Allergies Reaching Epidemic Proportions in UK

by Gopalan on Sep 26 2007 7:32 PM

Allergies Reaching Epidemic Proportions in UK
Allergies of various kinds are adding to the problems of the health administrators in the UK.
A report by a committee of the House of Lords says the country is lagging far behind the rest of Europe in its efforts to tackle allergies.

About a third of the UK population will develop an allergy of some sort during the course of their lives, says the report from the science and technology committee, as allergic diseases have trebled in the last 20 years to the point where the UK has one of the highest incidences in the world.

Allergic food reactions can kill, while hayfever, asthma and other debilitating conditions can hold children back at school and cause lifelong difficulties. Yet Britain, unlike other European countries, has failed to adopt treatments that can cure some allergy sufferers and the UK is short of specialists, says the committee.

It is particularly critical of the guidance given to pregnant women and young children not to eat peanuts - which it says should be immediately withdrawn.

Lady Finlay, who chaired the committee's year-long inquiry, said: "Academics and clinicians have told us that a growing body of evidence has suggested this guidance may not only be failing to prevent peanut allergy, but might even be counter-productive."

The evidence for avoiding peanuts is nine years old. "We reviewed it carefully and we're not convinced it stood up," she said. "We heard evidence that in some parts of the developing world where groundnuts are used as a kind of soup for weaning, and in Israel where peanuts are incorporated into a kind of rusk for weaning, they don't have the allergy that is developing here."

Some of the evidence heard by the committee suggested that depriving children of peanuts in early life might actually cause an allergic reaction later on.

The committee was also concerned at the lack of availability of immunotherapy - a treatment for allergies such as hayfever which involves giving gradually increasing doses of the substance which triggers an attack, such as grass pollen.

"It is very effective, said the committee's scientific adviser, Barry Kay, of Imperial College London. "It is used worldwide and has been the subject of numerous clinical trials. It is being used in a few centres but the ratio of usage to need is much lower than in Europe or North America or any other country where allergy services are up and running."

Part of the reason might be to do with the inappropriate use of immunotherapy in the 1980s when, Prof Kay said, "there were sadly a number of deaths". Unqualified practitioners gave injections to patients, usually in GP surgeries with no resuscitation facilities for anyone who might go into anaphylactic shock.

Today injections are given only by expert clinicians with hospital facilities easily available if necessary. Furthermore, there are now tablets available which are placed under the tongue and can be taken at home. A hayfever sufferer might take one a day for a couple of years to overcome an allergic reaction to grass pollen.

Lady Finlay said hayfever could have "a devastating effect on young people's achievements in examinations", which might destroy their chances of getting to the university of their choice and impact on their career.

The committee recommends that a dedicated allergy centre should be set up in every strategic health authority, headed by an allergy specialist. These would act as clusters of expertise for all the specialists involved in treating allergies.

The Royal College of Physicians said that in spite of four other reports, one of which was from the college, "provision of services for allergy is patchy and inadequate in the UK" with too little funding.

The Department of Health said it would consider the recommendations but argued there are 90 allergy clinics in England already, led by a range of specialists. Lady Finlay, however, said the committee believed they must be led by allergy experts. The department also said it had funded extra allergy posts this year.

Its guidance on peanuts followed advice from the expert advisory committee on toxicology. "The Food Standards Agency is now commissioning a review of all the most recent scientific literature on the role of early-life exposure to food allergens - particularly peanut - in the development of allergy or tolerance," it said in a statement. The guidance would be reconsidered once that is complete.

The west is in the grip of an allergy epidemic. No one knows for certain why allergies are rising rapidly in rich countries but are rare in the developing world. One theory is the hygiene hypothesis - that the immune system over-reacts to pollen and dust because westerners are brought up in an environment which is too clean.

According to Allergy UK, the most common allergens are pollen from trees and grasses, house dust mites, moulds, cats and dogs, insects such as wasps and bees, chemicals, medicines and food such as milk and eggs. Less common allergens include nuts, fruit and latex. Symptoms include sneezing, runny nose, itchy eyes and ears, severe wheezing, coughing, shortness of breath, sinus problems, a sore palate and nettle-like rash.


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