Every year, more than 15 million school days are lost to asthma and allergies, making back-to-school time a great time for a few reminders for parents:
• Have a plan. If your child has asthma or allergies of any kind, your child’s school needs to know. Make sure you have contacted the school and filled out paperwork that will make everyone aware of your child’s condition and give your child access to needed medications on campus.
• Have medications on hand. If your child needs an inhaler for asthma, or an EpiPen or antihistamines for allergies, make sure those are always available at the school. “They should have it with them. It shouldn’t be across campus with a nurse,” says pediatric allergist Roger Katz, M.D., a clinical professor at UCLA School of Medicine with a private practice in Santa Monica. He says that delays in getting these medicines could be life threatening.
• Remind kids and school personnel about food allergies. Even children who know what they aren’t supposed to eat might be tempted by food offered by a classmate.
While fall means the start of gym classes that could aggravate exercise-induced asthma, and Santa Ana winds that bring extra pollen from the high deserts to torment allergy sufferers, there are also new tests and treatments on the horizon.
One, called FENO (fractional exhaled nitric oxide), allows doctors to easily gauge inflammation in the airways. Patients exhale into a machine that measures the amount of nitric oxide (NO) they exhale, which goes up when inflammation is present. Becoming more widespread, FENO is best for ages 6 and up, is covered by some insurance companies (and costs around $50 without coverage), and Katz says his Santa Monica practice has had it available for about 18 months.
For children with allergies, identifying the sources of their suffering is now also much easier, as skin testing for allergy has become more accurate. Experts have now identified the exact antigens for things like cat, dust mite, grass, pollen bee venom and other allergies, allowing for quicker and more accurate diagnosis. “All of these are better today than they were five years ago,” Katz says.
Easier treatment of some of these allergies is also on the way. Instead of allergy shots to help kids become less sensitive to allergens like dust mites and grasses, doctors will be able to provide “oral desensitization,” placing small, controlled amounts of the allergen under the tongue to build tolerance. Katz expects these therapies to be approved by the U.S. Food and Drug Administration and on the market in the next six months.
In a study published July 19 in the New England Journal of Medicine, researchers from Johns Hopkins Children’s Center reported that this type of therapy also showed promise in children with egg allergies (which as many as 3% of children have by age 3). During their study, funded by the National Institutes of Health, they found that 11 of 35 patients treated with egg immunotherapy experienced complete, long-term elimination of allergic reactions, and the remaining 24 were able to tolerate higher doses of egg with mild or no symptoms – offering a protection against serious allergic reactions from accidental exposure.
They note, however, that the treatment is still considered experimental, and should yet be used outside medical research studies.