Rx-cellent: New attention for 50 million allergy sufferers

As doctors await an unprecedented medical report on this growing problem, here's a preview - plus tips for today.

In this article:
Allergy shots: Doctors divide over their use.
Tips for surviving hay fever (without drugs)
Food allergies: Labels should be more specific, activists say.
Insects: Beware a biting fire ant.
New prescription antihistamines considered safer than old over-the-counter.

he sneezing and itching that strike 35 million Americans when "ah, spring" turns to ah-choo may not seem debilitating. But each year, hay fever and other allergies make 50 million people ill and cause 10 million lost school days, 3.5 million lost workdays, and $15 billion in medical costs.

At last, the medical community has a unified approach in a new report that gives health-care practitioners - from physician's assistants to allergy specialists - the best ways to diagnose and treat 13 categories of allergy.

"The message here is not to trivialize allergies," says Gary Rachelefsky, M.D., of the American Academy of Allergy, Asthma and Immunology, part of the 21-agency task force that wrote the report.

"People think, 'Oh, I just sneezed,' but they also may get headaches, or be tired. Allergies can worsen or cause asthma, sinusitis and middle-ear infection in children." Allergies underlie so many serious conditions that they are the sixth-leading cause of chronic disease in America.

In fact, one in three patients has symptoms relating to allergies, according to the National Institute of Allergy and Infectious Diseases' director, Anthony S. Fauci. "They might not necessarily say they have an allergy. They might say they have a skin rash or a runny nose." Other symptoms to watch for include itchy nose, ears or throat; snoring; disturbed sleep; and altered hearing, smell or taste.

If it sounds like just about any sniffle might be suspect, it's true: A big reason for concern is that allergies are skyrocketing in prevalence. Societies acquiring the Western lifestyle, it appears, also acquire allergies - from smog, diesel fumes, new foods and chemicals (of 6 million chemicals, 3,000 are known to cause allergic reactions). Cities, crowded with people, cockroaches and dust mites, are allergy hotbeds.

Corralling allergy can be tricky, because severe allergic reactions - called anaphylaxis - are stealthy and swift. The new report counsels the severely allergic to carry shots of epinephrine, a successful antidote.

The main thrust of the report is awareness and education; it will be available in June on the Internet, through clinics and primary-care doctors, and via a hot line at 1-800-822-2762.

By Lydia Strohl

Should shots be given earlier and more often?

or decades, people suffering from hay fever and other allergies have used allergy shots as a last resort.

"We should be thinking of it earlier, rather than later," says Ira Finegold, an allergist in New York City and past president of the American College of Asthma, Allergy and Immunotherapy.

He suggests that more Americans with allergies could benefit from the regular injections, called immunotherapy or allergy vaccines, which aim to make people less sensitive to their allergies by injecting them with larger and larger amounts of the allergic substances. Generally, patients receive a shot once or twice a week for six months, then once monthly for years. No one tracks the total number of Americans who receive shots.

The case for "earlier": A recent study in Norway suggests that early use of allergy shots in childhood could reduce allergy symptoms and, best of all, prevent the development of asthma in some children.

Robert A. Nathan, an allergist and professor at the University of Colorado Health Sciences Center, says that "immunotherapy, after a three- to five-year period, will largely get rid" of hay fever.

Allergy shots are considered effective for hay fever and insect stings, less so for allergies to pets and molds, and the effectiveness for asthma is controversial. Shots for food allergies are considered dangerous because of a high risk of bad reaction.

The case for "later": "People should not be gung-ho" about allergy shots, says Thomas Platts-Mills, M.D., of the University of Virginia School of Medicine. His reason: possible serious side effects. Common side effects are minor, such as swelling and hives. But allergy shots also can cause frightening, life-threatening reactions.

And the benefit may be brief: A 1997 study in The New England Journal of Medicine found that shots reduced allergy symptoms in adults with allergies and asthma during the first year they received them. But by the second year, the group receiving the shots had regained many of their allergy symptoms.

New technology, including genetic engineering, may cut down on side effects and make allergy shots better, said Platts-Mills. "If it worked a little better or was less likely to cause a reaction, the equation would change considerably."

By Patricia Braus

Go to top

No needles. No drugs. 5 tips for surviving hay fever:

1. Keep car windows closed.
2. Do less outside in the early morning, when pollen is most present.
3. Shut your windows at night and use an air conditioner.
4. Forget about mowing the lawn when the pollen count, wind or humidity is high.
5. Plan your vacation elsewhere when pollen season is at its peak.

Source: American Academy of Allergy, Asthma and Immunology