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:: Class trip:: Emergency kit
:: Atopic dermatitis and vaccination
:: Preventing an 'allergy career'
Class trip - Markus, 11 years
I want to go to a camp with my class in May, but I suffer from severe pollen allergy with hay fever and asthmatic response to grass. My parents hesitate to let me go.
What we recommend
You have to expect a heavy load of airborne grass pollens in May. Particularly on a class trip you will spend a lot of time outdoors, and typical strategies like "take a shower in the evening" and "keep the windows closed" can hardly be kept up. It is very important for you to be fit and show no allergy symptoms when you leave home. You should take your allergy medication on a regular basis. This way, you ensure the best allergy treatment during your class trip. If you suffer from asthma, we recommend that you take spray preparations one therapy level higher than you need otherwise.
Emergency kit - Maximilian, 9 years
His parents ask: Last summer our son was stung into his hand by a bee. After 10 to 20 minutes he reacted with swelling of the lips, itching of his entire body and tightness in his chest with difficulty breathing. What do we have to take into account for this summer?
What we recommend
There is a very high risk for Maximilian to have similar or even stronger symptoms if he is stung again this summer. He must carry a so-called "anaphylactic shock kit" at all times during the summer, containing 1 tablet of an antihistamine drug, e.g. Zyrtec, and, depending on his weight, 2 tablets of cortisone, such as Decortin 50 mg, and an adrenalin injection device, such as Anapen. He should have a blood test performed to determine precisely the antibodies against bee and wasp venom, and he should be informed about the possibility of SIT (specific immunotherapy), i.e. injections against the allergy.
Atopic dermatitis and vaccination - Jan, 7 months
His parents ask:
Jan suffers from atopic dermatitis and is to be vaccinated soon. What shall we do?
What we recommend
In principle, all children should be vaccinated in accordance with the valid guidelines of the Ständige Impfkommission STIKO (Standing Committee on Vaccination). Worries that a stimulation of the eczema might occur after vaccinations are justified only insofar as after vaccinations, just as after infections of the upper airways, temporary deterioration of the skin is possible. As a rule, this deterioration persists for only 4 to 7 days and only in extremely rare cases leads to lasting eczema attacks.
In an extensive study in Scandinavia with more than 100,000 vaccinations, no correlation between the generally recommended DTaP-IPV-Hib vaccination (tetanus, diphtheria, polio, HIB and pertussis) and the measles-mumps-rubella vaccination on the one hand as well as the frequency of occurrence and the degree of atopic eczema on the other hand, was found.
Caution is advisable, though, for children who are highly allergic to hen's eggs with vaccine against measles.
Preventing an 'allergy career' - Laura, 3 months
Her parents ask:
We, her parents, both suffer from hay fever, Laura's brother is 4 years old, had severe eczema as an infant, and now he has asthma. What can we do to avoid the same allergy career for Laura?
What we recommend
Unfortunately, in your case - if both parents and siblings have a disposition for allergy - the statistical probability for Laura to develop an allergy as well (depending on study up to 80 % probability) is very high.
The scope for prevention by parents is very limited.
It would be advisable if her mother could exclusively nurse her for 6 months; rather monotonous complementary food should be introduced slowly and gradually. Exposure to second-hand smoke and solvents, e.g. from new furniture and varnishes, is to be avoided.
The most important thing, however, is to be watchful and to take warning signs seriously, such as slight eczema, beginning itching, bowel problems, restlessness, later lasting colds, coughing when under strain (e.g. when laughing, crying, screaming) and to discuss them with your pediatric allergologist. The best way of preventing severe asthma for Laura is to treat allergic diseases of infancy, such as food allergies or hay fever at kindergarten age, in good time.