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AAAAI and FAAN educate about dangers of anaphylaxis

With the upcoming school year approaching, the American Academy of Allergy, Asthma and Immunology (AAAAI) and the Food Allergy & Anaphylaxis Network (FAAN) are asking every parent of a child with food allergies or a known insect sting allergy to alert their child’s school to the condition and have an action plan ready.

A potentially life-threatening allergic reaction, called anaphylaxis, can be triggered by exposure to one or more allergens, including foods, insect stings, drugs, and latex products. Anaphylaxis can affect multiple areas of the body (such as skin, respiratory tract, gastrointestinal tract and the cardiovascular system). Symptoms can include severe headache, nausea and vomiting, sneezing and coughing, hives, swelling of the lips, tongue and throat, itching all over the body, and anxiety. The most dangerous symptoms include difficulty breathing, a drop in blood pressure, and shock - all of which can be fatal.

“All school staff must be made aware of the potentially severe nature of an anaphylactic reaction,” said S. Allan Bock , MD , FAAAAI, and Chair of the AAAAI’s Anaphylaxis Committee. “Parents need to work together with teachers, coaches and school nurses to avoid triggers and act quickly if a reaction occurs.”

To protect your child, and prevent anaphylaxis, the AAAAI and FAAN encourage parents to take the following steps before the school year begins:

* Work with an allergist/immunologist to identify your child’s triggers and reinforce these to your child. If possible, provide your child with a medical bracelet or necklace that identifies his or her specific allergy.
* Tour your child’s school or childcare facility before school starts, and meet with the staff to inquire about policies regarding foods and other potential triggers brought into the classroom.
* Provide staff with information and resources to educate them about your child’s allergy. Have your child’s allergist/immunologist provide clear, written instructions on recognizing a reaction early and administering medication in case of a reaction. Inform staff to call 911 immediately if a reaction occurs.
* Teach staff when and how to properly administer medications such as injectable epinephrine, encouraging them to handle the medication and ask questions. Explain to them that they cannot delay in administering medication to your child, and that they are obligated to assist your child and to include him or her in normal school activities. Children with a history of anaphylaxis should carry epinephrine with them at all times.

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Nasonex (mometasone) is a prescription steroid nasal spray used to treat symptoms associated with seasonal and year-round (chronic) allergies in patients 2 years of age and older. Seasonal allergies are often caused by exposure to outdoor allergens such as grasses, weeds, and tree pollen while chronic allergies are usually caused by indoor allergens such as dust mites, mold, and pet dander.

Nasal corticosteroids are commonly regarded as the most effective type of drug for treating allergic rhinitis (also known as hay fever), even though antihistamines seem to be more popular.

In addition to treating symptoms associated with allergic rhinitis (sneezing, runny nose, watery eyes), Nasonex is the only prescription nasal spray clinically proven to help prevent most seasonal nasal allergy symptoms in patients over the age of 12 years. Nasonex is also the only drug in its class approved for children so young. Doctors recommend starting treatment with Nasonex 2 to 4 weeks before the anticipated start of the pollen season to prevent symptoms.

A Different Kind of Steroid

The steroids contained in Nasonex are not the same type of steroids taken by athletes and extreme bodybuilders. Nasal corticosteroids are sprayed directly into the nose and reduce inflammation in the mucous membranes making the area less reactive. Nasal corticosteroids also don’t affect you like oral corticosteroids, which have side effects including weight gain, weakened bones and skin, and high blood pressure.

Harold Nelson, M.D., senior staff physician at National Jewish Medical and Research Center in Denver, says that he rarely uses antihistamines because he finds nasal corticosteroid sprays to be a cheaper and more effective option for patients. He says, “There’s never been any convincing evidence that there’s any systemic side effect from nasal steroids.”

While nasal steroids generally affect only your nasal area, some people are concerned because studies have shown that they can cause children to grow more slowly. Dr. Nelson says that this doesn’t appear to be a serious issue because, “If there is any slowing, it’s very transient in the first couple of months and is not continous and cumulative.” In addition, most of the studies used the drug beclomethasone which is absorbed into the body more easily than other nasal corticosteroids like Nasonex.

During clinical trials of Nasonex, the most common side effects included headache, viral infection, sore throat, nose bleed, and coughing.

How to Use Nasonex

To avoid stinging, burning, and bleeding in your nose, Dr. Nelson recommends aiming the spray bottle away from the septum, the wall of cartilage that divides the nose. This works best if you hold the inhaler in one hand and spray the medicine into the opposite nostril. And if you use the spray regularly, be sure to use a dose just large enough to keep your symptoms at bay.

If you’d like to know whether Nasonex can help you or your child please contact your doctor or healthcare provider.

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