Allergy-Problems from a global perspective

The global problem of Allergy

I came across a very interesting and powerful editorial that summarized many issues dealing with the worldwide problem of allergy.

Allergy is a major health problem-clearly not in everyone and not in the majority of the population. Worldwide allergy affects 10-30% of people. As far as a single chronic clinical condition, that is a significant number. Also, the prevalence has increased.

The impact of an allergy can be life-threatening (acute severe episodes) or chronic (daily symptoms). The allergic condition does have a major socioeconomic burden and allergy also has the obvious effect on a patient or a family’s quality of life.

Despite advances in research on causes, associations, risk factors, and treatment of allergy there are many inadequacies and unanswered questions. This editorial shares those concerns.

This is a consensus statement from a group of 40 noted researchers and clinicians from four continents who met in Switzerland last year. The banner for the meeting was simply ‘Allergy and Allergic Diseases: Barriers to Cure’.

Allergic conditions deal with many broad areas of medicine. Allergy affects a wide range of organ systems; eyes, respiratory tract, gastrointestinal tract, and skin. The conditions vary in severity and their course.

Listed are the concerns and needs (these come from the experts and are my summations of their summation);

  • The cause(s) for the increase in allergy prevalence is unknown. Environmental considerations    include; air quality, diet, climate, UV radiation, direct skin contact, and psycho-social interactions.
  • A specific environment may protect or put someone at risk if they have the genetic predisposition towards allergy.
  • Interactions between bacteria, pollutants, and the immune system are marginally understood.
  • There is inadequate understanding of those natural mechanisms that lead to acute vs. chronic suffering with allergy or resolution of allergy.
  • There needs to be a better classification system for severity/types of allergy.
  • New therapies need to work on the pathways that lead to an allergic response.
  • Better translational research is needed (taking what is learned in the laboratory to the bedside).
  • Better tools are needed to analyze the information or data regarding allergy.
  • There needs to be a plan for prevention of allergy.
  • We need better tools for diagnosis and prediction of a response to treatment.

The article also noted the gap between what we know about allergy and the application of that knowledge to those who struggle with allergy.

  • There is a shortage of well-trained allergists in most countries
  • Education and training efforts regarding allergy need to start with the medical students, especially for a condition that affects so many people
  • Awareness campaigns are needed for targeted groups such as nurses and school teachers
  • There needs to be close cooperation with patient organizations
  • Decision makers for developing and approving health policies and administration must be made more aware of the issues and problems of allergic diseases

Reviewer’s note-

It scary what we do not know and it is even scarier that we are not doing much about a few things when we can.

Allergy is a public health problem.

The editorial challenges us to make a change.

This year Dr. Vitalpur and I will be offering clinical teaching about the immune system and allergy in particular to first year medical students.

I have always wondered why allergy is not a required resident rotation – a requirement by the governing board of residencies. The condition affects so many children and is thought to affect so many more. I can easily see the impact of having at least a few weeks of exposure to the specialty in our allergy clinic.

We are most happy to speak at support groups or schools and we have done that many times. I am concerned that we are not asked more frequently to go out in the community.

We get involved with patient organizations and are willing to be involved with more.

It is unfortunate that we are not asked about policy or design. More often we have a reactive role in this regard.

The challenge is before us.

FEL (2-2-2012)

February 2, 2012 · fleickly · No Comments
Tags: , ,  · Posted in: Allergies, Allergy as a gobal problem, Allergy in Children, Developing Allergy, Environment