Home' Hastings Mail : May 25th 2011 Contents 7
HASTINGS MAIL, MAY 25, 2011
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Hawke's Bay European
Environment is now
too clean for kids
By NEILL GORDON
MONTHLY VISITS LIKELY
Asthma Hawke's Bay and Vincent Crump are
investigating the possibility of him holding a
monthly clinic in Hawke's Bay. A special allergy
clinic at the Hastings Health Centre during
Asthma Week was booked out. The Hastings
District Masonic Trust paid for four low-income
families to have a consultation for their chronic
eczema/allergy/anaphylaxis family member
who otherwise would not have been able to
CASHEWS A DANGER
Food allergies are not as common as people imagine.
''The actual prevalence is in fact only about 7 per cent of children under three and perhaps 2 per cent of
the general population,'' writes Vincent St Aubyn Crump in Allergies -- New Zealand's Growing Epidemic.
Peanuts have been generally regarded as the most common cause of death through severe allergic
reactions, known as anaphylaxis. New research shows that cashews can be responsible for even more
severe reactions, Dr Crump writes. Egg sensitivity in infancy is a strong predictor of asthma.
''About 2.5 per cent of young children react to eggs [the major allergen is in the egg white], but tolerance
is usually achieved by the time these children reach the age of five,'' he says.
Anaphylaxis is a whole-body allergic reaction. It happens rapidly and, if not treated quickly with
adrenalin, can cause death. Dr Crump says during the reaction histamine and other chemicals released
by the body cause blood vessels to dilate. ''Blood pressure drops, fluid leaks from the bloodstream into
the tissues and this in turn reduces the volume of blood. The result is severe shock.'' Fluid can also
leak into lungs, leading to constriction of airways and difficulty breathing.
In New Zealand and Australia, a list of allergens must be declared on food labels. These are: cereals
(wheat, rye, barley, oats) containing gluten and their products, crustacean products (crab, prawns,
crayfish), eggs and egg products, fish and fish products (including shellfish), milk and milk products,
peanuts and soya bean (and their products), added sulphite (due to intolerance, not allergy), and tree
nuts, sesame seeds and their products.
Vincent Crump: The Auckland-based doctor is one of
just seven allergy specialists in New Zealand.
a bit of dirt'
With one in four Hawke's Bay children -- about
8500 -- suffering from asthma, it's not surprising a
visit from an Auckland allergy specialist drew a
About 250 people attended a recent Napier lec-
ture by Vincent Crump to learn more about why
New Zealand has some of the highest rates of
asthma in the world.
There are various theories about why asthma is
so prevalent here and in Australia, Britain and
America, but no one knows for certain.
We know asthma is partly genetic and partly
environmental, but something must have changed
over the past 20 to 50 years in the environment
because the genes wouldn't change that quickly,''
Dr Crump says.
The hygiene hypothesis -- that exposure to dirt
and bugs at a young age helps develop the
immune system and people in the developed world
are living in environments that are too clean and
overly sterile -- makes a lot of sense, he says.
The countries where it's increasing are all
countries where there are increasing standards of
living and people can be thought of as being more
The kids are getting more antibiotics when
they're younger -- there are quite a few studies
showing that kids who have had two or three
courses of antibiotics before they get to the age of
one are more likely to be asthmatic or develop
With the modern living, our kids don't get
exposed to the bugs they used to in my time.
Back then they were playing in the dirt but
We believe kids' immune systems need a bit of
dirt, a few bugs to mature normally and modern
kids aren't getting exposed to the bacteria, viruses
The other side of this is, he points out, is that
very few kids today die from measles and
We've come a long way in terms of deaths from
infections but perhaps this is the price we're pay-
ing for all of that.''
While it appears that cleanliness is contributing
to the allergy epidemic, there are a whole lot of
other causes, too.
Dr Crump says other studies have shown that
children who grow up on farms where they are
exposed to animals have fewer allergies than
youngsters brought up in cities.
We believe these kids who live on farms get
exposed to the animals and they play out in the
dirt, whereas [with] the kids in the city, half of
them spend their time indoors watching television
or playing PlayStation and they don't really play
Antibiotics also play a role early on, Dr Crump
Kids who have been given more than two or
three courses of antibiotics in the first year of life
also have more allergies because, we believe, they
kill off the good bugs that they need in the gut for
their immune system to mature normally,'' he
The reverse of that are some studies that show
that giving probiotics to infants will also prevent
allergies, probably from the same principle of
replenishing the bugs in the gut.''
Cigarette smoke has also been strongly linked
to allergies, he says.
We would encourage no passive smoking in the
Allergies also appear in families who are
About 10 to 15 years ago there was a belief that
if pregnant mothers cut out allergenic foods like
peanuts, other nuts, fish and shellfish when they
were pregnant, then their children would not
However, we are probably seeing the opposite.''
Now the advice given to pregnant women is to
not cut out any foods, except for those that could
Knowledge is changing rapidly and advice is
changing all the time.
What we're telling mothers now is totally dif-
ferent to what we used to tell them 10 years ago,
so people have to keep up by discussing it with
their family doctor.''
More information: asthmanz.co.nz or at
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