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ALLERGY: A SEEMINGLY INNOCUOUS MENACE & ITS SOLUTION

"Allergy, " which was always thought to be rare in India with very few cases being reported, is now taking a larger epidemic form with the advent of "modernisation" and "improved standard of living".

Due to globalization people are exposed to materials including food items never encountered before. Deviating from traditional practices of breast feeding, home made weaning food and lesser exposure to nature has resulted in the new generation being more prone to Allergic reactions to milk protein found in ready-made tin milk or bovine milk, grass pollen and many other food items. The Gene-Environmental interaction within our immune system, which reacts abnormally to usually harmless substances is the main reason why Allergy is gradually increasing. Its present occurrence is around 20 to 30 percent in general population.

House Dust Mite, a tiny microscopic creature that thrives on dead human scales and is found in any cloth material that can not be washed & dried, is a single most common allergen found as a causative factor in humid, coastal environments like that of Goa. It is found in mattresses , pillows, sofas, carpets, curtains etc. The soft toys which harbour these bugs contribute to repeated wheezing which is a common in recent times. The older generation which used to sleep on straw mats on smeared and dried cow dung floors prevented such mites to thrive. But with an improved socio-economic status, homes are equipped with items which are ideal for the breeding of mites and an air-conditioned environment further boosts its growth.

Moisture present in enclosed bathrooms without exhaust fans encourages growth of molds or fungi which is another common cause of indoor Allergy mainly contributing to allergic rhinitis and asthma. Molds easily grows on any damp area and food material like bread, tomatoes etc.

Seasonal Allergy could be due to highly allergenic pollen, while some other pollen Allergies can be perineal like that of common grass. A good knowledge of local arobiology is essential for diagnosing pollen Allergy. Pollens contributes immensely to symptom of wheezing in older children and also nasal and respiratory allergy in young adults.

Pet dander Allergy which is common in western world, is rare in Goa may be because we are used to stray cats & dogs in our locality. Among insects, cockroach is a very common cause of allergy.

80% of Food Allergy is due to antigens namely egg, milk, wheat, soya beans, fish, shell fish, peanut and other nuts like almond, walnut etc., which are termed as the "Big 8 of Allergy." The cause can be easily confirmed by performing an allergy test.

Recent research in the field of Allergy has contributed to its better understanding and management. Allergists nowadays use a simple, modified and painless Skin Prick Test done usually on the forearm or on the back.

Chronic Urticaria or repeated rashes and wheal that last more than 6 weeks can have reasons other than allegens also as causative factor. Various autoimmune conditions in which one's own immunity reacting to yourself can be one of the cause.

Along with antiallergic and symptomatic medication, environmental control or avoidance is possible once the allergen is identified.

Different Allergic conditions that have waxing and waning episodes with chronic disability can have permanent relief. Immunotherapy is a treatment modality in which the antigen responsible for the allergic symptoms is given in significantly low dilution and its concentration is gradually increased over a long period till one can tolerate and become immune to same antigen. This tolerance building can take long time up to 6 months to 1 year and once developed should be continued for 3 to 5 years for long term remission. Good news is today highly standardized injectable subcutaneous immunotherapy is available in India and also since last few years sublingual (Oral drops) immunotherapy has become more popular in giving symptom free life to these patients.