July 1, 2008

Insects, Food to Blame for Allergies

By Madhavi Rajadhyaksha

MUMBAI: If you've been blaming your allergic cough, running nose and itchy skin on flowering trees or neighbourhood pets, it's time to do a rethink. Insects, particularly mosquitoes, cockroaches and dust mites, are to blame for nearly 50% of the allergies in India. And food - especially peanuts, chocolates and legumes - is the other big culprit.

This is what a Mumbai allergy specialist found after he set out to map the "desi" allergy index.

"Since we are a tropical country, our allergies and asthma are very different from the west. Our flora, fauna and foodstuffs are different. It's time tropical allergies and asthma are recognized as distinct in themselves," says Dr Wiqar Shaikh.

The doctor studied 3,389 patients from across the country who visited various Mumbai hospitals from 2003 to 2007. Shaikh's study also shows that allergies can be gender-sensitive. Teenage boys are less likely to be sniffling through college as they outgrow their allergies by adolescence while girls may continue to suffer in these years.

In the US and Europe, pollen from flowering plants is a common trigger for allergies, accounting for 20% of all cases. Not so in India where a mere 8.61% of patients studied showed wheezing or blocked noses because of pollen. Asthma and rhinitis predictably formed the major chunk of all allergies.

Interestingly, food allergies are more common here than among westerners. Take, for instance, the allergy to rice which was only reported from Japan till now but which has showed up among Indians. Or take chocolates, the second most common food allergen in the study. While the western palate is most sensitive to milk, egg, meat and wheat,Indians are likely to react to peanuts, chocolates, and legumes (dal).

Dr Shaikh, attached to the Prince Aly Khan and Saifee Hospitals, works as an honorary physician at the state-run JJ Hospital and has several research publications to his credit. He conducted this study along with his daughter Dr Shifa Shaikh, who was then an intern at Nair Hospital to get a measure of the incidence of allergies in India, as most data used by doctors here is nearly a decade old. Their findings were published in the Journal of the Indian Medical Association in April.

High stress levels increasing allergies among Indians: Study

In an attempt to map the "desi" allergy index, Dr Shaikh has found that the number of allergies had increased from 25.3% in 1997 to 28.96% in 2007.

Dr Pramod Niphadkar, who heads a support group - the Asthma and Bronchitis Association of India - agrees with the overall findings. "While it is difficult to comment on the incidence, the general trend of allergies and asthma definitely speaks of an increase," he says, blaming it on a range of factors from lack of exercise and high stress levels resulting in poorer immunity to increased pollution.

Do allergies come with warning signs? Dr Niphadkar says food allergies are easier to spot since most of us can link an outbreak of rashes or vomiting with the food consumed if it happens repeatedly.

"The trickiest are drug allergies as there are no specific tests to confirm or rule them out," he says.

The study showed anti-inflammatory drugs such as aspirin and ibuprofen, penicillin and sulphonamides were to blame for most drug reactions. For most common triggers, allergy tests are recommended for people who don't find help from standard medication.

It's best to be cautious, advises Dr Shaikh, as predictably, avoidance measures are one of the most effective ways to deal with allergies. For instance, the analysis showed that artificial jewellery containing nickel sulphate was the most common cause of skin rash. A person who knows this simply avoids using such jewellery. An extreme allergic reaction could also prove fatal.

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