Allergic asthma is on the rise in children - Magicmaman.com
Asthma is a recurrent inflammatory disease of the bronchial tubes that causes seizures and difficulty in breathing. It is a genetic disease: the patient has genes that predispose him to hypersensitivity of the bronchi. These are then more reactive than average and narrower. When a child has a parent who is himself asthmatic, he has a 40% risk of being asthmatic too (vs. 20% in the general population). The rate increases to 80% when both parents are. Moreover, if asthma is genetic, there is always an interaction with the environment. The disease will express itself more or less in a child depending on where he lives, regular exposure to air pollution (fine particles in the air modify a person's immunity) and the passive smoking (tobacco is very irritating to the bronchial tubes) or during exercise. Asthma attacks are characterized by wheezing on expiration, a dry cough – particularly at night around 2 a.m. – and which does not not stop. The child tires, sleeps badly, and his daily life like that of his family is impacted. In the case of allergic asthma, attacks are mainly caused by an allergen: dust mites, molds, pollens, food, animal hair (dogs and cats). As a result, the bronchi narrow again and it is even more difficult for the air to pass.
3 BRONCHIOLITIS IN THE YEAR, DIAGNOSED ASTHMA
Allergic asthma generally begins in childhood – before the age of 5 in the majority of cases – and can affect babies under 1 year old. In infants, 20 to 50% of asthmas are allergic; in school-age children, the rate rises to 80%. It is considered that a toddler who has had three bronchiolitis in the year is asthmatic. “Certainly, all children suffer from multiple infections during their first years, underlines Pre Jocelyne Just, head of the pediatric allergology department at the Trousseau hospital in Paris. They thus build their immunity and this is normal as long as the infections are confined to the upper respiratory tract (nose-throat)”. This is less so when the bronchi (lower respiratory tract) are affected several times in a few months. In our latitudes, infants are rather "mono allergic": allergy to dust mites dominates. The older children get, the more “multi-allergic” they are generally. Around the age of 7-8, allergy to pollen is frequent and later still, allergy to animal hair. When early allergic asthma is "mild", it generally disappears between the age of 3 and 5 years without sequelae. On the other hand, if it is accompanied by allergic rhinitis or conjunctivitis, eczema (same atopic condition as asthma), it can persist until adulthood. It frequently happens that there is a remission in adolescence with the possibility of reappearance later. Remember that asthma is an organic disease but when it is poorly balanced or poorly treated, it can have a significant psychological impact.
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Children living in cities are more at risk of developing allergic asthma. Why ? Many European studies have shown that those living on farms near animals (hosting many infectious agents) developed less asthma and allergic diseases than others. In the USA, the children of the Amish community, who live on the farm like our ancestors, suffer from it much less! It is explained by the hygienist theory which also suggests that a sanitized environment (excessive hygiene, abuse of antibiotics, etc.) reduces exposure to microorganisms beneficial to our immune system. Insufficiently stimulated, it ends up turning against its host, in this case our body, and can react to previously harmless substances such as dust mites and pollen.
Another explanation, in town, the child is exposed to more pollution – in particular that of fine particles – and this has an impact on the health of the bronchi. There is also evidence that pollens are now more allergenic than in the past due to climate change. Indeed, weakened, they burst into parts of smaller sizes which penetrate further into the respiratory tract. All allergies are on the increase in Western countries, whether allergic asthma, food allergies, allergic rhinitis and allergic conjunctivitis. The figures are instructive. In 2015, one in three people were allergic. In 2050, according to the World Health Organization (WHO), one in two people will be affected.
AN ENVIRONMENT ADAPTED TO THE DISEASE
The best way to prevent allergic asthma is to avoid exposure to the allergens in question. Elementary! This is why it is essential that a diagnosis be made quickly by an allergist in order to identify the triggering factor. We use prick tests, which consist of depositing a drop of the suspected allergens on the skin using a small tip. Some twenty minutes later, the test is positive if a wheal appears at the injection site. Once the suspects have been flushed out, usually dust mites for toddlers, “you first have to improve your environment, reminds Pre Jocelyne Just. Air all the rooms in the house for at least half an hour, avoid carpets, wall hangings and double curtains – especially in your bedroom –, wash your sheets at 60°C, use pillows and blankets made of washable synthetic material as well than a dust mite cover on the mattress. In short, clean the house!
NO WATER OR SYRUP IN CASE OF COUGH
Despite all the precautions taken to eliminate allergens, drug treatment is still necessary. It consists of short-term bronchodilators (to dilate the bronchi and allow air to pass more easily) and, in some cases, oral corticosteroids to limit inflammation of the bronchi. The best known bronchodilator is Ventoline®. On this subject, Pre Jocelyne Just reminds parents that when their child has an asthma attack, coughs, etc., they are first given neither water nor syrup – which will have no effect – but a bronchodilator ! Basic treatment includes inhaled corticosteroids and possibly long-lasting bronchodilators. If it acts effectively on the symptoms, it does not treat the cause of the disease. Desensitization, from the age of 4 and a half to 5 years, is often effective. Administered sublingually, the daily treatment consists of spraying or depositing an extract of the allergen under the tongue in order to obtain tolerance from the immune system and cause it to no longer react excessively. A desensitization lasts several years, from three to five years.
In the case of very severe allergic asthma (rare, 3 to 5% of asthma), doctors can offer biotherapy such as anti-IgE in bimonthly or monthly subcutaneous injections which block the allergic reaction and improve control. asthma.
SHOULD WE BE AFRAID OF CORTICOIDS?
Corticosteroids have a negative image: they prevent growth, make you fat... According to the Asthma and Allergies Association, inhaled corticosteroids do not enter the bloodstream (and therefore have virtually no risk of causing effects on organs other than bronchi). In addition, the dose of the drug is very low compared to that contained in oral corticosteroids (in tablets). Be aware that the risks of inhaled corticosteroids are much lower than the risks of undertreated asthma!
HOW TO PREVENT AN ASTHMA ATTACK?
Avoid triggers when possible. For example, arrange the child's bedroom when he is allergic to dust mites (no carpets, curtains, etc.). Allergic to animal hair? Beware of contact with the animal in question. In case of air pollution, ask the child not to run or kick a ball. And when the atmosphere is saturated with pollen, prefer mornings to afternoons to go out. After a walk, rinse the child's hair with water in the evening to prevent pollen from settling on the pillow. Do not forget sunglasses if asthma is accompanied by allergic conjunctivitis.
Take your long-term treatment regularly when it has been prescribed by the doctor. It is long-lasting and must be taken every day, even when the child is not having an attack.
Attend an asthma school and go there with your child to learn how to manage the disease. These schools offer interactive workshops – avoiding the onset of a seizure, knowing how to monitor your breath and using your medication correctly. Numerous studies have shown that people with asthma who have benefited from this education have better controlled asthma (fewer attacks and breathing difficulties at night, fewer absences from school or work, etc.). Find the list and addresses of asthma schools on asthma-allergies.org, asthma tab then click on “Childhood asthma”.
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