Tuesday 21 November 2017

An end to allergies - could this be the game changing treatment for hay fever?

It's peak pollen season, causing misery for hay fever sufferers. But one treatment could be a game changer

Cat Kennedy must take her hay-fever medicine before going outdoors.
Cat Kennedy must take her hay-fever medicine before going outdoors.

Áilín Quinlan

Teacher Cat Kennedy was happily overseeing the activities of her pupils on school sports day - until she had to be rushed to hospital after being overcome by hay fever.

The active 40-year-old from Blackrock in Dublin has had the condition since childhood, and though determined not to let it take over, it can make life miserable for several months of the year.

Cat is only one of many. According to new research, a staggering 40pc of Irish adults suffer from allergies and many find their lives are severely disrupted.

By then, one-in-five has taken sick days, one-third miss more than four days, and more than one-third report problems sleeping and effects on mood.

The research, which was conducted among 1,000 Irish people, found that hay fever accounts for 21pc of allergies. It is the most common allergy reported, followed by dust (13pc), food nine pc, and animal dander 5pc.

Cat Kennedy gets hay fever every year, from shortly after Easter through to September, experiencing a runny nose and itchy eyes.

To combat the extreme discomfort caused by her hay fever, she takes a mix of antihistamines, eye-drops, oral steroids and a saline nasal rinse to clear pollen out of her sinuses.

"I also have very bad asthma for which I get an injection, which also helps hay fever," she says.

An enthusiastic hiker and runner, she must take her medication before going outside during these months.

If she forgets the consequences can be uncomfortable, or worse.

"I have forgotten on occasion," she admits. A school sports day a few years ago became memorable for all the wrong reasons after Cat suffered such a severe attack of hay fever and asthma combined that she had to be brought to hospital by ambulance.

"It's extremely disruptive if I forget my medication. I have to take everything from about the beginning of May or I'm in trouble. I don't let it run my life. I do my running and hiking but I always have to take precautions."

Asthma and hay fever

Up to 80pc of Ireland's 470,000 asthma sufferers also have hay fever. There are more than 30 types of pollen and 20 types of spores which can trigger hay fever, which is also known as seasonal allergic rhinitis.

Grass pollen is the most common, although tree pollen can also cause problems, in particular from elder trees, horse chestnut, hazel and most commonly, birch.

For some people, symptoms are triggered by just one or two of the factors above, while others are affected by more.

The majority of sufferers find that the allergy can severely disrupt their lives, with up to 94pc of hay-fever patients reporting that their symptoms have an impact on their day-to-day work.

Allergy expert, Dr Paul Carson, points to predictions by experts that the figure for allergies is set to increase by 50pc in the next decade. Allergy is going to be an "enormous" healthcare burden in the coming years, he says, adding that it's believed the increase is driven by pollution in the atmosphere and the amount of chemical additives in our food, which he says are "swamping" our immune systems, particularly in young children.

"Allergy management is very poor generally in Ireland," he says, adding that part of the problem is a lack of adequate training for doctors to ensure they are skilled in allergy management.

With the peak grass pollen season upon us, it's important to have a plan to manage your asthma and allergies, warns Kevin Kelly of the Asthma Society of Ireland.

We are in the throes of hay fever, warns Professor Stephen Lane, consultant respiratory physician at Tallaght and Peamount Hospitals and professor of respiratory medicine at Trinity College Dublin.

"May, June and July is the peak period," he says, adding that hay fever affects about 15pc of the population. The allergic reaction can be debilitating.

"The condition brings runny, itchy red eyes, blocked runny nose and even wheeziness," says Lane.

Even worse, he says, children with hay fever can develop asthma as they grow older as a result of a process called the Allergic March.

"It can begin with eczema, then move to hay fever and then asthma. It can progress into early adulthood, says Prof Lane

Allergy management

The general advice is that someone with seasonal hay fever should avoid areas of grassland and keep car windows closed during pollen season, particularly in late morning and late afternoon. Don't sleep with your bedroom windows open, and try smearing Vaseline inside each nostril to capture the pollen grains.

"Monitor the pollen count, wear wraparound sunglasses to stop pollen grains getting into your eyes and stay inside if possible on hot, blowy, days. Rain precipitates all the pollen onto the ground."

Don't mow the lawn if you have hay fever, he cautions, and remember, a dull, damp day is better for hay fever. Describing the condition as "awful," Prof Lane says it can even make people depressed.

Prof Lane is a fan of Dr Paul Carson's Hayfever Relief App, and emphasises that sufferers can also avail of medical treatment such as antihistamines, either by prescription or over the counter, as well as topical steroid treatment in the form of eye drops or nasal sprays taken three or four weeks before the pollen season starts. "Some patients can require a course of oral steroid tablets if they have very severe hay fever."

However, he says, one treatment, available in Ireland since 2008, can not only treat hay-fever symptoms and even get rid of it in many patients, but it can also potentially stop the Allergic March in children, thus enabling them to avoid developing asthma later in life.

The treatment, known as Sublingual Immunotherapy (SLIT), simply involves taking a daily tablet under your tongue for three years.

"The advantage of SLIT is manifold. It's a treatment which can treat hay fever as effectively as steroids or antihistamines but also it can potentially get rid of it for good," says Prof Lane.

"There is very promising evidence which is very compelling," he says, adding that essentially the treatment works like a vaccine.

"You take it for three years and it induces tolerance, in other words, it retrains your immune system not to be allergic."

New lease of life

SLIT worked for enthusiastic golfer and mother-of-three, Pauline Corby, a radiology services manager who lives in Naas, Co Kildare.

"Around April or May of every year my eyes would become itchy, I'd have a runny nose, inflammation of my nasal passages and wouldn't be able to taste food - it was awful!

"I'd have it every day right through summer. It was torture and got worse as I got older."

Pauline says that when she played golf she had hay-fever symptoms.

"Trying to hold a club and hit a ball was very difficult," she says.

Pauline consulted her GP and tried all kinds of remedies, but nothing really worked.

Then in 2013, she attended a talk by Prof Lane about hay fever.

She made an appointment to see him and following her consultation underwent allergy screening and a pulmonary function test to gauge her lung capacity.

She was initially put on an inhaler and steroids as well as a nasal spray, but later began SLIT.

"Basically, I took a little tablet every day under my tongue for three years and also one puff of an inhaler per day as the PF test had shown that my lungs were not working to full capacity."

She started the treatment in the autumn of 2013 and the results have been eye-opening.

"When spring 2014 arrived my symptoms failed to return. I simply didn't have them, and that has been the situation ever since."

She finished the tablets last autumn and has never looked back.

"Now although I still play a lot of golf , I don't have any symptoms. I couldn't believe I'd get so much benefit from one little tablet."

* You can monitor the daily pollen count on www.asthma.ie

For advice, call the Asthma Society of Ireland on 1800 445464

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