22 Jul 2015

Allergies and the age of Avoidance

From New Zealand Society, 3:35 pm on 22 July 2015

“When I was young fella I was allergic to horses, cats dogs, all sorts … my eyes would swell up and my mouth. But with fish it’s pretty bad—end-stage is anaphylactic shock.”

Actor Paul McLaughlinPaul McLaughlin is lighthearted as he relays his story. He had eczema and asthma throughout his childhood and has since grown out of these lighter allergies, although one that has never left him is his allergy to fish. He isn’t allergic to crustaceans or shell fish, just swimming fish, and he’s acutely aware that he needs to avoid it at all costs.   

“Every now and then I would stray into something that would have a bit of fish in it and my mouth would swell up,”  he says.

On these occasions he uses ice water to reduce the symptoms, and if that doesn’t work the next step is antihistamines.

Although avoiding fish might be all well and good, he knows from experience that it isn’t always possible to keep a handle on what he’s eating, especially if someone else is serving the food. He was at an opening night event for a theatre show when he was advised that what he was about to eat was potato. “After a couple of minutes I realised that it was fish. This was 9:30 at night…my throat and everything was swelling up, and I started getting tired, almost sleepy.”

Paul was dropped off at the urgent after hours pharmacy, thinking he would be okay. He couldn’t remember his address and before he knew it the staff were rushing him into a room where they gave him some oxygen and a big shot of adrenaline. “It wasn’t what I thought it would be like,” he says, “it got very dreamy and I was very relaxed about it.”

This was a few years ago now, but it was the first time that Paul had ever gone into anaphylactic shock. His allergy is so severe that can’t touch fish, let alone eat it. He has, however, found ways to avoid fish and carry on with life as normal. Fish 'n’ chips with the family means that his portion of food is wrapped up separately, and he still goes fishing with his father, “I sit in the boat and he baits the hooks,” he laughs.  

Dr Robert WinklerDr Robert Winkler is a paediatric immunologist and allergist who has been working in the field for twenty years, and says that allergies are on the rise worldwide. “It’s mainly to do with lifestyle.” Modern houses, less contact with microbes—the more sterile we try to be, the less confrontation our immune system has with the good bugs that we need in order to develop a well working immune system.

“Genetics are one of the main triggers to allergy, but there are many other factors—contact allergies are more common now, with people allergic to products that they’re using.”

Winkler says children up to the age of three are more prone to allergies, although a majority grow out of them by the age of eight, “Peanut allergies can be for life, but 20-percent will grow out of it.” The rise in peanut allergies has increased over recent years, especially in children and Winkler puts this down to an abstinence of this particular food whilst babies are in utero. “For years we’ve been telling mums in pregnancy to stay away from peanuts, [but] the immune system probably needs these things in order to develop tolerance.”

He sees one to two cases of anaphylaxis per week, some of which are caused by food whilst others are increasingly caused by an allergic reaction to common everyday drugs such as paracetamol, ibuprofen, antibiotics. Anaphylaxis includes respiratory problems, severe vomiting, heart failure, collapse and shock.

There is no way to eradicate allergy, and Winker says that there are many tests available. He advises that if you or your child shows physical symptoms of allergy that you should consult an immunologist whereby you can undergo a skin prick, blood test or challenge test, the latter, exposing you to the allergen in incremental amounts, whilst the patient is being monitored.

He would also like parents to be wary of putting their children on special diets that avoid the ‘supposed threat’ due to a perception that their child has an allergy. Winkler says that this is happening frequently, and parents run the risk of their children losing out on vital nutrients.

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