A SNEEZE and a wheeze are just one sign of an affliction affecting Australians at a greater rate.
Allergies are the fastest growing chronic disease in Australia, ranging from eczema and itches to full-blown and potentially deadly anaphylaxis.
For years the Riverina has been known as a hotbed of allergic reaction, but proper diagnosis and treatment required a long wait and travelling to a capital city.
However, children under the age of 18 can now be diagnosed for allergies in Wagga Wagga, and treatment and management applied without the need for onerous travel times.
Wagga-based paediatrician Dr Theresa Pitts has recently commenced clinics for the region’s children in a bid to alleviate the anxiety and stress parents can feel when coming to terms with allergies in their child.
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This new clinic provides diagnosis and advice on food allergy, medication allergy and airborne allergy, as well as management of eczema, allergic rhinitis (hayfever) and asthma.
“Allergy is an increasing entity in Australian children,” Dr Pitts said. “It causes a significant amount of stress for parents and discomfort for children.
“I am passionate about ensuring allergies are diagnosed and managed correctly, to avoid this stress, as well as to avoid an increase in allergies in the region.”
Families previously had to travel to Sydney, Melbourne or Canberra for similar services, which is time consuming and expensive, along with facing waiting lists of over 12 months.
“Holding clinics in Wagga means a shorter wait time for our patients, it lessens travel time and it allows allergy testing specific to our region,” Dr Pitts said.
While also working as a general paediatrician, Dr Pitts said the monthly clinic focuses only on allergies.
“I work with a nurse who is trained in skin-prick testing and provides education, as well as who manages food challenges,” she said.
“Allergy is important to diagnose due to the anxiety around avoiding a particular food, or of a child having a serious reaction.
“An allergy can be dangerous if not treated, including causing death. It can also cause a child to be unwell on a daily basis, particularly affecting sleep.”
There has been an increase in allergy diagnosis across the country. However, “why?” is a harder question to answer.
Some put forward the “hygiene hypothesis” - lack of early exposure to infections - but other reasons could be delayed introduction of allergenic foods or methods of food processing.
In paediatrics, food allergies are the most common, especially to eggs, nuts, and milk. In older children, allergic rhinitis due to grasses, pollens and dust mites tend to be more prominent.
Dr Pitts completed a graduate certificate in allergic diseases before being able to commence the clinics, including a practical component at Sydney Children’s Hospital and Campbelltown Hospital.
“I was very lucky to undertake my training with some of the best immunologists in the country,” she said. “I’m also a member of ASCIA, the governing body of allergy in Australia.”
Diagnosis is mainly through skin-prick testing, using a variety of allergens - such as eggs, milk, fish and nuts, to grasses, pollens, moulds and dust mites - determined after taking a medical history and speaking with the parents and child (if possible).
“We put a small drop of the extract on the child’s forearm, then we use a point to make a superficial break in the skin,” Dr Pitts said.
“After fifteen minutes, we measure the size of the reaction. It looks like a welt if it is positive.”
Management includes education around the allergy.
If a food allergy is detected, avoidance of the food is often required. An Epipen may also be prescribed.
For allergic rhinitis, management techniques can include a steroid nose spray or immunotherapy, a new treatment that changes the way the immune system reacts to the allergens.
Eczema may require wet dressings.
“The detection of an allergy can create a significant amount of stress for the family, so counselling may be required,” Dr Pitts said. “Schools often need a management plan.
“A big part of allergy testing is to actually prove that no allergy exists. Often a child avoids a food due to fear of allergy, or they have a reaction that they outgrow. The next step is then to introduce the food into the diet safely.
“Avoiding a certain food in a non-allergic child can increase the development of a true allergy later on. It is crucial not to restrict foods, unless there is a good reason.”
Allergies are the fastest growing chronic disease in Australia.
In 2005, the total cost of allergic diseases was about AU$30 billion per annum (ASCIA Access Economic Report 2007), or $7400 per person with allergies.