The relationship between allergies and your immune system

Our immune system is a wonderfully complex set of processes that protects us against bacteria, viruses and fungus – the things that get us sick.

Allergies occur when our immune system reacts to an innocuous substance such as pollen as though it was a pathogen, thus causing an inflammatory response.

Why does this happen? It is not completely understood why some people develop allergies but the answer probably lies in your genes. Your own risk of developing allergies is related to your parents’ allergy history. If neither parent is allergic, the chance that you will have allergies is about 15%. If one parent is allergic, your risk increases to 30% and if both are allergic, your risk is greater than 60%. The allergic response develops after repeated exposure to a substance so you may indeed develop an allergy to something you had no problem with in the past.

The allergic response is mediated by several chemicals released by your body including histamine, leukotrienes and cytokines. These substances cause itching (histamine) and tissue swelling which leads to that nasal congestion and, when the inside of the breathing tubes are swollen, asthma.

Helpful Medications

Antihistamines such as diphenhydramine, loratadine, cetirizine or fexofenadine are some of the over the counter medications commonly used to combat allergies. These medications are particularly helpful if the predominant symptom is itching. Antihistamines often have to be used with other drugs that block the effects of the other chemical mediators in the allergic response.

Prescription leukotriene inhibitors such as montelukast can be used.

Nasal steroids are often used for congestive nasal symptoms.

Inhaled steroids are often used in persistent asthma symptoms.

Oral steroids are occasionally used for severe reactions.

If you have an especially severe reaction, your provider may prescribe you an injectable form of epinephrine to use in the case of an emergency so that you can then seek medical attention.

The best allergy treatment is avoidance of whatever you are allergic to. Educate yourself about your allergies. Learn to recognize the symptoms of a severe allergic reaction and when to seek immediate medical attention. Be proactive about taking over the counter and prescription medication early to keep your allergy symptoms under control. If you have severe and persistent allergies, you may need to see an allergist and may need allergy shots.

Fear not – allergies can be managed and new medications are being developed all the time. Visit the allergy clinic at Campus Health to learn more.

An unknown visitor to Disneyland was sick with the measles virus and spread the virus to other unvaccinated individuals, one of whom traveled through airports and other states. The disease is highly contagious and the Centers for Disease Control estimate that 90% of the people close to that person who are not immune will also become infected.

There were no measles cases originating in the United States from 2000 until 2011 but now there are an increasing number of outbreaks over the last few years. There was a dramatic uptick in measles cases in 2013, and the trend continues. From January 1-February 13, 2015 there have been 141 reported cases in 17 states with the majority of cases linked to the Disneyland transmissions.(1) There have also been outbreaks of Pertussis (whooping cough) and Mumps, including outbreaks on college campuses.

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Why are preventable disease outbreaks happening?

Increased global travel makes it more likely that an individual who is not yet symptomatic but still contagious can bring a disease into the country while another factor makes it more likely that the disease spreads – the growing number of individuals in the United States, especially children, who are unvaccinated against these common childhood illnesses.

Why this backlash against vaccination?

There are many reasons why parents choose to not vaccinate their children.

SIDE EFFECTS: Some individuals believe that vaccines cause serious and sometimes fatal side effects and parents do not like the idea of introducing toxins into their children’s systems. Vaccine side effects are reported through a national registry, and serious adverse reactions are extremely rare. Most adverse reactions are minor discomforts.
INGREDIENTS: By November, 2009, in the face of growing public concern, the mercury based preservative thimerosol was removed from all US vaccines with the exception of certain tetanus, meningococcal and influenza vaccines. The ingredients in current vaccines are safe in the amounts used. This is supported by multiple medical organizations, both national and international, both government and private.(3) Paul Offit, MD, notes that “children are exposed to more bacteria, viruses, toxins, and other harmful substances in one day of normal activity than are in vaccines.”(4) There is also some concern that some vaccines may contain materials that are morally objectionable. In the 1960’s some vaccines were made from the cells of aborted fetuses however this is no longer the case. Some are made from animal products or human albumin however.
LINK WITH AUTISM?: Another concern is that vaccines cause autism. This persistent misconception stemmed from a 1998 paper written by British physician Dr. Andrew Wakefield. His research has been discredited and the paper retracted as Dr. Wakefield was found to have fabricated data for financial gain. His license to practice medicine in the UK was revoked.
HERD MENTALITY: Unvaccinated adults and children may also be relying on the fact that so many people have been vaccinated that the diseases covered by vaccines are so rare that the disease will not spread and they will rarely come in contact with the virus. As the number of unvaccinated individuals increases, the disease will spread more readily as witnessed by this current measles outbreak and the outbreak in the Amish community. It is true that no vaccine is perfect and it is possible to get the disease even if vaccinated. However these instances are rare and it is likely that a vaccinated individual would have partial immunity and have a milder case of the disease.

The decision not to vaccinate holds complicated considerations. The unvaccinated individual may infect other individuals including young children under the age of 1 who are too young to be vaccinated, or individuals with a compromised immune system who cannot be vaccinated. These folks are not making an active choice to not be vaccinated, and yet they could become very sick or die because of someone else’s choice.

Trending conversations are now about rights—that balance between the rights of the individual vs the good of society. Paul Ofitt opines in a recent blog post, “Is it your right to catch and transmit a potentially fatal infection?” Is it?

(1). http://www.cdc.gov/measles/cases-outbreaks.html

(2)http://www.pbs.org/wgbh/nova/body/whooping-cough.html

(3), (4) (vaccines.procon.org, last updated on 02/06/15)