Atchhooo!! Sneeze season

It's winter and many of us are taking full advantage of the cool weather by going camping on the weekends, dining al fresco, walking in the parks and on the beach.

However, winter also brings with it niggling colds, flu and respiratory disorders, not to mention allergies and insect bites - conditions that could easily spoil a good holiday season.

"If you're allergic to dust, mould, pollen, dust mites and insect bites, winter can be the most difficult time of the year," says Dr Emad Arafa, head of the allergy clinic at NMC Speciality Hospital, Dubai.

If at this time of the year, you tend to suffer from frequent upper respiratory infections - colds, throat disorders (such as laryngitis), middle-ear and sinus infections - chances are that you may be harbouring an undiagnosed allergy.

"One of the natural ways that the body responds to the tiny particles that trigger allergies is by producing mucus," says the doctor.

"Mucus helps trap growing viruses and bacteria in our body. If you experience more than three or four bouts of upper respiratory infections in a year, you need to undergo an allergy test."

Also, if your cold or flu lasts more than a week, don't dismiss the symptoms as just another winter cold. "This can be attributed to our continued exposure to dust," Dr Arafa says. "The best thing to do in this case is visit an allergist/immunologist for an accurate diagnosis."

A common skin condition that many people develop during winter is eczema. This is often an allergic reaction to something in our environment. Skin allergies are also caused by certain foods or differences in weather conditions.

"For example," Dr Arafa says, "you may be accustomed to living in colder countries like Russia and Switzerland but if at this time of the year you travel to the Middle East for sun-bathing, a sensitive skin might experience eruptions or rashes due to sudden changes in temperature.

In contrast to the rest of the world where winter means staying indoors, in the UAE, this is the time almost everybody looks forward to going outdoors and enjoying the weather. This means prolonged exposure to pollen, dust, sand (and suspended particles) and pollution in the air. All these can cause allergies, chest congestion, difficulty in breathing and redness in eyes."

So it's not uncommon to have a spike in the number of respiratory and skin-related health conditions.

This is also the time of year when people travel a lot. And it is during the course of their travels that they also experiment with different cuisines. Both these situations are ideal allergy-triggers if the person is prone to them.

"When abroad, play it safe as far as food is concerned. Never mix foods and don't try new beverages unless you're sure you won't have problems with them because certain unfamiliar foods and drinks can cause an allergy or lead to food poisoning."

What is IgE?

"IgEs respond to the invasion of the body by foreign substances like bacteria and viruses."

Most common allergies

Hair dye, nickel, direct sun exposure are other common allergens.

Is winter the only time for allergies?

"Not necessarily," he says. But for a cross-section of people, colder climatic conditions tend to lower their immunity levels, particularly in this part of the world, leaving them more susceptible to illnesses. "This is why cold and flu become the talk of the town and people keep worrying about them during this time of the year.

There are ways to prevent bacteria and viruses from playing spoilsport in winter, he says. Keep your house well-ventilated. Allow sunlight and fresh air to circulate freely in the rooms. Vacuum your house, especially mattresses, at least once a week. If you have carpets or rugs, keep them clean.

Dr Arafa says, "Since most residents switch off their air conditioners during winter, they forget that mould accumulates and builds up in them." Once the air conditioners are switched on during the early part of summer, the mould and mites get blown into the house and these can trigger severe breathing problems. So it makes sense to clean the AC ducts if you've not used it for a while.

Dust mites found in houses are another cause for worry.

"We define [mites] as microscopic animals belonging to the spider family. There are more than 50,000 types of dust mites. They live only up to six weeks but can reproduce at an incredible rate. They particularly multiply and grow in warm and humid environment. You'd be shocked to know that at any given time, about two million dust mites can be found in a used mattress. Other places where you are likely to find them include the padded areas of furniture, carpets, rugs, curtains, bed sheets, stuffed toys and so on.

They can colonise themselves very easily and rather quickly in any environment favourable to their growth. For example, if you have a clothes dryer or washing machine in a closed room, an increase in humidity and lack of ventilation will lead to the proliferation of dust mites."

Interestingly, dust mites themselves don't provoke the allergies. "Dust mites feed on human squama, the micro particles that our bodies release like nails, body hair, skin flakes, and it is their droppings and secretions that cause allergies," he says.

How to avoid an allergy

"Getting adequate sleep is very important to build immunity," says the doctor. "Ensure you get eight hours of sleep every day.

"You could also use a humidifier to provide controlled levels of humidity in your house and prevent your home from becoming a breeding ground for viruses and bacteria. Keep the intake of minerals and vitamins regular and sufficient," he adds. Ensure that you always have a balanced diet.

"A multivitamin course [on the advice of a doctor] can help improve your immunity. Always drink plenty of water and juices.

"Avoid close interaction with those who are suffering from flu or a cold. Don't share the affected person's towels or handkerchiefs. At work, clean your hands using a sanitiser after using a computer keyboard."

Allergy tests

"You could take an allergy test to find out if you're prone to allergies," advises Dr Arafa.

1. The most common type of allergy test is called skin prick testing. "In this test, one can measure specific IgE attached to the skin's cells. It's best for the detection of inhaled and ingested (edible) allergies. Drops of allergens are applied to the skin in a row and then using a lancet, the skin is pricked through the drops one by one. It is not painful but yes, a bit uncomfortable. The good thing is anybody can take the test, including infants. This test takes about 30 to 45 minutes to show the results along with the information on the allergens."

2. Blood tests can best measure the amount of IgE circulating in the blood. "A sample of blood is taken from the vein in the arm and then depending on the laboratory, the results can be obtained in a week or two," says Dr Arafa.

3. Patch testing doesn't seem to have that much clinical value nowadays. "But it is the best way to find out more about contact dermatitis (eczema) where allergy is suspected," he adds.

How to keep allergies at bay this winter

Keep your home well ventilated. Allow fresh air and sunlight to freshen up your house.

Air/sun mattress and pillows every week. This will kill dust mites.

Vacuum clean your house everyday or at least once a week to keep dust under control.

Pest-proof your house once every six months.

Adopt moderate hygienic measures in the house to keep it clean.

Include more raw foods in your diet to help your body gain natural immunity.

Avoid areas where fuel emissions are high (garages and enclosed parking areas).

Avoid eating food, fruit or nuts that you aren't familiar with while on vacation abroad.

Work hard towards lowering your stress levels.

Right treatment of allergies

"The best treatment for chronic allergies is immunotherapy (IT). It is a well-established treatment for individuals suffering from long-term and persistent allergic conditions. It is a bit expensive and can show results only if taken regularly, without a break.

"In this treatment, increased doses of allergens are administered in the individual till he can tolerate the exposure to allergens without developing any major symptoms. This treatment is also widely known as ‘desensitisation'.

"However, I don't think it's right to call it by that term because it is rare for patients to completely overcome their allergies. I'd rather call it ‘hyposensitisation'."

Other types of treatments include the administration of antihistamines and/or steroids.

"The prescription-strength drugs like antihistamines and inhaled corticosteroids damp down the allergic response. But long-term use of corticosteroids may lead to changes in the bone and can even lead to an increased risk of cataract. They are best avoided in children."

So next time you have had a red nose for too long, try going for allergy tests. Ask your doctor if you need something more than a bowl of hot chicken soup.

Top 10 allergens

Dust mites

Pollen in grass

Mould (hidden in air conditioners)

Black ants

Cockroaches

Milk

Peanuts

Cat

Dog

Horse

Important facts

You can share utensils with an allergy patient because allergies are not transferred by contact.

If you are allergic to strong smells, you can still use perfumes but not directly on the skin. Spray it on the clothes instead.

Eczema patients should always wear 100 per cent cotton clothes.

If you are asthmatic or have a history of urticaria, reduce spice in your foods.

Do not overdo the use of sanitising gels or other cleansing material on your hands, body or clothes.

Do not switch between too hot or too cold drinks too frequently.

Always keep pets away from your bed.

Take walks or exercise in open, free and green areas.

Stop smoking, actively and passively.

Ways to keep your immunity levels high

Wash your hands regularly with soap and water. Especially after shaking hands with people or touching door knobs, lift buttons, rails of staircases, public telephones etc.

Take stock of any existing medical issues like asthma, diabetes and blood pressure.

Treat any sick person at home immediately.

Eat more fresh fruit and vegetables.

Do some moderate exercise like walking 30 minutes a day.

Get yourself involved in social activities.

Avoid crowded places.