According to the Allergy Foundation of South Africa (AFSA), allergies, or allergic diseases as they are otherwise known, are on the increase globally from lower through to upper-income countries, and some 40% of allergy sufferers are children.
The Foundation says that no fewer than a third of all South Africans will develop some allergic disease such as asthma, allergic rhinitis (hay fever), eczema, food allergy or a severe allergic reaction (anaphylaxis) at some point during their lifetime.
Netcare’s medical director Dr Anchen Laubscher says allergies can not only have a negative impact on an affected child’s quality of life, but a severe allergic reaction can even be life threatening.
“Allergic conditions are among the most common of childhood chronic diseases. It is of critical importance for parents and childminders to be aware of what could elicit an allergic response as well as to the symptoms of allergies and, severe allergic reaction in particular, so that they can take the appropriate action to protect their children, should it ever become necessary,” warns Dr Laubscher.
“The severity of an allergic reaction can vary widely. The chronic, persistent effects generally range from mild and hardly noticed to significantly inconveniencing. In some cases, however, there can be a sudden and dramatic reaction such as severe skin inflammation, vomiting, swelling and respiratory compromise. Such a reaction may be an indication that the child is suffering a severe allergic reaction, or anaphylactic shock, which is considered a medical emergency.”
What is an allergy?
What exactly is an allergy? Dr Laubscher explains that an allergy is caused by the human body’s own immune system overreacting to a substance from the environment that is completely harmless to most other people. The immune system mistakenly responds to an otherwise harmless substance as if it were a serious threat.
“This triggers the release of chemicals such as histamine, which may result in a number of symptoms. The substances to which the immune system reacts are known as allergens, and some of the best known of these are peanuts, penicillin and bee sting toxin.”
She points out that children may develop allergies from exposure to substances such as certain foods, medicines, house dust mites, pollens, mould spores, animal danders, insect spore (i.e. from cockroaches), latex rubber, pet hair, cow’s milk, seafood, insect bites and stings, and many others. Allergic symptoms may affect the throat, nose, ears, eyes, airways, skin and digestive system.
The importance of managing allergies
“Among the problems with allergies in children is that we may not be aware that they have them and yet the symptoms may be causing the little one to suffer from malaise, and severely negatively impacting their quality of life. Your child’s concentration may be impaired by the allergy, for instance, and their school grades may suffer.”
“In addition, the fact that a child may not normally have a severe reaction to an allergen does not mean that they will not develop one at some future time. For this reason, it is important that possible allergies in children be medically investigated and if positively identified, closely managed with the assistance of a healthcare professional,” adds Dr Laubscher.
Head of clinical leadership at Netcare 911, David Stanton, says that anaphylactic shock is a severe whole-body allergic reaction to a substance to which the child or adult is allergic, and happens immediately after exposure to the allergen. “The child’s blood pressure may drop severely and their airways swell up and become blocked as their system attempts to process the allergen or the substance causing the reaction.”
Stanton says that the following may be signs that a child is suffering anaphylaxis:
- Swelling at the throat or mouth that may constrict breathing
- Difficulty breathing or swallowing and choking or wheezing
- Rapid pulse or irregular heartbeat
- General or localised skin changes such as a rash or itching, pale skin, blue skin colour, skin redness, sweating
- Pain in the abdomen and/or chest
- Nausea and vomiting
- Feeling faint/loss of consciousness
- Severe headache
According to Stanton, the symptoms of anaphylactic shock usually appear within two hours after exposure to the allergen, although they may only be evident as much as four hours later. In some cases the allergic reaction can be almost immediate.
What should you do?
“Should your child suffer a severe allergic reaction, call an emergency medical services provider such as Netcare 911 [082 911] immediately. While it can be alarming to witness someone develop anaphylactic shock, particularly as they may swell up and suffer difficulties breathing, try to stay calm and remain on the line with emergency medical services provider call-operator who will be able to provide guidance to you while you are waiting for medical assistance.
“You should lie the child down and elevate their feet to assist in reducing the risk of shock. Avoid administering an antihistamine in a child younger than six months, or if they are struggling to breathe, as they may choke on the tablet.
Mande Toubkin, Netcare’s general manager emergency, trauma, transplant and corporate social investment, says that although it is not always easy, the best way to prevent a child suffering a serious allergic reaction is to as far as possible make sure that they avoid having contact with their particular allergen or allergens.
“Children or adults who are allergic to bee or wasp stings, or tree nuts, for example, should strictly avoid all contact with these. Those who are allergic to foods such as peanuts or tree nuts can suffer a reaction from even trace amounts, so they must be sure to even avoid foods that have been prepared in close proximity to nuts,” she points out. Fortunately, food manufacturers will usually place a warning on packages if foods have been prepared with nuts.
“If your child is allergic to bee stings, you can take steps to try to ensure they don’t get stung. For instance, if they are playing in the grass, request that they wear shoes so that they can avoid stepping on a bee. Highly allergic children should also wear a medical bracelet and parents should carry an adrenalin auto-injector with them at all times as per the advice of a medical doctor. Antihistamine pills should also be kept close at hand, as they may be useful in the event of a less serious allergic reaction in an older child.”
Forewarned is forearmed
“In addition, if your child does have a serious allergy problem, inform their teachers and caregivers about it and explain what should be done in the event of a reaction. Forewarned is forearmed, and a few basic precautions can assist to keep your child safe,” she concludes.