What is that itching and burning?

We have nut cake and strawberries for dessert. My heart sinks. We haven't informed our hosts about our daughter's allergies. She can't tolerate strawberries or nuts. What I almost feel most sorry for at that moment are the cooks who are desperately rummaging through their cupboards and drawers to find something sweet that my daughter could eat. She herself no longer feels so affected at such times.

As a family, we have become accustomed to cooking with food allergies and intolerances in mind. Alternative ingredients are so firmly integrated into our everyday lives that we forget about allergies now and again.

A chronic disease with many faces

Allergies are a widespread, chronic illness. According to the aha! Allergy Centre Switzerland foundation, around a quarter of the Swiss population suffers from an allergy. In Germany, according to the latest statistics, it affects over 34 per cent of women and around 27 per cent of men. Certain allergies are easy to adapt to. For example, there are many food substitutes. These make it possible to enjoy eating despite intolerances.

Fragrances, for example from cosmetics or detergents, can also trigger an allergy.

Other allergies are hard to get used to. Some are so severe that even the slightest contact triggers severe symptoms. An allergic shock can be life-threatening. Pollen allergies can also severely impair the quality of life of those affected. Many pollen allergy sufferers are therefore hardly looking forward to spring. The great hiking and camping camp with the class in June is a nightmare for a child with a severe grass pollen allergy.

What happens in the event of an allergy?

In the case of an allergy, the immune system reacts hypersensitively to substances that are actually harmless and foreign to the body. These (usually proteins) are known as allergens or antigens. They can be pollen, food, house dust or animal hair. Medications, insect poisons and fragrances, especially from cosmetics or detergents, can also trigger an allergy.

Normally, the immune system ensures that the body is protected from attacks by pathogens such as bacteria, viruses or fungi. The body's own immune system then triggers a kind of defence reaction. Allergic symptoms can therefore be similar to a cold or flu.

Allergies can also cause stomach ache, diarrhoea, vomiting, skin rashes or the formation of blisters on the skin. Current research indicates that allergies not only cause external symptoms such as colds or skin reactions, but can also affect internal organs. These include inflammation of the gastrointestinal tract, damage to blood vessels, the central nervous system, joints and kidney inflammation.

In many cases, a primary food allergy develops up to school age.

Cross-allergies and food allergies

Is my daughter's hazelnut allergy directly related to her hazelnut pollen allergy? Not necessarily. Like many so-called cross-allergies, the hazelnut intolerance is more likely to be due to the birch pollen allergy. The body thinks the hazelnut is a birch pollen and a dangerous one at that.

If the proteins in a food are similar to those in pollen, the immune system can have an allergic reaction to them. Such cross-allergies are therefore referred to as «secondary food allergies». Birch pollen allergy sufferers react to hazelnut, almond, pome fruit (e.g. apple), stone fruit (e.g. peach or cherry), strawberry, kiwi, celery, carrot, soya and peanut. Dust mite allergy sufferers can also react to crustaceans such as crab, scampi or lobster.

A «primary food allergy» is something else. It mainly affects small children (4 to 8 per cent) and only a few adults (less than 3 per cent). According to Swissallergy, eight foods are responsible for more than 90 per cent of food allergies: crustaceans, fish, soya, wheat, nuts, peanuts, eggs and milk. The symptoms usually manifest themselves on the skin as itching, hives, swelling or severe eczema. Shortness of breath, vomiting and circulatory problems are also possible.

In many cases, a primary food allergy develops by school age. However, the allergen to which the toddler reacts must be consistently avoided for two to three years. A suspected food allergy should always be clarified by a doctor. Avoiding foods unnecessarily is more likely to promote allergies.

Children with atopic dermatitis are more likely to develop asthma or hay fever later on.

Children and allergies

Children's immune systems are still in the developmental phase. This is why children are affected differently by allergies than adults. They react more sensitively to allergy triggers. The skin is still thinner, so allergens can penetrate the body more easily. This leads to allergic reactions being more severe.

There is the so-called «allergy career». Young children with atopic eczema are more likely to develop allergic asthma or hay fever later on. Studies also show that slightly more than half of children with severe atopic eczema also develop a food allergy.

Children whose parents or siblings already suffer from allergies have a higher risk of also developing allergic reactions. Most new cases of hay fever occur between the ages of six and sixteen. Three quarters of all cases occur before the age of 25. Even though allergies can develop at any age, children and adolescents are particularly affected by an allergy diagnosis.

Climate change and environmental pollution are increasing pollen allergies.

How are allergies treated?

There are three main ways to treat allergies:

1. Avoidance of allergens (allergen avoidance): This is particularly possible with food, fragrances, contact allergies (for example, by touching latex, plants or metals) or animal hair. You leave out or avoid what causes discomfort.
2. Symptomatic treatment: Allergies that can hardly be avoided (e.g. pollen allergies) can be treated with medication such as antihistamines, nasal sprays or eye drops to alleviate symptoms.
3. Hyposensitisation: In desensitisation, low doses of the allergen are regularly injected under the skin or given as tablets or drops under the tongue. Hyposensitisation lasts at least three to five years. It is mainly offered for allergies to pollen, house dust mites and insect venom.

To this day, allergies cannot be cured. However, there are areas that are more suitable for allergy sufferers. Allergy-friendly climates are found mainly by the sea (Atlantic or North Sea), where the sea breeze blows low-pollen air, or in the mountains, where the pollen season is shorter. There are hardly any house dust mites at altitudes above 1500 metres. This is why Davos, for example, is a very popular place to live and holiday for allergy sufferers. The annual misery associated with our place of residence prompted us as a family to completely change our lives and actively avoid the pollen.

Climate change, environmental pollution and allergies

Climate change and environmental pollution are increasing pollen allergies. According to the European Journal of Allergy and Clinical Immunology (2020), plants are producing more pollen in response to high levels of carbon dioxide in the air. The pollen season starts earlier and lasts longer due to global warming. Increased and rainy storms during the pollen season lead to an exacerbation of respiratory allergies and asthma in allergy sufferers.

There is evidence that air pollution changes the nature of tree pollen. Polish scientists collected birch pollen samples at various locations. They came to the conclusion that birch pollen in places with high levels of air pollution is more aggressive than that from areas with clean air.

How allergies affect families

If one family member has an allergy, everyone else is usually affected too - in very different ways. Here are a few examples:

• If a child is allergic to certain foods, this can lead to emotional tensions: If they are not allowed to eat nut chocolate or almond biscuits when visiting, they may feel sad. Siblings then sometimes feel guilty and prefer to go without, or they can't really enjoy the treats.
• Speciality foods are often more expensive than conventional foods, which has an impact on the family budget.
• It affects everyone when a child can't go on a trip into the countryside on a sunny spring weekend and has to stay at home.
• Weekly medical appointments for desensitisation put a strain on the family calendar. For younger siblings, this sometimes means spending many hours in waiting rooms.

Above all, however, allergies can put parents and affected children under psychological strain. In an English study, over 40 per cent of parents reached the clinical threshold for post-traumatic stress disorder. A further 39 per cent reported moderate to extremely severe anxiety. The more severe the allergy, the greater the psychological stress for the parents.

There is also increasing evidence that psychological stress exacerbates allergies, allergic reactions and asthma. Conversely, data points to a connection between the occurrence of hay fever and depression or anxiety disorders. In both cases, allergies can severely restrict the quality of life of those affected.

What helps in everyday life?

Home is usually a safe place for allergy sufferers. It is the easiest place to avoid allergens and keep symptoms under control. The biggest challenges therefore often start on the doorstep.

At school, the old floor cushions for the morning circle become an asthma trigger for the child with a dust mite allergy. After the boy with a fragrance allergy uses perfumed hand soap at the neighbour's house, he gets wet blisters all over his skin. The peanut flips at her classmate's birthday party are life-threatening for the girl with a peanut allergy.

Parents have a responsibility to inform those around them about their children's allergies. It is important that they encourage their children to deal with allergens, symptoms and medication confidently and competently from an early age. If parents feel insecure, it is therefore essential that they themselves receive medical or psychological counselling and support.

Schools help children with hay fever by showing understanding if they are unable to concentrate or are very tired during the pollen season.

But society can also do a lot to improve the quality of life of people with allergies. There are already some positive examples of this: Since 2018, restaurants, bakeries, snack bars etc. have been obliged to declare allergens in their food. This helps many allergy sufferers to eat out more relaxed. In addition, there are more and more allergy-friendly products in supermarkets. These can be recognised at first glance by allergy labels.

Schools and teachers make everyday life easier for children with hay fever by showing understanding if they are unable to concentrate or are very tired during the pollen season. On days with a high concentration of pollen in the air, it helps to set up an air purifier in the classroom or hang a pollen screen in the window. Pollen allergy sufferers should be allowed to spend their break indoors during the worst days.

On their birthday, kindergarten or primary school children like to bring a cake. If a child with a food allergy has something suitable for themselves, they never have to watch the others feast. There are various aspects of socialising with friends and acquaintances that make it possible to have a relaxed get-together despite an allergy. Good communication is the be-all and end-all here too. If I had informed the hosts I mentioned at the beginning with the nut cake and strawberries about our allergies, they would have been spared an unpleasant situation.

Catering to the special needs of allergy sufferers is sometimes difficult. However, it is particularly valuable for children if they do not have to experience this. It is becoming increasingly common for two different desserts to be served, for someone to meticulously fish all the carrots out of the soup or for everyone to mix their own fruit salad. The more relaxed everyone is about it, the better.