HEALTH
After the sneeze, the wheeze
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The growing incidence of allergic rhinitis is a cause for concern, Dr. Ruby Pawankar tells KALPANA SHARMA.
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K.GOPINATHAN
Conditions of rhinitis are aggravated when pollution levels rise.
WATERING eyes, non-stop sneezing, wheezing, coughing — these symptoms afflict so many people in India, and particularly in our cities, that we have come to accept them as an "occupational hazard" of urban living. In fact, according to a leading allergy specialist, this condition — allergic rhinitis that is recognised as the precursor to the more serious problem of asthma — is nothing short of a 21st Century epidemic.
One in every 10 Indian children suffers from allergies and asthma, says Dr. Ruby Pawankar, one of the main organisers of the International Joint Congress on Allergies in India and the SAARC region, held recently in Mumbai. The conference brought together over 1000 people from 30 countries, many of them leading experts in this field.
Serious problem
Dr. Pawankar, who is currently a professor in the Department of Otolaryngology at Nippon Medical School in Tokyo, Japan, says that only in the last couple of years has the World Health Organisation (WHO) recognised allergies, and particularly allergic rhinitis, as a serious problem.
Dr. Pawankar, who is an ENT specialist, says that in India, different types of allergies affect an estimated 25 per cent of the population. Yet the condition is often not acknowledged because medical schools do not recognise the treatment of allergies as a legitimate specialisation. As a result, there are only a few trained experts who can diagnose the condition.
Harmful consquences
Dr. Ruby Pawankar.
The consequences for children are particularly harmful, she says. A study on the prevalence of allergic rhinitis in Southeast Asia found that allergies impacted the quality of life of up to 80 per cent of children in the age group of 6 to 11 years.
Conditions like allergic rhinitis affected their sleep pattern, their learning performance, and their ability to play games and participate in leisure activities.
Why does the condition get aggravated when pollution levels rise in the city? Dr. Pawankar explains that atmospheric pollutants like sulphur dioxide, or nitrogen oxides or suspended particulate matter (SPM) are not allergens.
But they enhance and amplify the severity of the disease in people who are already sensitive to a variety of allergens such as dust mites, animal dander, pollen, fungi, moulds and even cockroaches.
She also points out that if allergic rhinitis is not treated, it develops into asthma.
Lack of information about the condition leads most people to deal with the problem symptomatically.
Even parents, she says, treat children for such allergies only up to the point where they get some relief without understanding that it is a condition that ought to be taken seriously and treated.
Recognise triggers
People need to first recognise what triggers off their allergies. Dr. Pawankar says that allergic conditions are hereditary.
If both parents have allergies, the chances of the child getting them are as high as 80 per cent. If one parent has an allergic condition, then the chances of passing it on to the child are 30 per cent.
Apart from allergies that affect the respiratory system, people also have food allergies.
For instance, people develop allergies to milk, eggs, fish, shellfish, chickpeas, and fenugreek and to some fruits.
Dr. Pawankar admits that there is no cure for such allergies. But she holds that the new generation of drugs allows people to manage allergic reactions and lead a normal life.
She also acknowledges that some of the first generation drugs for allergic rhinitis and asthma had severe side effects. But today, she says, the second-generation drugs are non-sedative and control inflammation caused by allergies.
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AN allergen or a substances that causes allergy, like pollen, makes the body defend itself by producing antibodies. When an allergen and an antibody combine, the body releases histamine and other chemical substances into the bloodstream, causing an allergic response. Pollen, dust, mold or other substances that can be inhaled, are common allergens.
Symptoms of seasonal allergic rhinitis usually decrease with the arrival of cold weather. Perennial allergic rhinitis lingers all the year and is caused by indoor allergens like feathers, mould spores, animal hair or skin or dust mites. Pollen, dust and mould spores are location specific, so you may develop allergic rhinitis if you shift places.
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