allergy is an abnormal sensitive reaction by human immune system to a foreign particle. An allergy could show up as a skin rash or difficulty in breathing, swollen and reddened eyes, depression or uterine contractions. An allergy may impact more than one organ in our body. But every allergy will have a specific reaction. An allergy is not a disease but a condition. Hence it is important to note that it is not communicable.
WHO estimates that over 20% of the world population suffers from mediated allergic diseases such as allergic asthma, allergic rhinitis and allergic conjuctivitis, atopic eczema/atopic dermatitis and anaphylaxis.
So who are the most common victims of allergies? It could be any of us. However, instances of allergies have been higher among children, thanks to rapid urbanization and industrialization, giving very less scope for our immune system to evolve to meet everyday challenges. “This increase is especially affecting children, who are bearing the greatest burden of the rising trend which has occurred over the last two decades,” said Dr Ruby Pawankar, the President Elect of World Allergy Organisation. She attributes the increases to growing industrialisation and fast changing biodiversity coupled with sedentary lifestyles are causing a surge in allergic diseases, especially among children. “The way these are occurring, we believe by 2050, about 50 percent of all children will have some sort of allergies,” Dr Pawankar, an Indian doctor who is currently associated with Nippon Medical School in Tokyo.
According to Pawankar, a WAO paper indicates that allergy poses a major global health issue. It has also provided some high level recommendations to governments and health authorities. “It has asked governments to institute environmental control measures by lowering indoor and outdoor air pollution, tobacco smoking and allergen and drug exposures,” she said. “It also calls for developing national allergy action plan to promote the prevention of allergic diseases and immune tolerance, aiming to decrease the burden of allergic diseases.”
The instances of allergies are higher children of those parents who are also allergic. “While allergy per se is not communicable, it is important to understand that many a times allergies could lead to secondary infection which can be communicable. And diseases spread easily among children in schools, play areas and extracurricular classes,” said Saurabh Naik, a Mumbai-based pediatrician.
“Allergic diseases accounts to only 15-30% of the population, however, this prevalence is slowly rising in certain developing countries such as India. Further, a patient with allergy may have different clinical manifestation. These statistics indicate that allergy has a definite genetic inheritance and research to find a distinct gene for allergy and allergic diseases is still underway,” said Dr. Bill Brashier, Chest Research Foundation of Pune in a paper titled Pathogensis of Allergy, published by Indian Academy of Allergy.
Diagnosis of allergies in India has a few setbacks. Following are the important ones:
Lack of specialization: When one has an allergy, we usually run to organ specific doctors. If we have a skin rash, we go to a dermatologist, or a pediatrician if the patient is a child or we even run to pulmonologist if it is a wheezing or asthmatic attack. “There aren’t many allergologists around. There is no course in India for a doctor to specialize in allergy. The doctors who have dealt with a lot of allergies, are just consulting as allergologist,” said Dr Neeta Rajani, a Mumbai-based dermatologist.
Cost of Diagnosis: “The cost of diagnosis is also quite expensive in India. Each allergy profiling costs around Rs 4000-5000,” added Dr Rajani. But when once the allergen is established, treatment is not a problem. “One just needs to avoid consuming or being in contact with the allergen,” she added.
To not remain in contact with the allergen is also a complicated process sometimes. For instance, if someone were allergic to nuts, they would not be aware that many ready-to-eat foods may contain nuts and, “We Indians do not have the habit of reading the ingredients before buying,” said Dr Naik. So, when one consumes, let’s say a chocolate, which have nuts in them, they are bound to be affected.
Diagnosis: Anand Diagnostic Laboratory (ADL), Bangalore’s leading diagnostic lab, recently introduced the Euroline method of testing. One unique thing about this allergy testing is that it uses blood samples for the testing. This is the most cost effective method of allergy profiling. The other methods are highly expensive and will not be able to isolate all types of allergens. “With regards to profiles from Euroline, we have two types: food allergy profile and respiratory allergy profile. There are around 30 different allergens that are identified using this technology,” said Dr N Jayaram, Director of ADL.
Cure: The first step toward cure is to identify the allergen. “When one has an allergic attack, we usually see the severity. Something like a small rash on wrist due to imitation jewellery may go away after the jewellery is removed. In some severe cases, we will have to administer steroids. If it impacts the respiratory tract, then the patient needs to hospitalized,” said Dr Rajani.
List of Common Allergens in India
Here is a quick list of common allergens in India.
• Timothy grass
• Cultivated rye
• Eucalyptus sp.
• Parthenium hysterophorus
• Carnation flower
• Sunflower seeds
• Mites(D1 & D2)
• Dermatophagoides farinae
• Cat epithelium
• Dog hair
• Pigeon feathers
• Chicken feathers
• Aspergillus fumigatus
• Tricophyton Mentagrophytes
• Cotton yarn and fabric
• Straw dust
• Sheeps wool
• Hen eggs yolk
• Milk powder
• Wheat Flour
• Soya bean
If you are manifesting any allergy symptoms, please go get them tested now.