Tag Archives: allergy

Quick Tips to cleaning household mould.

Cleaning Kids Toys
The classic bleach-bath water mixture
Ingredients
1/2-3/4 cup bleach (white king, domestos)
Tub of water (bath tub or deep laundry tub suitable)

Method
Add Bleach into the tub of water. Soak toys overnight and the next day squeeze residue water out of the toys. Then lay out to sun and air dry.

A naturally effective alternative
The essential oil- bath water mixture.

Ingredients
2 teaspoons of Eucalyptus oil or tea tree oil
Tub of water (bath tub or deep laundry tub suitable)
mould

Method
Add oils into the tub of water. Soak toys overnight in the natural anti- mould essential oil eucalyptus bath water mixture. The next day squeeze residue water out of the toys. Then
lay out to sun and air dry.

ESSENTIAL
The natural anti- mould home spray

Ingredients
2 teaspoons of Eucalyptus oil or tea tree oil
Water in a spray bottle

Method
Mix oil into the water bottle. Spray on affected area and leave to soak for a few minutes before wiping away.

For some, hives are an existence of chronic irritation. They present randomly, burn, sting and campaign to ruin your day with constant reminder.

For those lucky not to have experienced them yet doesn’t mean you won’t. There is a 15% chance you could get hives at least once in your lifetime (girls, your chances are higher than boys (1) ) even if it’s just ‘acutely'; defined as less than 6 weeks duration.

Although 1.8% of adults worldwide battle with them regularly, right now! (2)

A real b-*–itch.

People absolutely hate them and they give people real anxiety. Hive sufferers having higher rates of psychological distress (3) The physical discomfort compounded by the emotional torture that there is no cure to end the wretched affliction rates them high on A-n-n-o-y-i-n-g.

Chances are there would be many chronic hive sufferers out there who remain frustrated with diagnosis; or lack of diagnoses. Even if they saw their local doctor about it; the front-line primary response that

“Hives are rarely due to a nasty underlying disease. Although they can be uncomfortable and cosmetically embarrassing, they are not dangerous. Most people with hives do not need tests” (ASCIA, Urticaria)
can be somewhat deflating if your living with chronic hives.

Not nasty. Not dangerous. No tests recommended.

Left to manage urticaria chronically or left on long waits to see one of the highest privately billing specialists (4)- making access to allergy specialty care hard, if you want you to find out more about the unremitting itch.

Hence the WAO 2017 theme “The Agony of hives”.

To top it off, even if you see an allergist, allergy testing often yields no answers (5) making idiopathic chronic urticaria a frustratingly common diagnosis ie. no cause identified.

It’s hard to swallow but in 80% of cases, a cause is not identified.
Although an autoimmune basis of most of the ‘idiopathic’ forms is now being hypothesised. (6,7)

Said differently, because urticaria can be caused by absolutely almost anything (the list of causes as long as your arm) it’s often hard to work it out, especially on your own. It takes real medical detective work and a good physician ready to outshine the failings of “google-medicine” by showcasing how careful history-taking is actually the best form of assessment.(5)

During a typical chronic urticaria consultation, much time is spent breaking down popular misled beliefs. At the front line of primary care allergy medicine, 2017 World Allergy Week is an opportunity to shatter 3 current common hives misconception.

1. Hives = Allergy
2. Patients with hives need allergy skin prick testing.
3. There is nothing much anyone can do about hives

1. Hives = allergy

While it is true that Allergies can cause hives, the reverse is not, hives are not only always caused by allergies.

Hives can be caused by so many things – from changes in temperature, cold weather or infections to preservatives and common medications like codeine, aspirin or even oral contraceptive pills.

A #PractitionersPearl is to always check their medication history.

Medications are infact a common cause of chronic urticaria commonly overlooked because of this following fact.

Medications can still cause hives even if you have been on them for a while….making diagnoses tricky because patients least expect it to be their blood pressure table, oral contraceptive pill , NSAID or aspirin.

A pearl for patients out there is not to overlook an obvious immeasurable cause of hives – stress. Classically hives can be the tell-tale sign of stress

Its refreshing to see actors like Anne Hathaway readily admit to being afflicted with urticaria when they are nervous, bothered or hot under the collar.
agony of hives

2. Patients with hives need allergy skin prick testing.

Many patients seen at our collective. care allergy and Australian Allergy Centre clinics regarding chronic hives expect skin pick testing to confirm their suspicion that their hives are caused by food or an environmental allergens. Not true.

In fact, the role of allergy skin prick testing is controversial in the investigation of chronic urticaria. Food allergy actually represents such a small possible cause many argue about the value and many test results are not always clinically useful, therefore skin prick testing is reserved for when the history is suggestive of an allergic cause.(5)

Other tests outside of allergy testing like inflammatory blood markers (ESR), thyroid function + antibodies, autoimmune screens, coeliac testing as well as skin biopsies (if there is concern of urticaria vasculitis) are sometime arranged to filter through the list of possible underlying causes.(8)

3. There is nothing anyone can do about hives

While there is no cure there still are treatments. Although time is truly the wonder healer with 80% of urticaria settling within 12 months. (9) But when a cause isn’t immediately obvious, patients face trialling different measures or medications to control the symptoms of urticaria.

First line treatment currently involves reassurance, avoidance of exacerbating factors and non-sedating antihistamines. (10) Traditional antihistamines, if not working at usual doses can be prescribed up to 4 times the labelled dose to help achieve adequate control. Additionally the use of H1 and H2 receptor antagonists such as doxepin can be titrated up balancing against side effects like sedation. (11)

There is some light at the end of the tunnel with newer modalities.

While narrow band UV-B phototherapy treatment still remains inconclusive although with some promising results as an alternative treatment (12), immunodulator, omalizumab injections currently approved for asthma, is showing really promising results. The World Allergy Organisation Journal quotes (13, 14, 15) large multi centre, randomised, double-blind, placebo controlled phase III trials of omalizumab, at doses of 150 and 300mg every 4 weeks for 3 months show significantly improved urticaria outcomes compared with placebo.

…….. it’s currently awaiting PBS listing in Australia-Otherwise this treatment costs over $400 per shot – chronic urticaria sufferers, let’s hope it’s not another agonising wait.

More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide are being used for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future too.

Other therapies including psychological treatments and acupuncture should be offered. In one study acupuncture induced partial remission of chronic urticaria in the majority of the patients. During 3 weeks of study, the efficacy of acupuncture was greatest in the third week of treatment (16) and many studies (17,18,19) suggest psychological treatments such as relaxation treatments and hypnosis positive impact for urticaria.

What collective.care Allergy Clinic plans to contribute for this 2017 The Agony of Hives World Allergy Week

At collective.care allergy our commitment to health professionals and community education includes:

A well-overdue explanation about the complexity of chronic hives to the public
Acknowledgment of their relentless nature and effect of psychological health
Acknowledgement of the difficulty in identifying a cause for chronic urticaria
Commitment to continue to send updates to our patients about any new emerging treatments that become available including PBS listing of Omalizumab
Pioneer our collective.care chronic urticaria case conferencing so we can collaboratively manage with allergy, immunology, dermatology, general practice, acupuncture and psychologists chronic urticaria using chronic disease management planning principles.

———————————————————————————————————-

About:

Dr Suzan Bekir MBBS (Hons1) FRACGP is co-creator of collective.care and Australian Allergy Centre, Australia’s first GP-shared care model for specialist clinics including Allergy, ENT, skin, laser and cosmetic medicine. She is clinical director and head of GP accredited special skills training programs for Allergy, ENT, eye, metabolic, skin, laser and cosmetic medicine.

For any Media enquiries for upcoming World Allergy Week 2017 please contact Christian Burden on 0481940809.

References :

Deacock SJ. An approach to the patient with urticaria. Clin Exp Immunol. 2008;153:151–61.
Zuberbier T, Balke M, Worm M, Edenharter G, Maurer M. Epidemiology of Urticaria; a representive cross-sectional population survey. Clin Exp Dermatol 2010; 869-73.
3. Ozkan M, et al.Psychiatric morbidity and quality of life in patients with chronic idiopathic urticaria. Ann Allergy Asthma Immunol. 2007.

4. Gary L Freed and Amy R Allen. Variation in outpatient consultant physician fees in Australia by specialty and state and territory. Med J Aust 2017; 206 (4): 176-180.

5. S Fernando et al. Chronic urticaria. Assessment and treatment. Australian family physician. Vol 39 (3):2010

6. Sharma VK, Gera V, Tiwari VD. Chronic urticaria: Expanding the autoimmune kaleidoscope. Med J Armed Force India. 2004; 60:372-8.

7. Dalal I, Levine A, Somekh E, Mizrahi A, Hanukoglu Chronic urticaria in children: Expanding the “Autoimmune Kaleidoscope” Pediatrics. 2000;106:1139–41.

8. Wai YC, Gordon LS. Evaluating chronic urticaria patients for allergies, infections, or autoimmune disorders. Clin Rev Allergy Immunol. 2002;23:185

9. Gaig P, Olona M, Munoz Lejarazu D, et al. Epidemiology of urticaria in Spain. J Investig Alergol Clin Immunol, 2004; 14:214-20.

10. ASCIA. urticaria. https://www.allergy.org.au/images/pcc/ASCIA_PCC_Urticaria_hives_Feb2017.pdf

11. Smith P, Corelli R .Doxepin in the management of pruritus associated with allergic cutaneous reactions. Ann Pharmacother 1997;31:633–5.

12. Aydogan K metal. Narrowband UVB (311nm, T1L01) phototherapy in chronic urticaria. International Journal of Dermatology. Jan 2012 (51)1:98-103.

13. Maurer M, Rosén K, Hsieh H-J, Saini S, Grattan C, Gimenéz-Arnau A, et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med [Internet]. Massachusetts Medical Society; 2013 [cited 2016 Apr 8];368(10):924–35.

14. Saini SS, Bindslev-Jensen C, Maurer M, Grob J-J, Bülbül Baskan E, Bradley MS, et al. Efficacy and safety of omalizumab in patients with chronic idiopathic/spontaneous urticaria who remain symptomatic on H1 antihistamines: a randomized, placebo-controlled study. J Invest Dermatol [Internet]. 2015 [cited 2016 Apr 5];135(1):67–75.

15. Kaplan A, Ledford D, Ashby M, Canvin J, Zazzali JL, Conner E, et al. Omalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy. J Allergy Clin Immunol. 2013;132(1):101–9.

16. Iraji F, Saghayi M, Mokhtari H, Siadat A. The efficacy of acupuncture in the patients with chronic urticaria: Acupuncture in the treatment of chronic urticaria: A double blind study. Int J Dermatol. 2006;3:2.3:185

17. Buffet M et al. Management of psychological factors in chronic urticaria. When and how. Ann Dermal Venereol 2003.

18. Bering AM et all. Chronic urticaria: importance of medical-psycological approach. Our Ann Allergy Clin Immune, 2006.

19.Consoli SG wet al. Psychological factors in chronic urticaria. Ann Dermal Venereol. 2003.

Many people do not recognise that hayfever, otherwise known as Allergic Rhinitis, is one of the most common chronic respiratory conditions in Australia with an estimated 3.2 million sufferers (AIHW 2010). It causes serious annoyance – the sneezing and itching and irritation is one thing but the chronic blocked nose, snoring + mouth breathing, fatigue and sinus infections is often under-reported!  Even your GP may not know yet about the evolving field of AIR allergy and it’s serious complications – especially to kids! Air allergy is a new field requiring a multidisciplinary approach between GP’s, ENT, allergy, sleep medicine, orthodontists and oromyofacial therapists.

But it is the serious chronic presentations of hayfever that really interfere with day to day living leading to poor sleep, poor concentration, poorer work performance and even time off school or work. Not to mention the orthodontic bills parents have to cope with when they finally recognize that hay fever was the original cause of their child’s blocked nose which led them to mouth breathe which led to the tongue thrust and now changes in the development of their palate, jaw and face (Page and Mahoney 2010).

In addition to reducing quality of life, hay fever is also linked with the development of asthma, especially for kids. Approximately 2 million Aussies suffer from asthma and an estimated 700, 000 will have both hayfever and asthma (AIHW 2010). In fact, there is very good evidence that patients with hayfever and asthma have asthma symptoms are more difficult to control compared with  patients with just asthma alone! (Van den Berfe et. al. 2002) and we also now know that treating hayfever will in fact reduce emergency department hospital presentations for asthmatics. Makes sense to treat, right!

So basically, allergy testing for hayfever and treating hayfever is so much more important than many people recognize.  Its certainly not something to be left to just chance or a last minute over the counter pick -up from the late night chemist. It requires air allergy testing and monitoring for the complications of air allergy and getting serious about treatment with a proper chronic disease management plan rather than a  just “take this spray and see how you go!”

Really effective new treatments are now available (and guess what,  not just DRUGS too!) which can effectively treat allergic rhinitis (as well as asthma). With more and more immunotherapy options available to desensitize against allergens like pollen and dust mite (even in tablet and drop formulations) and UV intranasal phototherapy (Rhinolight)  to assist with symptom control, there is more to offer than just anti- histamines and nasal sprays that you can get from a chemist. Mind you, evidence that treating allergic rhinitis particularly with intranasal corticosteroids, can reduce asthma related hospital visits (Walls R et al) is still a strong first line treatment.

rhinolight
Light therapy for the nose is offered by our Doctors for hay fever symptom control.

Putting up with hayfever is a serious no no! People should really start seeing that air allergy is growing (WAO, 2015) really fast, just as much as food allergy! While we are all getting educated about food allergies and how they can be life threatening, people shouldn’t under-estimate the life threatening effects of air allergy. Thunderstorm asthma kills!  Yes, Thunderstorm Asthma is real and likley to get worse (WAO, 2015) and the biggest risk factor for it is…..hayfever.

My best advice – if you want to get the mos tcurrent advice and not get the run-around, see GP’s who understand allergy, the serious complications of air allergy and can connect you with the right tream of specialists. Remember, breathing is life and we shouldn’t take breathing for granted.

 

Dr Suzan Bekir is a General practitioner with private practice in Double Bay and who works at Australian Allergy Centre and collective.care Allergy/ENT. Bella Vista, Wollongong, Edgecliff. Bulk Billing air allergy testing available. 1300 344 325 for appointments. 

 

As a GP working in family medicine and Allergy, I recognise it’s hard to keep on top of ever-changing research and guidelines on what to feed children. If only the headlines could keep still for long enough we may be able to digest the facts to disseminate the right information to parents! 

Guidelines surrounding infant feeding rely heavily on available scientific evidence at-the-time, especially surrounding allergy prevention and new research means our guidelines are constantly changing making it hard to keep up.

Over the past four decades, we transitioned from the early introduction of solids (before four months of age), to telling parents about reducing exposure of potentially allergenic foods like peanuts, cow’s milk and eggs to delaying the introduction of allergenic foods to even denying mothers their morning peanut butter on toast! 

However, we are now adopting the view that early exposure may be protective or at least have a neutral effect, even in at-risk infants! At-risk meaning  those with a family history of allergy should not avoid allergenic foods! In a study published in the New England Journal of Medicine, atopic infants at risk for peanut allergy were randomised to either consume or avoid peanuts until five years of age. Amazingly, the prevalence of peanut allergy was significantly greater in the avoidance group, indicating that preventing exposure to potentially allergenic foods is unwarranted, even in at-risk infants.

So where does that leave us to advise parents…

peanut allergy

Here are seven infant nutrition tips that also summarise the current infant feeding facts that  even your local doctor is learning right now!

  • Maternal exclusion of potentially allergenic foods is unwarranted during pregnancy or lactation. So, yes you can have the peanut butter!!!
  • If possible, children should be exclusively breastfed for six months, with the introduction of solids at four to six months (with continued breastfeeding). 
  • Introducing solids should be based on the child’s developmental progress, including feeding behaviour (such as transition from sucking to biting), appetite, growth, and their expressions of interest in food. I suggest this is something to discuss at your 4 and 6 month vaccination apppointments with your GP or early childhood nurse.
  • The evidence does not support the delayed introduction of potentially allergenic foods, even in at-risk children. Parents can introduce one new food at a time to make it easier to monitor if there is a reaction. I always say, a new food every 48 hours when your first starting solids.
  • Repetition is the key. Children can be offered a food item up to 10 or more times before they will even put it to their lips! Do not stress if they hate the brocolli! So parents should keep persevering, let them explore the food and get familiar with it.
  • It is important to provide children with a wide variety of foods for texture and taste exposure. So parents should not assume their child won’t like a particular food (in fact, they might be surprised with what their child will eat!). Play with colours and shapes and presentation of food.
  • Infant taste-buds are sensitive. What may be bland to an adult, is not to an infant. So parents should be discouraged from adding too much salt or sweeteners to their child’s food.

Dr Suzan Bekir is a general practitioner with a special interest in family medicine and allergy and works at Australian allergy centre and collective.care allergy.

Concerned about food allergy? Want to speak to Doctors who understand allergy and perform food and air allergy skin prick testing on site, then please call Australian Allergy Centre and collective.care Allergy clinics on 1300 344 325. Bulk billing available.

Bella vista, Wollongong, Edgecliff. 

reference

Adapted from M. Jensen.7 nutrition tips to share with new parents, Medical observer.  31 January 2017

 

As we enter the worst allergy season in history, then you probably know someone right now who is suffering from runny nose, itchy nose, sneezing, itchy watery eyes or blocked nose who would benefit from knowing about this new allergy treatment offered by Allergy Doctors with no cost to the patient.

RHINOLIGHT is the newest non drug hay fever treatment that will bring welcome relief to those suffering from seasonal allergies. And the best news of all – there is no cost to the patient!

For most people, spring is a time for enjoying the outdoors after emerging from our long winter sleep. But for those of you who suffer from hay fever, it can be a painful time. Watery eyes, sneezing, and runny noses are some of the symptoms of hay fever that hold you back from enjoying what should be one of the best times of the year.

But there’s some good news for those looking for a new hay fever treatment. And that’s Rhinolight®.

Rhinolight® is a phototherapy treatment of the nasal mucus suitable for patients who suffer from hay fever. Rhinolight® treatment reduces the body’s immune response to inhaled allergens like pollens, moulds, animal skin, and mites, while also reducing the symptoms of hay fever.
rhinolight

foto-terapi
Treatment involves exposing the nasal cavities to light at a particular wavelength (5% UV-B, 25% UV-A plus 70% visible light) for 2-3 minutes at a time, which reduces the cells’ ability to recognise and respond to inhaled allergens, and release histamine, which is responsible for the symptoms of allergic rhinitis (Rhinolight Ltd., 2014).

The Benefits of Rhinolight® as a Hay Fever Treatment

According to clinical trials, there are several benefits to using Rhinolight® as a hay fever treatment.

Rhinolight® significantly decreases the severity of common symptoms such as sneezing, runny nose, nasal itching and nasal blockage, for up to 12 months. (Koreck et al., 2005)
It’s appropriate for children as young as 6, pregnant or breastfeeding women, and athletes who are banned from using steroids. (Rhinolight Ltd.)
Rhinolight® is painless hay fever treatment with minimal side effects. Patients won’t feel heat or burning during treatments. The only side effect is a temporary dryness of the nose, which can be relieved with a little vitamin E oil.
Rhinolight® phototherapy is a good hay fever cure for chronic seasonal allergy sufferers who are unresponsive to conventional anti-allergic or hay fever treatment.
For patients with severe symptoms, Rhinolight® may be performed as a complimentary treatment, to enhance the effectiveness of medicines or allergen immunotherapy (Rhinolight Ltd., 2014).
For the most effective relief of hay fever symptoms, doctors recommend eight Rhinolight® treatments within six weeks. Patients often report symptom improvement within the first few treatments.

Thinking of giving Rhinolight® a try? At collective.care centres and Australian Allergy centre Rhinolight® is covered by our Medicare consultations, with no additional charges to you.


Make this year the year you treat hay fever without the extra pharmacy bill.
Call our team on 1300 344 325, or book an online appointment to see one of our specialists, who will advise you whether Rhinolight® is suitable. Bulk billed consultations with our doctors are available. We also offer bulk billed skin prick allergy testing to assess for hay fever and offer Rhinolight treatments under medicare consultations.

References:

Brehmer, D. 2010. Endonasal phototherapy with Rhinolight® for the treatment of allergic rhinitis.

Expert Review of Medical Devices 7, 1, 21-26.
Koreck, A., Csoma, Z., Bodai, L., et al. 2005.

Rhinophototherapy: A new therapeutic tool for the management of allergic rhinitis. Journal of Allergy and Clinical Immunology 115, 3, 541-547.
Rhinolight Limited [Rhinolight Ltd.]. 2014. Rhinolight-IV

Phototherapeutic Device: User manual. Szeged, Hungary: Author: Sophie Davidson – Allergy RN

Struggling with hay fever, asthma or allergic eye symptoms? You are not alone. 1 in 5 Australians suffer from allergies. Finally there is a new era of allergy treatments available for patients suffering from allergies.

One of these new treatments is a new house dust mite allergy tablet. This month, Actair was launched heralding a milestone in specific house-dust mite allergen immunotherapy. So if you thought you had to put up with runny nose, sneezing fits and blocked nose and sinus symptoms forever, you are wrong. New allergy treatments are starting to emerge to catch up with the global airborne allergy epidemic.

It is broadly accepted we are amidst a worldwide increase in the prevalence of allergic disease especially asthma and hay fever. Although the complications of the increase in respiratory allergies are increasing, there are treatments now available to help. Although the first line management of allergic disease includes educating the patient to avoid exposure to the allergen and pharmacological treatments such as nasal steroids for symptom relief, the only really curative treatment modality is allergen specific immunotherapy.

What many people don’t realise is that although immunotherapy might seem like a bigger investment in terms of initial outlay of costs compared with over the counter medications, they are investing in a more long term solution for their health. Over the counter relief treatments and “rescue” medications such as antihistamines or nasal sprays and rinses over an allergy lifetime can total up to be very expensive to patients, therefore it is shortsighted for patients not to consider the overall health and monetary value when considering immunotherapy.

Moreover, immunotherapy for pollens or dust mite has the capacity of changing the natural course of allergic disease for patients by preventing sensitizations with new allergens and development of asthma in patients with rhinitis. And that’s a fact. Studies show that Allergy immunotherapy for allergic rhinitis effectively prevents asthma and especially so for children. Yes, there is evidence we can prevent the allergic development of asthma! Longitudinal studies have confirmed that sensitization to HDM is one of the most important risk factors for the development of asthma in children.

Given the increase in HDM-induced allergic rhinitis and asthma, then more attention should be given to treatments such as immunotherapy which can be easily and safely administered.

Whilst allergy injections (subcutaneous immunotherapy) has long been used for allergy treatment, discomfort and adverse reactions have meant alternative routes have emerged. The alternative of under the tongue mucosal route of drops (sublingual immunotherapy) and now oral dispersible tablets has meant patients have a safer more convenient way to manage their allergies.

The under the tongue oral tablet allergy treatments to treat allergies first started with the emergence of pollen allergy tablets. There are multiple studies demonstrating patients with allergic rhinitis and or asthma improving using a standardized grass pollen tablet over the last few years and showing safety, tolerability and clinical efficacy.

Now, Actair, the new House Dust mite oral tablet immunotherapy has launched and preliminary studies are indicating that symptoms scores improve and stay improved even after one year after ceasing treatment. In a European study, individual symptom scores were markedly improved for sneezing, itching and nasal congestion by 22.2% reduced compared with placebo group (9.7%).

A significant symptom score improvement of 23% was demonstrated in the Rhinoconjunctivitis quality of life questionnaire after the first year compared to the placebo group. Results such as these are promising and although there are no long-term studies after one year or data for over 65 or under 5-year-olds available as yet for Actair, this is definitely a step in the right direction to providing patients with more choices for allergy treatment.

Fast Facts
– ACTAIR is a new house dust mite allergen extract tablet now available
– It is a form of allergen immunotherapy or desensitization treatment aiming to cure of dust mite allergy
– It’s an easy-to-use tablet – given daily under the tongue, which dissolves in two minutes and then can be swallowed
– Treats allergic rhinitis (hay fever) with or without conjunctivitis and allergic asthma that is triggered by house dust mites diagnosed by an allergy test
– ACTAIR contains a mixture of American (Dermatophagoides farinae) and European (Dermatophagoides pteronyssinus) house dust mite allergen extracts

The science of it
Actair works by re-educating the body’s immune system by actually targets the cause of allergy rather than just treating allergy symptoms with medications. It is a form of immunotherapy, which means desensitization. Allergen immunotherapy changes the way the immune system reacts to allergens, by switching off the allergy. The end result is that you become immune to the allergens, so that you can tolerate them with fewer or no symptoms.

Who can use Actair:
Adults and children can use the tablet over 12 who have been diagnosed with dust mite allergy.

How will it help my dust mite allergy?
Actair has been shown clinically to reduce the occurrence and severity of allergic symptoms such as runny nose, blocked nose, sneezing fits, itchiness of the nose, throat and eyes and asthma exacerbation.
Studies also show it reduces the use of rescue medications for flares and improves the quality of life.
For many patients whose HDM allergy this means an improvement in their snoring, mouth breathing and sleep.

How quickly does it work?
Works as quickly as 4 months.

How long does it last?
Unknown. At this stage there appears to be only one year follow-up data available.

How to buy it?
– Actair is TGA-registered in Australia
– It is Not PBS listed yet but available on PRIVATE SCRIPT from your doctor
– readily available in Australia at chemists and allergy clinics ( unlike many immunotherapy treatments which can take 8-12 weeks to be received upon ordering from overseas)
– Health fund rebates are available for private scripts but obviously, depends on your levels of cover.

How Do I start
If you have allergy symptoms we recommend an allergy assessment by an allergy trained doctor. Skin Prick testing is the gold standard method to diagnose dust mite allergy. Your Doctor will then recommend a treatment plan for your allergy. Actair is only one option available for management of dust mite allergy and your Doctor will assess your suitability for this medication or whether other treatments options are better for your health.

At Australian Allergy Centre our Doctors are allergy trained GP’s who require no referral and there is no wait for allergy assessment. We have Doctors available that bulk bill consultations and bulk bill skin prick testing for air allergies as well as other nose lab tests.

We offer education on avoidance measures, medical treatments, Rhinolight treatments and immunotherapy. For complex cases or those who require assessment with an ophthalmologist for eye symptoms or ENT for nose and sinus symptoms, our specialists assist with consultations. If you would like to make an appointment to see one of our Doctors you can call 1300 344 325 or book online.

references:
Bacharier LB, Boner A, Carlsen KH et al. Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy. 2008;63:5-34
Schmitt J1, Schwarz K2, Stadler E2, Wüstenberg EG3. Allergy immunotherapy for allergic rhinitis effectively prevents asthma: Results from a large retrospective cohort study. J Allergy Clin Immunol. 2015 Dec;136(6):1511-6. doi: 10.1016/j.jaci.2015.07.038. Epub 2015 Sep 12.
Host A, Halken S. The role of allergy in childhood asthma. Allergy 2000;55 (7):600-8
Maloney J, Bernstein DI, Nelson H et al. Efficacy and safety of grass sublingual immunotherapy tablet, MK-7243: a large randomized controlled trial. Ann Allergy Asthma Immunol 2014; 112 (2):146-53
Nerin N Bahceciler, et al. A milestone in house dust mite allergen immunotherapy: the new sublingual tablet S-524101 (actair) Expert review of vaccines. May 2016 At:16:46
Actair Product Information. Study 1: European multicenter, randomized controlled double-blind, placebo-controlled study conducted over 2 years with 509 patients with 300IR dose of Actair for 12 months and followed up subsequent treatment free year.

Recent research has revealed a strong link between the two, causing a recent change in the way doctors now treat them.

Hay fever now affects 3 million Australians. This means that 1 in 5 of us have to battle through spring and summer with runny noses, watery eyes, and the other symptoms of hay fever. On top of that, Asthma Australia reports 1 in 10 Australians now suffer from asthma, and around a third of these people report having asthma symptoms that interfere with their daily lives.

In Australia, hay fever and asthma are both on the rise. This isn’t really surprising as the same things can trigger both conditions; typically dust mite, pet allergens, pollen, and moulds. What also should come as no surprise is the fact that asthma and hay fever are often found in the same patients. In fact, the Australian Institute of Health and Welfare reports that around 80% of patients with asthma also have hay fever, and hay fever is one of the biggest risk factors for developing asthma.

Despite their similarities, the two conditions have often been treated as two separate conditions because one exists in the upper airway, and the other occurs in the lower airway however things are now changing and doctors are now referencing both airways to be part of a unified airway syndrome.

The upper airway consists of the nose, mouth, sinuses, and throat. The lower airway consists of the trachea, bronchial tubes, and lungs. And when they are functioning normally, they work together to form a kind of two-step air filter. When we have a cold, laryngitis, or hay fever, the symptoms show themselves in our upper airway. But when we have bronchitis or asthma, the symptoms show themselves in the lower airway.

Traditionally many consultations were focused on the lower airway because of the serious nature of bronchial and asthmatic problems, and during these consultations, not much attention was focused on the upper airway at all.

However, recent research suggests that making a distinction between the upper and lower airways doesn’t make sense, especially as the link between hay fever and asthma is now firmly established. The unified airway is a new way of thinking for doctors and now patients.

In fact, Doctors these days are now working with the understanding that asthma and hay fever are simply two manifestations of one unified airway and that a nose reacting to allergens will very often lead to inflammation in the lower airways too . Conversely, treating the nose will most likely affect lower airway inflammation. Asthma patients who treat their rhinitis can actually reduce their number of asthma-related hospital visits.

Dr. Tobias Pincock from collective.care’s allergy and ENT clinic says, ‘Recent medical research has highlighted the importance of looking at the upper and lower respiratory systems as one airway, and treating conditions like hay fever and asthma as two manifestations of the same problem, which they are in many cases.’

Treatment for upper and lower airway infections has traditionally been different because of the structural difference between the two. However, treatments like corticosteroids treat the underlying inflammation that occurs in both.

Allergen immunotherapy can also be effective in treating co-existing asthma and hay fever. Immunotherapy is a treatment carried out by a clinical immunologist or allergy specialist that reduces the severity of symptoms over time by introducing tiny portions of the allergen in the same way a vaccine is introduced to the body to prevent an illness. Over time, the body develops immunity, and allergy symptoms significantly reduce.

“Hay fever and asthma really reduce the quality of your life”says Dr Suzan Bekir, allergy/ENT GP from Australian Allergy Centre “It’s not until after our patients receive treatment that many patients really understand the impact these conditions were having on their daily lives”.


If you have concerns about your hay fever or asthma, contact us at our BULK BILL allergy clinic on 1300 322 345 or use our 1300 MYALLERGY or our online appointment system, and book in to see one of our GP’s who are trained in allergic rhinitis and asthma to assist with making sure you get the best available treatment.