It is well known that a high number of Barbadians suffer from asthma and that simple, irritating allergy symptoms, such as a runny nose, might be a warning sign of the disease.
That runny nose may be triggered in persons with allergies to indoor irritants, such as dust mites, mould, animals, or the outdoor variety of blossoms, weeds, and trees.
However, the island is yet to say definitively what the causes are, or exactly how many asthma sufferers there are in Barbados.
Quoting the Asthma Association of Barbados, Bayview Hospital’s Emergency Medicine Specialist with training in Allergy Testing and Immunology, Dr Hilary Moore estimated this week that between “18 to 20 per cent of our children are asthmatic”.
However, Dr Moore acknowledged that “there is not a clear number of how many adults are [asthmatic] at this moment in time”.
She also said there was uncertainty in terms of the number of asthma cases caused by allergies.
Speaking at the second of two public meetings on allergies and their relationship to other illnesses, Dr Moore said, “there is a lot of work that needs to be done in determining the prevalence of allergies in Barbados.
“We also need to do a lot more work in treating them effectively and seeing if we can manage the severity and incidence of asthma more efficiently in Barbados,” she said.
Dr Moore also revealed that doctors would be working with pulmonologists who specialize in asthma, “so that we can see if we can control it better in the future. . . . Hopefully in the next five to ten years we would be able to accomplish a lot, but we’re starting at ground zero,” she said.
Bayview is also supporting the effort and recently collaborated with a number of agencies, including the National Drug Council to sponsor a public lecture on health, including an allergy-testing clinic at the Lloyd Erskine Sandiford Centre (LESC). It was followed by a seminar for health professionals at the 3Ws Pavillion, UWI.
Allergy and Immunotherapy Specialist Professor Menachem Rottem conducted the LECS lecture on the topic, ‘Is it truly an allergy?’
“Allergy conditions are very common. They’re often associated with significant decreases in quality of life. They can usually and easily be identified, and can be effectively and safely treated if we do it the right way,” he explained.
According to Dr Rottem who practices and teaches in Israel, examples of allergies include allergic Rhinitis; conjunctivitis, inflammation in the eyes; asthma; atopic dermatitis [itchy, red, swollen and cracked skin]; contact dermatitis; food allergy; drug allergy; Urticaria, a kind of skin rash with red, raised, itchy bumps that may also burn or sting; angioedema; anaphylactic, which is a severe reaction that can lead to death.
“These are similar in that the mechanism causing them is similar, and it’s important to realize this because when a patient comes to a doctor and says, ‘I have asthma, or I have difficulty breathing, we must be aware that maybe he has other conditions which are related to that, and so everything should be treated in a holistic way, together, not to miss anything.”
He said that allergic rhinitis was one of the more prevalent allergies.
“Allergic rhinitis frequently precedes asthma, is both a risk factor for development of asthma and is associated with increased severity . . . . Patients with allergic rhinitis have a much higher chance of developing asthma.”
“Allergic rhinitis is very common. In the western world about one [in] five persons will suffer, or does suffer, from allergic rhinitis; in children every one [in] three, in Europe every one [in] two,” Dr Rottem said.
He also explained that the impairment caused by allergic rhinitis was dependent upon its severity.
“I mean runny nose, stuffy nose, the inability to breathe through the nose, but there is a very significant impact on everyday life whether it is sleepiness, alertness, ability to perform anything that you need to do”.
He spoke of patients with untreated allergic rhinitis having “a much higher chance of getting to the emergency room [with asthma complaints].
“In other words, in order to treat asthma effectively you have to recognize if they also have allergic rhinitis and threat it right away,” the medical doctor said.
Stressing that chances of persons with rhinitis coming down with asthma were higher, he said “these are related. It’s one airway, one disease, [in] the upper part of the airway and the lower part of the airway. . . . Not only do these conditions sometimes come together, but they come in an allergic march, one after the other.”
He advised that, “children who develop atopic dermatitis, which is eczema of the skin at a very young age, half-a-year until three years old, have a higher chance to develop allergic rhinitis,” and those who have allergic rhinitis have a higher chance of developing asthma.
However, he pointed out that patients could develop asthma without those symptoms, “but this is as typical an allergic march that we can see”.
Dr Rottem said that in treating a patient for allergic rhinitis the medical practitioner might first advise the person on ways to avoid the allergy. The second option is pharmacotherapy, the prescription of drugs,
Then there is immunotherapy in which the source of the allergy is administered to the patient in small doses creating tolerance in the person’s body.
“Of course, patient education, parents education is part of any treatment in allergy too.”