Anaphylaxis

Anaphylaxis is a rare but severe allergic reaction that can occur after exposure to an allergy-causing substance. If you have a history of allergies or a family history of anaphylactic reactions, you may be at higher risk. Causes of anaphylaxis include certain medications, latex, insect bites and stings, and foods such as peanuts, shellfish, and dairy products. Anaphylactic reactions are rarely caused by pollens.

Symptoms of anaphylaxis include:

• intense itching or burning
• sneezing or coughing
• flushing, redness of the skin
• watery eyes
• hives
• tightness in chest/difficulty breathing
• wheezing
• tongue swelling
• nausea/vomiting
• rapid/weak pulse
• decreased/low blood pressure
• shock
• dizziness/fainting

If you think you have had an anaphylactic response, you should see an allergy specialist. The specialist will evaluate your symptoms and ask questions related to your exposure and reactions to different allergy-causing substances. This will determine if you have had an anaphylactic response, and if so, what has triggered it. Allergy testing may also be part of the evaluation. Although anaphylaxis is rare, it is serious and potentially life-threatening. One out of every 2.5 million people per year dies from anaphylaxis.

Epinephrine

Epinephrine (adrenaline) is the drug that is most commonly used to treat anaphylaxis. If you are at risk, your doctor or specialist may recommend you carry an epinephrine kit, which includes a self-injecting shot. The shot can be self-administered, and should be given immediately after the reaction until professional medical attention is available. Follow-up by a medical professional should be performed as soon as possible. You may also want to wear a MedicAlert bracelet indicating your condition and instruct family members and friends how to administer the epinephrine to you in case you have a reaction and are unable to administer it to yourself.

Environmental control: allergies

Controlling dust mites, mold spores, house dust, animal dander, and exposure to pollen can help relieve and prevent allergy symptoms. Refer to the following list for ideas on how to control your environment and for better management of rhinitis (nasal - "hay fever") symptoms.

In the home

• Regularly air out tight, closed spaces like bathrooms and closets.
• Use a damp, not dry, cloth to dust rooms weekly.
• Reduce the number of indoor plants in your home - they are a breeding ground for mildew.
• Reduce or discard items that are likely to collect dust (e.g., dried flowers and stuffed animals).
• Use a dehumidifier or air conditioner.
• Remember to change air filters regularly in heating and air-conditioning systems.
• Keep windows and doors closed during heavy pollination seasons.
• If possible, replace wall-to-wall carpeting with wood or linoleum floors.
• Use dust masks when cleaning.

Bedrooms

• To relieve nasal congestion, try tilting the head of the bed upwards.
• Use allergen-impermeable covers on mattresses and pillows.
• Wash linens in hot water to kill dust mites.
• Use hypo-allergenic bedding, pillows, and blankets.

Outside

• Avoid the outdoors during early morning hours - this is when pollen levels are highest.
• Try to limit outdoor work - leaves, grass, peat, and mulch are common allergens.
• If you must mow the lawn yourself, remember to use a mask.
• Keep the grass cut short.

Pets

• Keep pets that produce dander (cats and dogs) outside.
• If pets must stay indoors, do not allow them into sleeping areas or rooms with upholstered furniture.
• If you have a young child who is clearly allergic to your pet, you should probably get rid of the pet (we are assuming you would prefer to keep the child), although some physicians may recommend low-dose nasal corticosteroids for the child.

Allergy treatment

Allergy sufferers should be seen by an allergist or an ENT (ear, nose, throat) specialist. The physician or specialist will ask questions related to the patient's medical history and may perform a series of medical examinations and tests. One common test is the "skin test," done by scratching or lightly injecting a small amount of allergen into the surface of the patient's skin. If a large hive develops, it usually means the patient is "sensitive" (allergic) to that allergen. Skin tests help to determine the patient's sensitivity to each allergen, making it easier for the patient and physician to formulate a plan to alleviate the symptoms caused by the allergens.

Environmental factors

Counselling in proper environmental control is often included as part of allergy treatment. Avoiding substances that cause allergic reactions may make symptoms more manageable. Preventative measures can reduce the frequency and severity of allergic reactions significantly.

Medications

Medications such as antihistamines and decongestants are commonly used to prevent and relieve allergy symptoms. They are widely available over the counter or by prescription. Anti-inflammatory agents such as cromolyn, nedocromil, and corticosteroids are also used to prevent allergy symptoms. These drugs work by helping to reduce inflammation in the airways caused by allergens. Low-dose corticosteroid nasal spray has become very popular and has proven to be extremely effective in managing the rhinitis (nasal inflammation) caused by allergies.

Allergen immunotherapy (allergy shots)

Allergy shots are given to patients with moderate to severe allergies. If the patient's allergy symptoms occur year round, or if the allergy is caused by a substance that is not easily avoidable, allergy shots may be the most effective form of treatment. In immunotherapy, the patient is given a series of shots or vaccinations to help build immunity to the allergen. Patients are given an injection once a week containing only the allergens to which the patient reacts. As the weeks progress, the concentration of the allergen in each shot is gradually increased. Typically, patients will receive injections for 3 to 5 years or more.

Immunotherapy is a relatively safe if somewhat old-fashioned method of treatment. The effectiveness of these shots can be quite variable.

School Health Profiles

The School Health Profiles helps state and district education and health agencies monitor the current status of school health education; school health policies related to HIV infection/AIDS, tobacco use prevention, unintentional injuries and violence, physical activity, and food service; physical education; asthma management activities; and family and community involvement in school health programs. State and local education and health agencies conduct the survey biennially at the middle/junior high school and senior high school levels in their states or districts, respectively.