About seven percent of six- to seven-year-old children and 15 percent of 13- to 14-year-olds have hay fever. They struggle during pollen season with sneezing fits, runny noses and itchy eyes. This not only affects outdoor play. Children with hay fever also have difficulty concentrating at school. That’s why school performance often drops during pollen season.
Early treatment is important
“Hay fever in children should not be taken lightly,” warns the chairman of the Society for Pediatric Allergology and Environmental Medicine (GPA), Professor Carl Peter Bauer from Gaißach. He advises early treatment by a pediatrician and adolescent physician specializing in allergies: “Hay fever can turn into chronic asthma. This can be prevented with specialist therapy.”
Hay fever often turns into asthma
The immune system of children with hay fever is hypersensitive to certain proteins from hazel, alder, birch or grass pollen. The result is an inflammatory reaction of the mucous membranes after pollen contact noticeable by swelling, redness, itching and secretion. In about one in three children with hay fever, allergic asthma also develops at some point, with coughing, whistling breathing and attacks of shortness of breath. The doctor calls this a “floor change,” because the allergy has moved down a floor from the nose to the bronchial tubes. “The first sign of incipient asthma is often a dry, irritating cough at night. At the latest with this alarm signal, a visit to the doctor is urgently required,” explains Bauer. Other typical symptoms of allergic asthma are whistling, wheezing breathing and shortness of breath because the bronchial muscles tighten. Swollen mucous membranes and thick mucus in the airways make breathing even more difficult.
Correct therapy for hay fever
Even children with mild asthma need consistent therapy. This not only improves symptoms, but can also prevent asthma from becoming worse or chronic over the years. This is because, while attacks of allergic asthma are initially caused only by contact with allergy triggers, later in the course of the disease, when the bronchial tissue is already damaged by frequent inflammation, non-specific triggers such as cold, exertion, dust and irritants can also cause an asthma attack. And: asthma can lead to death through acute shortness of breath. According to the Federal Statistical Office, about 1,800 people die of bronchial asthma in Germany every year. “This number is probably much too high. Asthma is often listed as the cause of death in death certificates, even if the death occurred due to heart failure, a pulmonary embolism or another acute event,” lung specialist and allergist Professor Gerhard Schultze-Werninghaus, President of the German Society for Allergology and Clinical Immunology (DGAKI) based in Bochum, Germany, expresses concern. He estimates that only a few hundred people die of asthma each year in Germany. “The number of deaths from asthma has been declining for years. One reason for this is modern active substances and the guideline-compliant – early – use of cortisone for inhalation,” Schultze-Werninghaus explains.
Asthma in children
Although asthma therapy has made great strides, the incidence of children with asthma continues to increase: the proportion of children with asthma symptoms aged six to seven years increased from 9.6 percent to 12.8 percent between 1995 and 2000. This means that one in eight children is affected. An increase in asthma frequency is also discussed for adolescents aged 13 to 14. “The study surveyed the number of people affected with symptoms typical of asthma. However, it is important to distinguish between permanent asthma disease and asthma symptoms, as they can also occur in the context of other diseases. Fortunately, not many adolescents suffer from chronic asthma,” says Bauer, a pediatrician and adolescent physician.
Children with hay fever to the specialist
With children suffering from allergies, a visit to the specialist is unavoidable. The pediatric allergist first determines the allergy trigger based on the medical history and allergy tests an important basis for successful treatment. “With the medications available today, patients can be virtually symptom-free – even during the pollen season,” says Bauer.For example, antihistamines block a messenger substance of allergic inflammation. Modern preparations – particularly important for schoolchildren – also no longer make them tired. Nasal sprays containing cortisone can also be a great help for hay fever if used regularly. “The new cortisones only work in the nose and hardly enter the bloodstream anymore. There is no longer any reason to fear side effects.” If symptoms persist, Professor Bauer, a pediatrician and adolescent physician, advises specific immunotherapy. This “allergy vaccination” with molecularly standardized allergen preparations prevents further sensitization and is the only therapy that reduces the risk of a change of stage, i.e. the expansion of the allergy into bronchial asthma. Timely initiation of therapy is crucial for successful treatment. In addition, in children with hay fever or mild allergic asthma, specific immunotherapy can achieve a permanent cure.
