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Common Allergies

13 September 2024

An allergy is an abnormal reaction of the immune system to substances that are usually harmless, such as food, medication and pollen. Allergic reactions can be mild to severe, and some may develop into a life-threatening condition that involves several systems in the body known as anaphylaxis.

The prevalence of allergies is on the rise, and today 25%-40% of the population in Israel suffer from some form of allergy. The most common allergies involve inhaled substances, foods, medication and insect venom.

If you suspect an allergy, contact your family physician. You should also consider contacting an allergy clinic as well.

Checking for an allergic disease involves several steps:
  • Anamnesis: in other words, conducting a medical questioning regarding the possible causes that triggered the suspected allergic reaction.
  • Tests: based on the questioning, the need for diagnostic tests will be considered. The options are: blood test or performing skin tests to detect sensitivity to common allergens, and occasionally controlled supervised exposure to substances suspected of causing allergies.
  • Treatment: after identifying the causes of the allergy and depending on its manifestation, a decision will be made whether to only treat the bothersome symptoms, or to simultaneously administer treatment to reduce the chances of the allergy.

Allergy treatments include, first of and foremost, reducing exposure to the allergen if possible. Although allergens are present in the environment and in the air, such as flower pollen, exposure to which is difficult to completely eliminate, in the case of food or medication allergies, you can completely prevent it. You may receive medications that reduce allergic sensitivity and alleviate symptoms. A person in danger of developing anaphylaxis will be instructed to carry an epinephrine (adrenaline) syringe, also known as “EpiPen". Controlled exposure to the allergen is occasionally recommended, through injections or by eating (in the case of food).

If your child has been diagnosed with an allergy, it is important that you remember that despite the fear, it is possible to live a normal life alongside the allergy, as long as you adhere to several rules and remain alert to the specific allergen. In addition, and most importantly: if the child has a known allergy that could deteriorate into a life-threatening reaction, they must have two EpiPens that are not expired with them at all times.

The immune system is one of the defense systems of the human body, and its main purpose is to "fight" foreign invaders such as bacteria and viruses. For those suffering from allergies, the immune system identifies substances that usually do not cause illness or harm to the human body, such as food, medications and plant pollen (allergens), as invaders and reacts against them by producing an antibody of the type Ige (immunoglobulin E). These antibodies activate the immune system to release histamines, chemical substances that are released in response to the allergen and trigger the allergic reaction.

The prevalence of allergies is on the rise, and today 25%-40% of the population in Israel suffer from at least one form of allergy.

Among the most common allergens you can find house dust mites, nests (grass, weeds and trees), animals (fur, feathers, hair, scales, saliva, feces), medications, various foods and insect venom as a result of bites.

Allergic reactions can be mild to severe, and some may develop into a life-threatening condition that involves several systems in the body known as anaphylaxis.

If your child has been diagnosed with an allergy, it is important that you remember that despite the natural fear for their health and possibly anxiety from a severe allergic reaction, it is possible to live a normal life alongside the allergy, as long as you adhere to several rules and remain alert to the specific allergen.

Symptoms

Allergies can manifest in a variety of symptoms, in one or more of the body’s systems (for example: skin, respiratory system, digestive tract), and they occur within minutes to approximately two hours from the moment of exposure to the allergen. Symptoms can vary in severity - from mild to severe reactions, some of which can develop into anaphylaxis (a reaction that requires rapid treatment and evacuation to a hospital).

Possible symptoms of an allergy:

  • Mild reactions

    • Skin rash and mild itching.
    • Itching and swelling in the mouth, lips and tongue.
    • Runny nose, sneezing, itchy nose and palate, tears, irritated and red eyes.
    • Abdominal pain, mild nausea and discomfort.

  • Severe reactions

    • Diffuse rash, redness and swelling of the limbs and itchy skin.
    • Significant swelling of the lips, tongue or mouth.
    • Nausea, spasmodic abdominal pain and diarrhea.
    • Shortness of breath, cough and wheezing.
    • Weak pulse, drop in blood pressure, paleness or cyanosis, fogginess or loss of consciousness.
    • Throat clearing, hoarseness, voice change, burning sensation or globus sensation.

Attention

Attention

Children can verbally describe the sensations of an allergic reaction such as: "something is stuck in my throat", "my tongue is heavy", "my lips are tense", "I have a lump in my throat", "the food is too spicy", "my tongue is burning" , “my tongue itches", “my mouth feels weird", "I have a hairy sensation on my tongue".

Diagnosis

If you suspect an allergy, contact your family physician. You should also consider contacting an allergy clinic as well.

Checking for an allergic disease involves several steps:

  • 1
    Anamnesis

    In other words, conducting a medical questioning regarding the possible causes that triggered the suspected allergic reaction.

  • 2
    Diagnostic tests

    Depending on the questioning, they will consider which diagnostic tests should be performed. The options are:

    • Blood test to detect allergies (RAST): a blood test for Ige antibodies that aims to determine which substance causes the allergy.
    • Skin tests (tests): a method to detect allergens by dripping extracts containing various allergens on the skin of the person being tested. The skin in the center of each drop is then gently scratched and wait about 15–20 minutes. The places where an allergic reaction such as swelling, redness or itching occurs confirms the existence of the allergy.
    • Challenge tests: in some cases, to confirm or rule out a suspected sensitivity, you will be asked to perform a diagnostic procedure that will include exposure to a substance suspected of being sensitive, for example eating food or taking a medication suspected of causing an allergy. This procedure can trigger an allergic reaction and is therefore performed slowly and under full supervision in a hospital allergy clinic.

  • 3
    Adjustment of treatment

    Once the cause of the allergy has been identified and depending on the way the allergy manifests, a decision will be made whether to administer any personalized treatment to the patient.

Treatment

Proper treatment of an allergic disease can significantly improve the quality of life.

These are the treatments and recommendations available today:

  • Treatment of allergy symptoms: this treatment will be administered as needed (only when symptoms appear) or regularly. A family physician or allergy and immunology specialists can help administer medication that reduces sensitivity and alleviates the symptoms of some allergies, for example: antihistamines (pill, syrup or drops) to alleviate seasonal allergy symptoms, or a nasal spray that contains a small amount of steroids and can help allergic rhinitis. A person in danger of developing anaphylaxis will be instructed to carry 2 epinephrine (adrenaline) syringes, also known as “EpiPen” with them at all times.
  • Anti-allergy treatments: various treatments are currently available designed to stop the process leading to the disease and reducing allergic sensitivity:
    • Immunotherapy: treatment with vaccines aimed at reducing allergic sensitivity (mainly in cases of allergic rhinitis, allergic asthma and sensitivity to bee stings). The treatment, which has an extremely high success rate, includes the gradual injection of an escalating dose of the allergen that triggers the allergy, so that the body develops a tolerance towards it over time.
    • Controlled exposure to allergenic food (food desensitization): a treatment method based on gradual exposure of the immune system to escalating doses of allergenic food, by controlled eating and under full supervision in a hospital. The goal is to reduce food sensitivity and prevent life-threatening situations in case of accidental exposure.

Recommendations on prevention

  • Inhaled allergens: when it comes to allergy to inhaled substances, the best way to deal with it is to prevent it in the first place, by minimizing the chances of exposure to the allergen. These are the ways that can help in prevention:
    • Allergy to dust mites: it is important to minimize exposure to dust by adopting several rules: vacuum frequently, ventilate the rooms of the house, avoid laying out carpets and curtains in the house and especially in the bedrooms, change bedding often, wash bedding and pyjamas at high temperatures, prefer pillows and blankets made of synthetic fibers, avoid fabric or fur toys, make sure to clean filters in the home air conditioning system.
    • Allergy to animals: the most effective recommendation for allergy sufferers is to avoid raising pets but if the love for animals is irreconcilable and a decision has been made to continue raising a pet at home, several measures can be adopted such as making sure to bathe the animal at least once a week and to comb the fur, clean the hairs scattered in the house using a vacuum cleaner and frequently wash the floor, prohibit the animal from entering the bedroom and make sure that it does not climb on sofas and furniture.
    • Seasonal allergy: because allergens from most plants are airborne, they are difficult to avoid. But the particular plant is whose pollens cause an allergy is known, avoid staying near it as much as possible during the period when its pollens are dispersed. In addition, keeping the house clean and turning on air conditioning to reduce the amount of allergens in the air can also help.
  • "Urticaria" contact dermatitis: avoid exposure to substances to which there is sensitivity and allergy.
  • Foods: it is important that children diagnosed with a food allergy always have 2 epinephrine syringes that are not expired on hand for immediate treatment in case of a life-threatening emergency.
  • Medications: if it is suspected that the child has received a medicine suspected of causing an allergy, stop taking it immediately and seek medical treatment and clarification. If it is known that the child is allergic to any medication, it is important to carefully check the ingredients of the medications given to them, always ask the pharmacy if there is a risk in the medications they receive, wear an allergy bracelet and of course - always be careful.
  • Insect venom: the best way to defend against this allergy is to be careful not to get stung. When going out into nature, avoid visiting areas with many stinging insects. Make sure to wear long clothes that fully cover body parts, wear high shoes and also apply insect repellents. It is important to install nets at home. If you sleep outside, close the tent or the sleeping bag, use a mosquito net and always remember to check shoes, bags and the sleeping bag before use (insects can hide in them).

Instructions on what to do in case of an allergic reaction

  • When a mild allergic reaction occurs involving one system in the body (nose, skin, mouth or digestive tract), an antihistamine medication (drops, pill, syrup or ointment) must be taken and it is important to remain under supervision.
  • If a severe allergic reaction or mild allergic reactions occur in two or more of the body’s systems at the same time, an epinephrine (adrenaline) injection should be immediately administered, the EMS should be called and evacuation to the emergency room should be arranged. If there is no improvement within 5 minutes of the injection, administer another dose of epinephrine until the MDA arrives.

Important to emphasize: any person who is known to have an allergy that may deteriorate into anaphylaxis should carry an epinephrine (adrenaline) syringe with them. In addition, and most importantly: if the child has a known allergy that could deteriorate into a life-threatening reaction, they must carry two available syringes with them at all times (it is important that they are not expired). Also recommended is wearing a medical ID bracelet and also to instruct children over the age of 12 to use the syringe themselves.

Rights of children with allergies

Children dealing with a food allergy that can escalate into a life-threatening reaction may be eligible to several rights:

The National Insurance Institute pays children who meet the eligibility criteria a monthly allowance from the age of 9 months and until the age of 10. To receive the allowance, a claim must be submitted with National Insurance Institute. If the claim is approved, the allowance will be automatically transferred to the bank account of one of the parents.

Information about the eligibility criteria and on submitting a claim on the National Insurance Institute website (Hebrew)

According to the Ministry of Education guidance (Hebrew), educational institutions in Israel must prepare for food allergies, while addressing the various aspects of the life of pupils who suffer from allergies, and keep an epinephrine injector readily available for emergencies, in order to provide them with a safe environment free of the allergen to which they are sensitive. The educational institutions must also provide them with adequate conditions for learning, including emotional and social inclusion.

By virtue of this provision, there are several rights including:

  • Personal assistance and integration: children studying in regular education frameworks and dealing with a life-threatening allergy to milk or multiple life-threatening allergies, are entitled to the accompaniment of a person who will facilitate their inclusion despite the medical limitation. This eligibility is largely for children from the age of 3 to the third grade. Funding for the assistance will be provided by the Ministry of Health and the local authority.

    Apply for personal assistance service for a child with an allergy

  • Conduct of the educational staff: educational staff members are taught about allergies and their dangers so that they can help in an emergency. The guidelines for the educational staff depends on the type of allergy - food allergies that involve eating food are addressed differently than food allergies that involve touching or inhaling a food product. The staff will receive all relevant information about each pupil's sensitivity from the information contained in the medical document transferred to the educational institution or the after-school program.
  • Placement of signs: there is an obligation to place prominently visible signs in the educational institution, inside and outside the areas of activity, about the allergy and note that the educational institution is an area free of the allergen - meaning, there is permission to bring the allergen and products that contain it into the educational institution and the area of activity.
  • Consideration of restrictions when performing an activity that involves a supply of food (such as a trip or a party): the educational institution is responsible for ensuring that the food provided to all pupils does not contain the allergen.
  • Providing emotional and social support to children with allergies: to prevent discrimination on the basis of allergies, pupils with allergies must be given the opportunity to receive professional (psychological or similar) support from the educational institution in accordance with individual needs, plan an adapted menu for all the events and activities of the educational institution, as well as programs for teaching pupils about the subject and its importance.

The information was written in collaboration with the Israeli Association of Allergy and Clinical Immunology.

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