Allergy: Why it remains a dire condition

At the age of five, Samuela Muhonga started experiencing on and off rashes, which were sparsely distributed on her hands and neck at first. Recently, she developed a rash that spread to the entire body. The rashes appeared in clusters and by the end of the day they looked like blisters. Following a visit to the doctor, her mother was advised not to give her eggs – one of her most favourite foods - as her body was found to be reacting to them. Jean de Dieu Nsanzimana, a dermatologist at Rwanda Military Hospital - Kanombe, says Muhonga’s case was due to food intolerance (food allergy), one of the commonest allergies, adding that allergic disorders can occur at any age in both men and women. “This was due to unpleasant reaction to the eggs she was being fed on, children as well as adults can be allergic to any food, pollen, and pet among others. But the most common ones include eggs, milk, soya, peanuts, wheat and fish,” he says. According to a recent research published by Food Allergy Research and Education, nearly any food is capable of causing an allergic reaction, and most allergens are proteins. The organisation states that 90 per cent of food-allergic reactions are caused by allergens from the group of proteins, such as peanuts, nuts, milk, eggs, wheat, soy, shellfish and fish. Food Allergy Research and Education is a US-based non-profit organisation dedicated to food allergy awareness, education, research and advocacy. However, Nsanzimana says it’s hard for one to recognise that a person is having a reaction to a particular food, which requires seeking medical attention if they experience an uncommon sensation on any part of their body. He warns that if not identified and prevented early, food allergic reactions can lead to distressing illness and at times become fatal. “For instance, the reaction of the skin can lead to deep and painful wounds, which would result into complications of other diseases that would require immediate medication,” he says. How allergy comes about According to Rachna Pande, an internal medicine specialist, allergy results from the body being hypersensitive to foodstuff, an inhaled substance or one applied over the skin. “For those having skin allergies, symptoms such as bumps, itching, redness and other skin conditions are very common, making it hard to identify the cause. Rashes can be caused by allergic reactions to a medication or a food, or an illness,” she says. Pande adds that when the body is exposed to certain substances, it becomes sensitive and antibodies (protective protein groups) are formed against the offending substance or antigen. Drugs can be used to relieve one of an allergy attack. / Lydia Atieno On subsequent exposure, antibodies in the body combine with this antigen and the resultant reaction causes these problems, she notes. Dr Nick Karugahe, a general practitioner in Kigali, explains that during a reaction, the immune system releases antibodies, which are proteins that deliver a message to cells which then send out histamine (an organic nitrogenous compound involved in immune responses), which causes blood vessels to expand triggering an allergy symptom. He notes that depending on the way one’s body reacts and how much of the allergen got into system, allergy may come in different forms ranging from mild to severe, making it hard for one to know the exact cause of what they are experiencing. “Such allergies could also manifest in mild forms such as sneezing, frequent colds, dry cough, mild itching with few eruptions and rashes on the skin. Severe attack of asthma or urticarial can be more troublesome symptoms of allergy,” he says. Complications due to allergy According Protais Munyarugamba, a specialist in ear throat and nose (ETN) at Harmony de Clinic in Kigali, at times, allergies are hereditary, and can cause other complications. “If the allergies are severe, one can develop diseases such as bronchial asthma and frequent cold, which run in families,” he says. Munyarugamba says sometimes allergy can be due to external causes such as worm infestations. He further explains that in this case, migratory larvae of worms lodged in intestine tend to produce allergy. An individual may have only one manifestation of allergy, such as recurrent sneezing, although some may experience multiple manifestations. “These can be recurrent cold, cough, asthma or skin rash related to change of season or exposure to dust,” he adds. Dr Karugahe says repeated cold, cough or skin troubles may lead to secondary infections and consequently get thicker. With recurrent health condition resulting from allergies, it can affect someone’s concentration thus affecting their work, he adds. “One may also experience a life-threatening allergic reaction known as anaphylaxis, which is associated with food allergies. This comes with symptoms such as loss of consciousness, shortness of breath, skin rushes nausea and vomiting,” he says. Risk factors Dr Munyarugamba points out that, depending on the causes, the risk factors may be controlled or even prevented. “If your family had a history of food allergies such as asthma or eczema, among others, one is likely to develop allergic reactions. When one is allergic to one food, the possibility of becoming allergic to another is high,” he says. According to Munyarugamba, age may also contribute to the risk of developing allergies. For instance, children are more prone to food allergies compared to adults due to their immature digestive system. Apart from food allergy, one can also develop skin allergies arising from exposure to dust, chemicals, pollen, pets as well as insect stings. How to go about it “Ideally, there is no specific treatment for allergies, but there are medications to ease and treat the symptoms,” says Nsanzimana. He says that for those experiencing symptoms such as colds or flu, it should not last for long, but if it does, this can lead to headaches which are as a result of extra mucus due to the swelling of nasal passage during the allergic reaction. In such cases, he advises that decongestants should be used to provide relief. “If one has a reaction on their skin manifesting as rashes, antihistamines and moisturisers should be applied, and for the severe ones, seeking medication for better management is important,” Nsanzimana advises. If after treatment one still experiences similar symptoms, seeking further investigation or changing of medication might help stop the situation. Karugahe says the best way to go for people who are allergic to pollen is stay away from foods such as bananas, cucumber and melon as they may worsen the symptoms. He notes that hot, spicy foods also can be of help to people with congested nasal allergy as they aid in clearing nasal passages. On the other hand, Karugahe says one should avoid some allergy symptoms like sneezing by vacuum cleaning their houses once a week, as well as washing their clothing and beddings in order to remove allergens that may be present in them. He notes that avoiding consuming foods that cause allergies helps in managing the condition. However, experts caution that making sure that one sees a dietician is essential since avoiding the foods that trigger allergies means that other options of foods with the same nutrients as those excluded should be included in their diets. Eating in restaurants for persons with allergic reactions should be avoided because some of the foods are prepared using ingredients that would result into allergies. Besides, Pande advises that one should learn to live with allergy, by observing the substance causing the it. This applies to substances applied on body or those eaten, as the most important thing to know and avoid, are the causes. “In situations involving exposure to dust, fumes, it is advisable to cover the nose. One also needs to use natural substances in place of chemicals, as chances of allergy are more with chemicals,” she says. *** EXPERT TIPS Ivan Ntwari, medical practitionerFor those who are sensitive to dust and other types of dirt, they should make sure they vacuum clean their habitats at least twice a week. Avoiding animal pets is also important. However, if the allergy is hereditary, one should find a way of relieving the symptoms and stay away from things that may trigger that allergy. -- Immaculate Kiza, medical studentIf one is allergic to specific foods, avoiding them will relieve their symptoms. On the other hand, reducing exposure to some allergens such as mites and insects is important as it delays and prevents allergy symptoms. For children, they shouldn’t be exposed to tobacco smoke as well as given too much of proteins. -- Claude Uwajeneza, nurseThose with asthma, they are at risk of having allergic reactions from a lot of things. So, to stay away from getting allergies, one of the best ways is to avoid colds, especially during rainy seasons. Also, those with skin reactions, seeing dermatologist is ideal so they can be put on right medication to avoid further skin complications. -- Raymond Awazi, pediatricianMothers should exclusively breastfeed their babies for the six months without including any foods. This is because some foods such as those in solid form are most likely to cause allergy to the infants. Additionally, minimising proteins in children’s diet is essential too.

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Allergy: Why it remains a dire condition