HOW MANY CHILDREN ARE ALLERGIC?
| Statistics show that there are several allergic children in your class. It’s important to spot the early signs |
The number of allergic children is on the rise throughout the world. And it’s not just home-work they’re allergic to! In a recent study carried out in a Paris suburb, more than 20% of the population of school children were suffering from allergies, and that is what is happening in most cities around the world.
The main illnesses affecting these children are:
- Asthma
- Nasal allergy
(hayfever, allergic rhinitis) - Food allergies
- Skin allergies including eczema, urticaria (nettle rash) and angioedema (swollen face, eyelids and lips)
- Allergy to insects such as bees and wasps
- Allergy to medicines
Exercise is an important trigger factor for asthma and urticaria.
It is important for all teachers and staff on the school premises to be aware of the signs and symptoms of these illnesses.
With a potentially allergic child in your charge, you should obtain advice from the school nurse or doctor.
WHAT IS AN ALLERGY?
| Allergy is the body’s abnormal reaction to certain substances. Reactions are as varied as the causes. |
Allergy is a harmful reaction involving the immune system which normally protects the body against infections of various kinds. The predisposition to over react to allergens seems to be inherited – and is called atopy.
Non-allergic individuals tolerate allergens and do not develop symptoms. On the other hand, the body of the allergic person may become sensitive to the allergen and form antibodies. On subsequent exposure to that allergen the antibodies may trigger the release of chemicals such as histamine which result in the clinical signs and symptoms of allergy.
Usually the reaction is limited to one organ or system of the body – the skin, the respiratory or gastro intestinal tract. Rarely all systems of the body may be involved causing a potentially life-threatening emergency: anaphylaxis.
RESPIRATORY ALLERGIES:
WHICH ARE THE MOST COMMON?
| Sniffles and coughs might be signs of respiratory allergy, the most widespread of all. |
Rhinitis and asthma are the most common. Allergy of the upper respiratory passages is called rhinitis; of the lower ones, asthma. Now let’s spot the symptoms:
Allergic Rhinitis causes sneezing, itching of the nose and a runny or blocked nose. These symptoms might be seasonal when the pollen count is high (seasonal allergic rhinitis, hay fever). They occur all year round if due, for example, to mites found in dust (perennial allergic rhinitis). The child often rubs the nose in an upward direction. This mannerism is called the ‘allergic salute’. Unlike a cold, an allergy is not contagious. Neither does the child have a fever.
Asthma means inflammation and narrowing of the bronchial tubes that take air to the lungs. The result is breathing difficulty of varying degrees, because the air caught in the lungs can’t escape. During an attack, the child becomes anxious and feels that breathing is restricted. He or she may feel a sense of suffocation. A milder but annoying manifestation of asthmatic children may be an irritating cough that gets on the nerves of all in the class.
Look out for an eye complaint that often accompanies respiratory allergies, especially hayfever. This is allergic conjunctivitis. The eyes will be red and watery. The child complains of burning and that light is bothersome. Both eyes are always affected, and the child will rub the eyes a lot because of itching.
SKIN ALLERGIES:
WHICH ARE THE MOST COMMON?
| Redness, dry skin or swelling are the warning signs. The risks run from social handicap to suffocation. |
Eczema and urticaria (nettle rash) are common skin diseases affecting allergic children. Identifying the allergens that cause them often requires the skills of a detective. Reactions may occur a day or a week after exposure. A food that the child eats may be the cause.
Eczema can be of two types. Contact eczema appears on the skin at the very spot where the allergen, or allergy-causing substance, came into contact.
The most well-known is ‘tummy button eczema’ provoked by the nickel in jeans buttons, or ‘earlobe eczema’ from earrings. Atopic eczema affects children genetically predisposed to it, and is a particular problem among infants and young children. It can affect all or part of the body, but especially the folds of the arms and behind the legs.
THE RAW TRUTH
| For children, the appearance of eczema can be tough to live with and can be a social handicap. The skin can become weeping and red or scaly and dry like snake skin. Itching is usually a big problem. |  |
These children are often branded as nervous or irritable. They have a tendency to be on their own or be spurned by others because of their skin condition. |
Eczema is not contagious, and these children must not be excluded from any aspect of school life. You can help make their life a lot easier by seeing that they do take part in everything.
Urticaria is an inflammation of the skin which looks like nettle rash. The child will say the swollen skin feels burning and itches terribly. It feels hot and breaks out in raised patches.
Angio-oedema results in swelling of the face and eyelids. It’s very striking because the facial swelling causes the eyelids and the lips to swell to twice their size. Angio-oedema may be dangerous because the swelli may affect the upper airway and lead to breathing difficult
ALLERGIES IN YOUR CLASSROOM
| You can take effective action by eliminating the main types of allergen, be it a potted plant or a furry friend. |
What are common allergens that cause reactions among school children? It may surprise you to know that all classrooms contain the common allergens found in the home:
MITES IN HOUSE DUST.
House dust is a delicate potpourri of allergens! Mites form the basic ingredient. Under the microscope they look like tiny spiders. They live, reproduce and die
in warm, damp crannies, and are happiest in cushions, mattresses and carpets. They can’t bear the cold or dry heat. Their other enemies are draughts and good ventilation. Your school premises will be more healthy if well-aired, and washed rather than swept, to avoid clouds of dust. The other ingredients in dust may vary with the life of the room.
MOULD.
In the classroom, mould is not usually a problem unless there is persistent damp or excessive condensation. Numerous pot plants are not a good idea as they encourage mould.
ANIMALS.
Tucked in a corner of children’s classrooms, you will often find a cage containing a guinea-pig, rabbit, hamster or some such furry friend. There are undoubted educational, psychological and emotional benefits to be gained from a close understanding of animals – but many children react to allergens from their fur and skins. On balance, furry friends are better avoided in the classroom. They can be kept in cages outside.
FOOD ALLERGY AT SCHOOL
| Symptom-causing substances should be excluded from the diet. If the ingredients can’t be traced the child should bring his own food. |
Despite the grumbling about school meals, genuine cases of food allergy, and particularly ‘false’ allergy, known as food intolerance, are growing by the day. Food intolerance and food allergy often produce the same symptoms (urticaria, eczema, asthma, etc). Biologically, however, the way they produce these symptoms is really very different.
To get to the root of the problem, it’s absolutely essential for the child, the family and the doctor to talk about it together.
THE CANTEEN:
The food, preservatives or colouring agents responsible for a child’s illness must be made known to the canteen staff. The most common symptom-causing foods are eggs and – in babies – milk, wheat, soya and peanuts. Food allergies change with our eating habits and trends. Nowadays, kids are developing peanut allergy. Dramatic reactions can result, especially because peanuts tend to be present in all sorts of nutty guises.
If it’s not possible to detect the exact ingredients of a school meal, which is often prepared by central kitchens and distributed oven-ready, the child must be allowed to bring his own food.
VENDING MACHINES:
These are usually crammed with fizzy and mass-produced snacks packed with preservatives, flavouring agents and colouring agents.
ALLERGENS OUTSIDE THE CLASSROOM
| Know the ‘danger periods’ for children allergic to pollen. For insect stings, follow doctor’s orders to the letter. |
A geography outing, a summer picnic or an afternoon of sports can turn into an unhappy adventure. Don’t get caught unawares.
Pollen is the most well-known allergen, and the most famous allergy is hayfever. Pollen has its national tendencies depending on the environment of each country.
Scandinavians are more prone to pollen from the silver birch than from grasses.
Italians and Spaniards and other Mediterraneans suffer mainly from pollination of pellitory. In countries such as Britain, France, Belgium and Germany, the culprits vary with the seasons, from trees to grasses to herbaceous plants. In South Africa grass pollen is by far the most common allergenic pollen.
In the child’s ‘danger period’ he may have to be excused from outdoor sport, although medication is aimed at allowing as normal a life style as possible.
Insects with a sting such as the wasps, bees and hornets, can be dangerous -even deadly. A child susceptible to these insects may show symptoms within minutes of being stung. These may be general redness and itching, breathing trouble, a
suffocating feeling and even loss of consciousness.
Place a bag of ice on the sting area after the sting and insect have been removed, and reassure the child. If general symptoms appear (pallor, breathing trouble or generalized rash, call an ambulance).
If the child has previously had a serious reaction, he may carry an injection of
adrenaline to be administered in a subsequent emergency. The older child will have been taught how to do this – but will value your calm support. Even after the injection has been given, the child should still be taken to a doctor.
ALLERGY AND THE SPORTING LIFE
| With a doctor’s report and a dose of understanding, sports teachers can help an asthmatic child get a well-rounded education. |
The main risk during physical education and sport is an asthma attack. Other problems such as urticaria and anaphylaxis due to physical exertion can arise. These are dealt with in turn.
First, one thing to remember:
Sport is necessary to a child’s growth and psychological and sensory development.
Children should not be prevented from achieving their full potential by asthma. If they are, their medication needs adjustment.
ASTHMA: HOW TO AVOID AN ATTACK
Asthma must be treated, followed through, and the basic treatment applied regularly, if necessary before sporting activities. The family doctor or paediatrician will regularly measure the child’s
respiratory function. This will provide a record of breathing ability and keep teachers and parents informed of normal expectations.
Even if the child’s breathing is normal, the actual physical exertion of sport could trigger an asthma attack. These children should have a physical examination to determine the threshold which triggers the asthma. The doctor might advise an increase in preventative medication to allow exercise.
During the pollen season, it might be wise for hayfever or other pollen sufferers to be excused from outdoor activities.
 |
A child’s successful return to sport will depend to a large extent on the understanding, patience and vigilance of the physical education teacher and trainer. |
PRECAUTIONS TO TAKE:
- Make sure the child has taken the recommended preventative medicine 15 minutes before physical exercise. Every child seeing a doctor or asthma specialist should carry the medicine with him.
- In cold weather be extra vigilant. Cold air is a powerful trigger for an ashma attack.
- At the start of each exercise period, a special warm-up session is advisable for asthma suffers. They should breathe in deeply through the nose and out through the mouth. Each child must find the rhythm they are comfortable with. Let the child run at his own pace to begin with. If he starts to have difficulty breathing, shown by a pressing
- need to inhale through the mouth or breathlessness, you should advise the child not to stop but to walk while watching his breathing using the technique of controlled expiration: with his mouth half-closed, he should take short breaths out to begin with, making them longer and longer as the restriction eases. This should be repeated until the child regains a comfortable, healthy breathing rate.
REMIND THE CHILD:
- Not to forget their medication
- To know their limits
- To know when to give in
- To remember to warm-up
IN CASE OF AN ASTHMA ATTACK:
- Stop the exercise
- Place the child in a relaxed position in which breathing is easy. Many children choose to sit down leaning forwards
- Reassure the child
- As soon as the child can take their medicine give one or two puits of the bronchodilator. This can be repeated in 15 minutes if he remains distressed. Teachers should learn the correct way of using these inhalers. If you are in doubt, please ask the child’s parents, doctor or the school nurse to show you how to use them.
OUT OF BOUNDS
For some asthmatic children horseriding is contraindicated because of
sensitivity to horse dander. Special training under medical supervision is necessary before competing in cross country running or other endurance events.
Asthmatic children should avoid deep-sea diving unless they have had medical advice to the contrary. Asthmatic children should be encouraged to swim.
Inadequate treatment, or understanding of correct use of treatment, has meant many children with asthma have not fulfilled their potential in sport. In fact many sportsmen at the highest level, Olympic champions and international stars -have asthma and are
proof that correct treatment means an unrestricted sporting life.
ANAPHYLAXIS AND URTICARIA FROM PHYSICAL EXERTION
Fortunately, these problems are not very common, but you should know about them. Again, knowledge of the illness, from a detailed medical report, will enable the PE teacher to remind the child to take the correct medicine.
This will probably mean taking antihistamines or special adrenaline inhaler before exercise.
The risk of this problem occurring is greater if the exercise takes place just after a meal.
ALLERGY TO MEDICINES
| The fighting spirit is the springboard to success |
In theory, the risk of allergy to medicine at school is minimal.
Precautions mainly apply to boarders.
All children’s medical records should indicate drugs to which they are sensitive. Children allergic to medicines should wear a Medic-Alert disc or carry an Allergy Identification card on which is engraved the name of the medicine(s) to which the child is sensitive.
Side-effects of medication: This must not be confused with allergy to medicines.
ALLERGIES AND THE BIG WIDE WORLD
The list of allergy-causing substances in the work place is a long one.
Young people who are allergic must remember this in their choice of career. For example, someone allergic to cats or dogs should
probably not become a veterinary surgeon.
Specialist career advice is available -and should be taken.
Certain types of occupational
asthma affect those with allergies more severely than others – but non-allergic people can also be affected.
Finally, the good news is that the majority of allergies clear up with age.
SIX OUT OF SIX
- Learn from parents or school doctor and nurse of the child’s allergies.
- Allow children to carry their emergency medicines, with them.
- Take notice of the diets recommended for the food allergic child and understand the importance of avoiding certain foods in these children.
- Make sure that P.E. staff understand the problems of the asthmatic child.
- Take appropriate measures to avoid exposing the allergic child to allergens or irritants.
- Be aware of children’s allergies to certain medicines – ask children to show you their Medic-Alert disc or Allergy Identification card.