Is respiratory allergy an emergency?

Allergies: symptoms, treatment and sublingual immunotherapy - 4 October 2016

It seems that respiratory allergy, take for example hay fever, allergy to house dust mites or to cat or dog dander, is often overlooked as if somewhat unimportant or something that cannot be changed. Why else would people wait on average 8 years to talk to their family physician or more than 10 years before finally bringing their concerns to an allergist or other specialist treating allergy?

We now know that respiratory allergy is a condition that evolves over time, tending to worsen with additional allergies or complications such as asthma and chronic sinusitis among others. It is not something static that you are simply born with and that nothing can be done about. Are such long delays in seeking medical help an indication that people do not expect much to be offered by allergists and other allergy specialists?

Well, the good news is that now, more than ever before, the science of allergy can help the 1 in 4 persons in western countries currently suffering respiratory allergies. Not simply masking its symptoms or providing advice that people won’t heed but rather by changing the very course of the allergic disease. Sublingual immunotherapy in particular offers a practical, safe and effective means of controlling not only the symptoms of respiratory allergy but further, to induce tolerance and decrease the risk of complications such as asthma.

Hence a new ethical issue: if we can safely influence the course of respiratory allergies, should we not fell compelled to intervene earlier and with greater determination, in children, with a single pollen allergy for example? It is no doubt great to provide a middle age person presenting with numerous allergies and asthma with unparalleled relief from a lifelong condition. But given the benefits and practical advantages of sublingual immunotherapy, should the profound implications of “turning things around” early on, of nipping allergy in the bud so to speak force every allergist to reconsider past treatment attitudes? Should the treatment of house dust mite or pollen allergy in a child be viewed as somewhat of an emergency?

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