Welcome to the Auckland Allergy Clinic web site. This section will bring you the latest breaking news in Allergy & Clinical Immunology and also additions we have made to the Clinic in the last month.

The Allergy News information provided on this web site is reviewd and approved by the Allergists at the Auckland Allergy Clinic. The information is sourced from International Medical Journals and Newspapers. These articles are chosen either because they are thought to be particularly good studies, very interesting Allergy News or relevant to New Zealand. The articles may not necessarily be the views of the editor. Where relevant the editor will add his/her comments at the bottom of the review.

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June 8, 2001

More evidence in support of the "Hygiene Theory" for increasing prevalence of Allergies, and the effect of indoor environment on asthma.

A case-control study published in June Thorax 2001, showed that the risk of asthma in Nepalese children is lower when families keep cattle living inside the living quarters, whereas it is increased by exposure to passive smoke and indoor use of smoky fuels.

Dr T Melsom of the University of Tromso in Norway, and colleagues examined the home environment of 121 school children ages 11 to 17 with asthma and 126 controls matched by school and ethnicity, factors believed to reflect socio-economic status. The children were taken either from the city of Kathmandu or the surrounding rural area.

According to the investigators report, 100 children lived in traditional houses of brick, stone and mud, primarily in the rural areas. The remainder lived in modern cement houses in Kathmandu. 40 families in the rural areas kept their cattle, buffalo, cows, horses, goats and pigs in the house at night.

Keeping cattle inside the house was associated with an adjusted odds ratio for asthma of 0.2. Children who lived in families where 2 or more individuals smoked and those who lived in a house with open fire or a burning stove without a flue were at approximately twice the risk of asthma compared with their counterparts.

Dr Melsom and colleagues suggest that the inverse association with inside cattle could be due to increased microbial exposure early in life that promotes non allergenic immunity.

Several similar studies also came to the same conclusions in Europe.

This is probably what is causing all the recent controversy with cat ownership in childhood and the lower risk of asthma, as in the report below.

June 8, 2001

Is growing up with cats protective for Allergies?

Contrary to many parents' instinct, infants who grow up with cats or dogs may be less likely to suffer from allergies and asthma later in life, preliminary research suggests.

``Traditionally, most people have thought that increased exposure to these allergens leads to more allergies,'' said Dr. Darryl Zeldin of the National Institute of Environmental Health Sciences. ``But I think those conclusions are being re-evaluated.''

Most research has focused on how to reduce allergy sufferers' exposure to household irritants, such as dust mites and pet dander.

But new evidence suggests that exposure to pets early in life might actually help the body build defenses against allergies and even asthma.

``Kids exposed to animals seemed to be better off,'' said Christine C. Johnson, a researcher with the Henry Ford Health System in Detroit who conducted one of several studies on the effects of pet exposure during infancy.

Johnson's study, involving researchers in Georgia and Michigan, found that exposure to two or more cats and dogs at 1 year of age made children less susceptible to other allergy-inducing substances by the time they turned 7, and that the exposure even improved some boys' lung function.

The study tracked 833 children, testing 473 of them after six or seven years to determine how exposure to pets when they were infants influenced their tolerance to allergens. The results were presented at an American Thoracic Society conference last month.

Johnson and other researchers still caution that the subject remains complex.

``Are we proposing that if every house in the county had cats, everything would be all right? I doubt it,'' said Dr. Thomas Platts-Mills, a University of Virginia allergy research specialist.

Platts-Mills also found that early exposure to cat dander decreased the risk of asthma, though not necessarily most allergies. A team of Swedish researchers reached the same conclusion.

Platts-Mills studied 226 children aged 12 to 14 in New Mexico and Virginia and published his results in March.

Asthma rates have more than doubled since 1980 - 17.3 million Americans suffer from the respiratory disease and 5,000 people die from it each year. Millions more deal with runny noses, swollen eyes and itchy skin caused by less serious allergies.

Researchers say the new findings could be in line with what doctors call the ``hygiene hypothesis.'' The theory holds that Americans grow up too clean, that a lack of environmental contaminants means immune systems overreact when they encounter allergy-inducing substances

June 5, 2001 Thunderstorms linked to Australian asthma epidemics The June issue of Thorax reported that atmospheric conditions associated with thunderstorms might increase concentrations of allergens enough to lead to asthma outbreaks in Australia. Dr Guy Marks of the University of Sydney and colleagues noted that patients have often reported worsening of their asthma in association with thunderstorms. The researchers conducted a case control studying 6 Australian towns. Using asthma emergency department attendance figures, they identified 48 epidemic days. They compared these with a random sample of 191 control days. Data on pollen counts, thunderstorms, and airflows associated with thunderstorm and cold fronts were examined for the days in question. Overall, thunderstorm outflows were detected on 33% of epidemic days, compared with only 3% of control days. The association was strongest in late spring and summer. In the town of Wagga Wagga - where one epidemic was examined in details - in association with a thunderstorm, 215 asthmatics attended local ER and 41 were hospitalised. The arrival of this thunderstorm coincided with an 8 12 fold increase in the ambient concentrations of grass pollen over the preceding 9 hours. The researchers suggest that thunderstorms create cold airflows, "sweeping up pollen grains and particles and then concentrating them in a shallow band of air at ground level." This they conclude "is a common cause of exacerbation of asthma during the pollen season." This finding is in keeping with earlier studies, where it was felt that the thunderstorm was needed to somehow breakdown the pollen grains to small enough fragments that can be inhaled into the lower airways. May 31, 2001 Good News for Food Allergy Sufferers Food labels may soon disclose the sources of flavourings that could cause allergic reactions, such as butter or peanuts, and use more easily understood terms for ingredients like casein, a milk product. The food industry issued a series of voluntary guidelines Thursday for labelling foods so that consumers can more easily avoid allergy-inducing products. Technical terms for ingredients such as casein or albumen, the white of an egg, won't disappear from labels, but packages will put the common terms, milk or eggs, in a special label or add them to the ingredient list. The Food and Drug Administration welcomed the standards, saying in a letter to the industry that they are a "significant step forward" and a "major health benefit to the food allergy sensitive consumer." "It will make life safer for individuals with food allergies and their families," said Anne Munoz-Furlong, founder of the Food Allergy and Anaphylaxis Network, an advocacy group that receives some industry funding. "It will cut down on phone calls to companies about ingredient information, saving the companies some money." Putting common terms on food labels will especially help children, she said. Some 7 million Americans who suffer from food allergies rely on ingredient labels to tell which processed foods are safe for them to consume. Some allergic reactions, particularly to peanuts, can be fatal, claiming about 150 lives a year. Eight food groups in addition to peanuts are responsible for most allergic reactions: Crustaceans such as crab and lobster, eggs, fish, milk, soy, tree nuts such as almonds and walnuts, and wheat. Because the trade groups can't enforce the standards, there is no penalty for companies that don't follow them. "Politically, these recommendations are designed to undercut legislation or regulations," said Michael Jacobson, director of the Center for Science in the Public Interest, an advocacy group. Industry officials say government regulation isn't needed and that consumer pressure will force companies to comply. "Food allergies are as much a priority for the industry as it is for FDA and any other agency. It was important to have some kind of consensus about what to label and how to label food allergens," said Lisa Katic, director of scientific and nutrition policy for the Grocery Manufacturers of America. Some companies, including cereal makers, already have been putting special labels on products. Kellogg's new Atlantis cereal has a special label that says: "Contains wheat and milk ingredients. Corn used in this product contains traces of soybeans." The standards discourage food makers from indiscriminate use of a warning label such as "May contain peanuts." Some companies are routinely using such labels to protect themselves against lawsuits, Munoz-Furlong said. Under the guidelines, such labels should be used "judiciously" and only when manufacturers can't avoid the possibility of allergens in their products.

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