Medical Health Information

An allergy is defined as an immunological response of the body, inappropriate and exaggerated towards certain foreign substances: allergens. An allergy occurs and in contact with pollen, dust mites, animal dander but also certain foods or medications. The environment contains many allergens to which the patient may react allergic.

Allergies can affect the eyes, skin, respiratory system such as the nose or bronchi.

Allergy Information
Today, the number of allergies is increasing in industrialized countries. WHO (World Health Organization) classifies allergic diseases fourth world conditions and considers that these conditions represent "a major public health problem." Allergy reaches all ages, but particularly affects younger. Respiratory allergies are the most common since it is estimated that about one in four present clinical symptoms of respiratory allergy (1).

Causes and mechanisms of allergy

Allergy requires several steps in order to occur. The first step is a step called awareness first encounter with the allergen. It is only from the second minimum contact the allergic reaction is releasing a substance called histamine, causing the symptoms. The action of histamine can be blocked by specific medicines called "antihistamines".

Allergy does not hereditary, but an allergic (or atopic) favors: Children allergic parents are more at risk of having an allergic sensitivity also.

Symptoms of allergy

Allergic symptoms are varied and may occur simultaneously or successively in the life of the allergic:

ENT symptoms
They lead demonstrations near the cold with stuffy nose, runny, sneezing ... is known as allergic rhinitis may be seasonal (pollen allergy or hay fever) or permanent (allergy to pet hair, to mites ...).

Ocular symptoms
They are associated or isolated and consist of eye irritation or allergic conjunctivitis affecting both eyes watery, red eyes and itching, red and swollen eyelids.

The inflammation of the bronchi
Meanwhile this symptom may be more severe, causing respiratory problems as asthma (wheezing, mucus production, cough ...).

Allergic conjunctivitis
This disease results in symptoms of redness and burning of the eye and eyelid.

Skin Problems
The skin can also be achieved in several symptoms, irritation, red blotches or spots. Atopic eczema (also called atopic dermatitis) occurs very early in the infant's life, with redness and itching of the face. Urticaria allergic (small red bumps and intense itching) occurs about him often after ingestion of a drug or a food. Angioedema is the most serious form of allergy, urticaria and generalized edema combination can lead to death.

With what should we be confused?

Contact eczema is a particular form of allergy called delayed. It reaches more adults and combines a red patchy rash, small vesicles (small fluid-filled pimples) and severe itching localized points of contact of the allergen (nickel, professional dyes ...) with skin lesions appear two to three days after contact. The treatment is to avoid contact with the allergen.

In addition, there are cases of true allergy to cow's milk, particularly in infants, but intolerance to milk protein, the most frequent case is often confused with an allergy.

Is there a prevention possible?

Identify the offending allergens can be avoided to the maximum. For example, the main food allergens are egg, peanuts, Rosaceae (cherry, apple, peach, plum ...), the Umbelliferae (celery, carrot, parsley,  fennel ...), tree latex (avocado, kiwi,  banana ...), seafood (oysters), crustaceans and fish.

For dust mite allergy, better moderate room temperature (18-19 ° C maximum), ventilate regularly, avoid carpets and other "dust traps" (curtains, carpets), using mite covers for mattresses, pillows, duvets and bolsters.

For allergies to pollen, avoid picnics and walks during pollination periods (spring, summer), do not mow the lawn or be present during mowing.

In all cases, smoking cessation is desirable.

When to consult?

Symptoms should be treated as emergency angioedema or anaphylaxis (or allergic). Difficulty breathing, generalized edema, voice changes are warning signs requiring the call SAMU Centre 15.

What is the doctor?

Before signs of allergy, a doctor consultation is required. This may refer you to an allergist to identify the allergen (or allergens) in question and develop a treatment.

Any allergy consultation through careful questioning and clinical examination. Depending on the suspected allergens, tests called prick tests or skin tests may be offered. Principle is based on the reproduction on a small scale and at the skin, allergic reactions: an injection is made on the skin (forearm, back) and a drop of allergen is deposited. In case of allergy, redness and itchiness occur.

Other tests or analyzes can be performed depending on the results of tests: blood tests, tests of reproduction ...
Treatments include the allergen avoidance. Of medicines called antihistamines fight against allergy symptoms. Finally, desensitization (or immunotherapy) is sometimes given to treat the cause of the allergy.

How to prepare my next visit?

To facilitate diagnosis and guide the tests, you can even establish a first list of allergens to which you are allergic. To do this, we must reconstruct the history of symptoms (length, frequency, precipitating factors, activities ...) and send it to the doctor during his interrogation.

What are the signs?
What tests should be done?

What are the symptoms of a food allergy
The onset of symptoms is usually very fast, a few minutes to 4 hours after ingestion of the food. But in cases of eczema and gastrointestinal symptoms, the symptoms are permanent or appear in delays of up to several days after consumption of the food.

Symptoms after the consumption often appear sometimes smell (steam inhalation of food), or by skin contact with the food or cosmetics containing food proteins.

Recognize the symptoms of a food allergy can be tricky, because they are different and all parts of the body can be affected (Table 2). Signs and are often associated with cutaneous signs are more common in children.

Table 2. Signs of food allergy.

Skin symptoms (skin) and mucosal
- Acute urticaria greater or lesser extent
- Eczema
- Angioedema (swelling of eyelids, lips, tongue, larynx in the most severe forms)
Gastrointestinal symptoms
- Oral Allergy Syndrome (has a tingling in the mouth and throat, swelling of the lips and feeling when swallowing gene).
- Nausea
- Vomiting
- Abdominal pain
- Diarrhea, bloody stools
- Growth retardation, sleep disorders, irritability in infants
Respiratory symptoms
- Rhinitis, rhinoconjunctivitis
- Laryngeal edema
- Cough, wheezing, difficulty breathing
- Asthma

Anaphylactic shock
It is the majority solemn manifestation of food allergy that requires instant treatment. It frequently begins with malaise, followed by itchy hives or complexity breathing. From time to time loss of consciousness related with a voltage drop is pragmatic. This is a true medical emergency requiring immediate care (call SAMU)

What tests should be done?

Identify a food allergy begins with a careful designed to clarify the family and personal history, what foods were consumed, the time to onset of symptoms after ingestion of food or suspects.

The diagnostic approach to food allergy occurs in 4 steps.

Step 1: The dietary survey carried out 7 days to define the chronological relationships between food intake and suspicious symptoms.

Step 2: Skin tests / patch.
Skin tests (skin) are made by the prick test technique that involves placing a drop of allergen on the skin and then make a stitch through the drop of reagent. Tests are carried on the arm or on the back, and reading is done after 15 minutes, the time required for the formation of the wheal. Sometimes these tests are performed with a natural food, and include first bite of food and skin. It is necessary to stop before the anti-histamines (at least 3 days).

Patch tests or "atopy patch test" foods are used in individuals who have eczema or gastrointestinal symptoms. Natural foods are placed in wells that are applied at the upper back and maintained by a plaster. Reading test is performed during the withdrawal of the cup at 48 and 72 h after application.
These tests are compared with the clinical history and may be supplemented by further explorations.

Step 3: The biological exploration is performed from blood samples for measuring specific IgE and skin tests complete. Other assays are performed in special cases.

Step 4: Test of oral provocation is the only test to prove the reality of a food allergy. It is supposed to be eating the food allergic conditions of maximum safety, ie in highly specialized hospitals. It identifies the amount of food that causes the symptoms and it defines the type of reaction triggered by the ingestion of food. The test is often preceded by a test application of the food on the lip (labial provocation test).

The elimination diet

For now, the only treatment for food allergy is avoidance diet of food identified by allergy testing. It is to eliminate all forms of food the food. It is a long process of education as we must learn to recognize the same masked allergens (in industrial preparations, for example), to decipher the labels to know what are some code or name, and also avoid drugs or cosmetics that may contain.

The labeling

The label is the identity card of a pre-packaged food. It identifies all the components that are listed in descending order after the word "ingredient." Ingredient is defined as a substance added intentionally. Indeed, it requires to be declared in the ingredients list all substances or derivatives of these substances in the list of 12 allergens mandatory labeling (Table 3). Reporting is mandatory regardless of the amount of food when it was used in the production of a foodstuff and is still present in the finished product, even in a modified form. Registration must be easily legible, clearly comprehensible and indelible.

Table 3. Foods mandatory labeling

- Cereals containing gluten (wheat, rye, barley, oats, spelled, kamut or their hybridised strains) and products made from these grains
- Crustaceans and shellfish products
- Eggs and egg products
- Fish and fish products
- Peanuts and peanut products
- Soybeans and soy products
- Milk and milk products (including lactose)
- Nuts that is to say: hazelnuts, brazil nuts, cashews, walnuts, almonds, pistachio nuts, Queensland,  pecans and macadamia nuts all products based on these fruits
- Celery and celery products
- Mustard and mustard products
- Sesame seeds and products made from sesame seeds
- Sulphur dioxide and sulphites> 10 mg / kg (or 10 mg) expressed as SO2
The list is unique but can be changed over time. The European Commission is exempt temporarily, until November 2007, the labeling of food derived to demonstrate their lack of allergenicity (Official Gazette No. 219 of 20 September 2005). This is the case eg glucose syrup from wheat, lysozyme (produced from egg) used in wine, whey used in distillates for alcohol, oleosins mustard seeds or celery.

A precautionary labeling appeared with honors from the list of ingredients "may contain ...", "possible presence ..." without specifying the quantity contained in these products. It is possible that these new records represent only a risk of contamination of finished products by food. It would be incidental presence of the allergen should not be present or may present rarely or very low quantities. These new records make it impossible to consumption of these foods by allergic patients, and seriously complicates the choice of food.

Treatment of reactions

Antihistamines, corticosteroids, bronchodilators, adrenaline ... are drugs that treat the symptoms of the allergic reaction but have no effect on the allergy itself. Desensitization, effective for respiratory allergies is not yet applicable in the case of food allergies.

Convert care
Project Home Individualized (or PAI) is designed for children with severe food allergy to counter the allergic emergency that may arise in school structures and extra-curricular. It aims to facilitate the integration and academic success of children with allergies. It comes from official documents. Its implementation is done at the request of parents, the physician of Education, in consultation with the Warden, and follows the instructions of the allergist who determined to avoid foods and medications to administer allergic reactions.

Food allergy is the name given to all clinical manifestations that occur after the consumption of a food (sometimes after skin contact or by simply breathing the smell) and in which there is a specific immunological mechanism (production specific antibodies, IgE).

Food allergy in figures

Food allergy is increasing. It is estimated that more than doubled in five years. Food allergy affects 3.4% of the population (adults and children), or 2,108,000 people. Children are three times more likely than adults. Food allergy affects 5 to 7% of children aged less than 15 years.

There is a gap between the actual and the food allergic population reflecting the thinking of being allergic. In fact, 20-30% of the population suffer from food allergies think. This impression is due to the so called "false allergies" that gather reactions caused by eating foods rich in histamine such as strawberry, for example. These reactions are similar to those observed in the "true allergies" but are not accompanied by production of specific antibodies. (IgE)

Why food intolerances are becoming more frequent?

The answers are many. It evokes a better understanding of food allergy, a diversification of early infant feeding, a genetic able to produce antibodies, exposure to new foods or food exotic internationalization of menus.

What are the foods most often implicated in food allergies?

Every food is proficient of causing a food allergy (Table 1) in hypersensitive individuals. Conversely, several foods are more probable than others to cause food allergy. In children, the main foods are cow's milk, egg, peanut (peanut), wheat flour, fish, and shrimp. With the internationalization of menus, food diversification, were added kiwi, nuts and sesame.

Table 1. Foods are classified in two categories.

1. foods of animal origin
- Cow's milk.
- Hen's egg
- Fish: cod, whiting, dab, sole, tuna, mackerel, shark ...
- Shellfish: escargot, oysters, mussels, clams, squid, octopus, cuttlefish, abalone, limpet, lobster, crayfish, shrimp, crab ...
- Poultry: chicken, turkey, duck, pigeon, goose, pheasant, quail
- Meat: beef mainly, sometimes, veal, pork, mutton

2. Foods of plant origin
- Peanut
- Cereals: wheat, oats, barley, rye, rice, maize
- Umbelliferae: celeriac, celery, carrot
- Solanaceae: tomato, eggplant, potato
- Nuts: hazelnuts, pistachios, almonds, pine nuts, walnuts, Brazil nuts, cashews, pecans, coconut, macadamia nuts ...
- Mustard and other cruciferous radishes, rutabagas, cabbage (red, flower, root, Chinese, Brussels), broccoli, horseradish, watercress, turnip rape
- Rosaceae: apple, apricot, cherry, nectarine, peach, plum, blackberry, raspberry, strawberry, medlar, quince, pear
- Fruits and exotic kiwi, mango, starfruit, pineapple, papaya, melon, fig, banana, orange, lemon, grapefruit, mandarin, kumquat, lychee, rambutan
- Spices: garlic, cardamom, coriander, cumin, turmeric, paprika, ginger, cloves, mustard, nutmeg, onion, paprika, chili, pepper
- Honey and bee products: honey, royal jelly, propolis, pollen loads
- Sesame

Seasonal Allergies

Achoo! No, this is not the traditional cold. Allergies are seasonal resurface. In Quebec, it is estimated that just over one in ten people are bothered by seasonal allergies.

Allergic rhinitis, the famous hay fever, is caused mainly by pollen, a substance that allows trees, grasses (corn, wheat, hay, rye, etc...) And herbaceous (ragweed, grass) to reproduce. All these plants are directly dependent on wind for pollination so that the outside air contains a lot of suspended pollen; pollen comes "infect" the respiratory system of people who are allergic. Dust, mold, pollution, animal dander, and even feathers can also cause allergy symptoms, ranging from simple sneezing and red eyes and swollen sinus infections and ear, chronic bronchitis and asthma.

An allergy occurs when the immune system becomes hypersensitive to certain substances and develops antibodies to fight them. This is when symptoms appear allergy.

Flowering plants whose pollen is too heavy to travel through the air, are pollinated by insects and are not responsible for the symptoms of allergy (asthma and sneezing).

All allergies are not directly caused by pollen, and sometimes it is a protein contained within the plant that can be found at the air. This is why it is possible that allergy symptoms occur without pollen in the environment.

Time and season

The weather directly affects the amount of pollen into the air. A warm spring and short term cause the pollen season is shorter than when the spring is fresh. It is also clear that the rain prevents pollen circulating through the air and consequently, the symptoms are much less severe during rainy days.

In Quebec, there are three "seasons" of pollination. In the spring, the pollen of trees and shrubs that causes the problem, while May to October it is the grass that problem. Ragweed and grass are a source of allergy from late July through September. It is estimated that over 75% of people with hay fever are sensitive to ragweed.

Prevention

To prevent allergic rhinitis or at least limit the symptoms, it is important to identify the source of the allergy!

The pollen is dispersed primarily between 8 am and noon each day.

As it is, especially when there is no rain and windy that pollen travels more, it is better to shorten trips outside those days, particularly in the morning and late at night.

Birch, ash, maple, poplar and oak are among those trees that produce more pollen. Try to stay away from!

By controlling the presence of ragweed in your neighborhood, you can prevent its spread. It must not only worry about your field, but be alert to its presence in your neighborhood. Why not organize a chore grubbing with some neighbors?

The allergic people should avoid going out when you mow the lawn.

Keep windows and doors closed can also help, as well as the use of an air conditioner at home and in the car.

If it is the eyes that are most affected, wearing sunglasses can be an obstacle to pollen.

Wash your hands frequently to avoid depositing pollen near your eyes or your nose. Similarly, you should wash your hair at the end of each day spent outside since the hair retained pollen like a net.

Clothing and linen's allergic person should not be dried out.

Treatment

Be sure to note what are the symptoms, duration, and when they appear. Thus, you will help the physician to identify the cause of allergies and how to relieve you.

Only 1 of four allergic person alleged to be able to control their symptoms effectively.

The application of cold wet compresses helps to relieve itchy eyes. It should also avoid rubbing the eyes.

Artificial tears can help clean the infected eyes.

Nasal sprays containing salt water to help relieve the itching of the nose.

Antihistamines available over the counter to help reduce the sneezing, runny nose and itching that accompany allergy. They are most useful when used before exposure to allergens. Ask your pharmacist to find the product that best suits, your symptoms and the age of the allergic person.

Before making a release, it is good to check if the air contains pollen.

We keep talking about pollen, but the sun also may be responsible for allergies: summer, a rash of small called benign summer light eruption is nothing but a sun allergy seasonal.

The first episode occurs on the second or third day of the summer holidays, after sunbathing, exposure to prolonged and intense rays. The buttons appear first at the neckline. The rash lasts five to six days, then disappears spontaneously when the person remains in the shade.

In recent years, scholars have observed an actual increase as the number of polymorphous light eruption. An increase or a part of them attributed to the use of sunscreen products. According to them, since the appearance of "sunscreen," people expose themselves longer without fear of getting sunburn.

However, this sunburn is caused by ultraviolet B, UVB, which are filtered by the "sunscreen," unlike UVA, lucite solely responsible for the summer, which are only partially filtered. This exposure would be one explanation for the increase in cases of lucite.

Anyway, lucite is an allergy that worsens with time. Neckline, it gradually spreads to the forearms, arms and even faces. It lasts longer, sometimes for the entire vacation. After several years, among the most sensitive people, the rash may even occur during a single weekend of May, or be triggered by UVA tanning booth aesthetic.

How to behave? Once declared lucite, it takes more sun exposure at least for the duration of the eruption, wear on protected areas and do not hesitate to follow the treatment prescribed by the doctor against drug's inflammation and itching.

It is more appropriate to apply the guidelines for effective prevention. We must expose gradually for 20 to 30 minutes maximum on the first day and the hours when the sun is not too strong. This precaution applies for several years. It must be applied every day, even after tanning installed.

Furthermore, effective, sunscreens, at least that filter UVA and UVB. But beware! No need to put the first few days, or precisely when the sun shines. Just remember to apply once or twice, even on a cloudy day, so that the symptoms recur.

We all know at least one person who is allergic to peanuts and at least one other participant in the festival season in full sneezing pollen allergy. To learn more about them, see our record on food allergies, as well as on pollen allergy.

Today, more and more frequently, the patient records contain allergists diagnoses mold allergy, allergy cleaners, dust mite allergy ...

New allergies, allergies more: why?

In rich countries, the number of cases of asthma has doubled over the last thirty years. In Canada, the disease now strikes one in eight children. Whether in North America, Europe and the United States, several studies have shown a link between what we might call the obsession with hygiene and increased cases of asthma.

This was confirmed by Dr Guy Delespesse, immunologist and director of the Laboratory for Allergy Research. Over the environment in which a child life is sterile, he said, the more likely it develops allergies or immune problem is high.

But how this link is it possible? From birth, the baby is in contact with germs from the environment, which then colonize the digestive tract and settle in his gut. With the good bacteria found there also, they form the balance of intestinal flora. The immune system, he distinguishes what is harmful and what does not.

Disinfectant in an almost obsessive, it closes the door to germs and bacteria that can colonize the intestinal flora, which prevents the immune system to defend against infections. It becomes more vulnerable to allergies.

Without changing our habits of hygiene, we must guard against these allergens, increasingly many who are attacking our health the main sources of allergens and some tips to keep them away.

Animals

Contrary to what is believed, allergy to our animal friends - and those we do not like! - Is not caused by their hair (whether long or short), but their urine, saliva and secretions from their glands. And it is not only affecting the animal allergic reaction can occur: the mere fact of being in his presence is enough.

This allergen can cause asthma, urticaria, eczema and rhino conjunctivitis.

Advice

Avoidance! There is no other way to get rid of the allergen do not approach the animal that causes your allergy otherwise you will suffer.

Some people are allergic to insect stings.

Household cleaning products

More and more researchers have established a link between the increase in allergies and asthma and exposure to chemicals contained in these cleaners.

Since manufacturers are not required to indicate on the label the ingredients contained in their products, it is difficult to know exactly what they contain. It is better than cure.

Advice

We mistakenly believe that Windex and other products destroy more microbes because they shine surfaces and fill the air with a "clean smell." However, the most effective cleaning agent remains ... soapy water simply plunging a micro fiber cloth to clean and change with each use.

And if you want to use a product sold in supermarkets, you can opt for biodegradable products of plant origin. To find them, they must meet the following criteria:

• Ingredients: they must all be natural or simple (pure soap, for example);
• The product is colorless, odorless and biodegradable;
• The packaging is recyclable and reusable.

Finally, lemon and baking soda is also very effective for cleaning purpose.


Mites
Mites feed on our dead skin particles. Their presence does not usually cause problems, but more sensitive individuals may eventually be affected and may be suffering from rhinitis or asthma.

These little critters are hiding in mattresses, carpets between the bristles and small cushions, pillows, upholstered furniture and stuffed animals. Humidity of 50% and promotes their proliferation.

Advice

• Eliminate the house carpets, mats and rugs, to the extent possible;
• Avoid buying furniture or stuffed upholstered
• Avoid bedspreads and duvet dives;
• Only use curtains made of light material;
• In addition to vacuuming the mattress, box spring and bed box regularly, it is strongly recommended to use mattress pads and pillows specially designed to reduce exposure to these insects and their waste;
• Wash's sheets, blankets all cozy and warm water (hot water because only kills mites) as often as possible (at least every two weeks).

Mold
The presence of moisture, a warm and dark are the three elements causing the mold growth. They produce spores that are released into the air we breathe.

Advice

• Maintain a maximum moisture content between 30 and 40% in the house;
• Use a dehumidifier in the wettest parts;
• Do not store objects in a closed container or closed for long periods;
• Humidifiers are a source of mold: the unit must be cleaned regularly;
• In the bathroom: make sure excess moisture is removed by a properly functioning fan, wipe the surfaces wet from the shower and use a fungicidal substance regularly;
• In the kitchen: Use a fan while cooking, empty the garbage as soon as possible, check the contents of the refrigerator and clean it frequently.

Drugs
Medications can cause side effects - nausea and vomiting, for example - those are not allergies. By cons, if you made a rash after taking penicillin for instance, there is an allergic reaction.

All drugs can be allergenic - even natural products - but the most common antibiotics, such as penicillin or sulfa drugs, and aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen.

There is no allergy test for most drugs. Allergists must rely on information that you provide to them about your medical history to see if there is allergy.

A person with a confirmed diagnosis of a drug allergy should wear a MedicAlert ® bracelet.

For mom ... beauty products
Cosmetics consist of some 10 000 different ingredients.

A large number of studies, tests and reported incidents have demonstrated that some of these chemical ingredients that cause allergies, including asthma cause.

These components are dangerous in makeup, in shampoos, body creams, oils into the body and face, masks, perfumes, makeup, etc.....

Advice

• Always read the instructions and warnings on the packaging;
• Perform a test on a small area of ​​skin before using a new cosmetic product. Wait 24 hours. If no reaction occurs, use of the product should be safe;
• Never share cosmetics: you may be exposed to bacteria of the other person;
• Do not dilute your cosmetics dry with water or saliva, because you could contaminate;
• A product whose label is marked "hypoallergenic" can still cause allergic reactions. "Hypo''' means "under" the product is only less likely to cause allergic reactions;
• Always wash your hands before applying make-up;
• Keep your cosmetics away from high temperatures and sunlight;
• Most cosmetics have no expiration date, but it is recommended to change mascara every three months;
• Choose a fragrance based on essential oils and buy soaps, shampoos and cosmetics unscented pharmacy or health-food shop.