Allergies and asthma, which typically start in childhood, are by far the most common chronic diseases among children in the United States. Consider the following statistics:
- Some 50 million Americans have allergies (about 1 in 5 people in this country).
- The most common type of allergy is hay fever (allergic rhinitis); the medical cost of treating it, when direct and indirect costs are added up, now exceeds $7 billion a year.
- More than 17 million Americans have asthma, and about one-fourth of these are younger than 18 years. Asthma accounts for about 4,000 deaths a year.
- Seventy to 80% of school-aged children with asthma also have allergies, which are among the most common triggers for asthma, closely tied with viral respiratory infections.
- If one parent has allergies, there’s a 25% chance that a child will also be allergic. The risk is more than doubled to 60% to 70% if both parents have allergies.
Many aspects of allergies, eczema, and asthma still are not fully understood. But advances in the diagnosis and treatment of these disorders are helping millions of sufferers.
What Are Allergies?
Many people mistakenly use the word allergy to refer to a disease or almost any unpleasant or adverse reaction. We often hear someone say, “I have allergies,” “He’s allergic to hard work,” or “She’s allergic to anything that’s green.” In reality, allergies are reactions that are usually caused by an overactive immune system. These reactions can occur in a variety of organs in the body, resulting in diseases such as asthma, hay fever, and eczema.
Your immune system is made up of a number of different cells that come from organs throughout the body—principally bone marrow, the thymus gland, and a network of lymph nodes and lymph tissue scattered throughout the body, including the spleen, gastrointestinal tract, tonsils, and the adenoid (an olive-shaped structure that is located at the top of the throat behind the nose).
Normally, it’s the immune system that protects the body against disease by searching out and destroying foreign invaders, such as viruses and bacteria. In an allergic reaction, the immune system overreacts and goes into action against a normally harmless substance, such as pollen or animal dander. These allergy-provoking substances are called allergens.
Who Is at Risk?
Although allergies can develop at any age, they most commonly show up during childhood or early adulthood. A search of family medical histories of a child with allergies will usually turn up a close relative who also has allergies. If one parent, brother, or sister has allergies, there is a 25% chance that a child will also have allergies. The risk is much higher if both parents are allergic. But the child will not necessarily be allergic to the same substances as the parents or always show the same type of allergic disease (eg, hay fever, asthma, eczema).
Symptoms Associated With Allergies
Eyes, Ears, Nose, Mouth
- Red, teary, or itchy eyes
- Puffiness around the eyes
- Sneezing
- Runny nose
- Itchy nose, nose rubbing
- Postnasal drip
- Nasal swelling and congestion
- Itchy ear canals
- Itching of the mouth and throat
Lungs
- Hacking dry cough or cough that produces clear mucus
- Wheezing (noisy breathing)
- Feeling of tightness in the chest
- Low exercise tolerance
- Rapid breathing; shortness of breath
Skin
- Eczema (patches of itchy, red skin rash)
- Hives (welts)
Intestines
- Cramps and intestinal discomfort
- Diarrhea
- Nausea or vomiting
Miscellaneous
- Headache
- Feelings of restlessness, irritability
- Excessive fatigue
When to Suspect an Allergy
Allergies can result in various types of conditions. Some are easy to identify by the pattern of symptoms that invariably follows exposure to a particular substance; others are more subtle and may masquerade as other conditions. Here are some common clues that should lead you to suspect your child may have an allergy.
- Patches of bumps or itchy, red skin that won’t go away
- Development of hives—intensely itchy skin eruptions that usually last for a few hours and move from one part of the body to another
- Repeated or chronic cold-like symptoms, such as a runny nose, nasal stuffiness, sneezing, and throat clearing, that last more than a week or two, or develop at about the same time every year
- Nose rubbing, sniffling, snorting, sneezing, or drippy nose
- Itchy, runny eyes
- Itching or tingling sensations in the mouth and throat
- Coughing, wheezing, difficulty breathing, and other respiratory symptoms
- Unexplained bouts of diarrhea, abdominal cramps, and other intestinal symptoms.
Where Does Asthma Fit In?
Although allergies can trigger asthma and asthma is often associated with allergies, they are actually 2 different things. In simple terms, asthma is a chronic condition originating in the lungs, whereas allergies describe reactions that originate in the immune system and can affect many organs, including the lungs. Many different substances and circumstances can trigger an asthma attack—exercise, exposure to cold air, a viral infection, air pollution, noxious fumes, tobacco smoke, and for many asthma sufferers, a host of allergens. In fact, about 80% of children with asthma also have allergies. Although allergies are important in triggering asthma, severe asthma exacerbations are often set off by the good old common cold virus, totally unrelated to allergy.