As the season of viral infections seems to be winding down, allergy cases are starting to crop up in the outpatient department of Delhi-NCR Hospitals.

Starting in December, doctors across India noticed higher cases of flu-like illnesses with an uptick in severity they blame on a mix of viruses including H3N2, Covid-19 and the common flu.

Now, due to the change of weather, complaints of coughing, sneezing, runny nose, watery eyes, and inflammation under the eyes and nose have increased in hospital outpatients and clinics.

Experts believe that air pollution in the capital increases inflammation and longevity, leading to persistent symptoms, especially wheezing.

These symptoms raise suspicions of bronchitis and other ailments, prompting medical practitioners to prescribe allergy tests.

However, according to experts, house dust mite and insect allergies are the most common allergies detected in testing.

Doctors also advise not to self-prescribe allergy panel tests – which are highly advertised by pathology labs during this season – but to seek advice from your physician.

Treatment of allergic reactions is usually with antiallergens and nebulization with bronchodilators except that no medication is prescribed at all but only prophylaxis against the allergen causing the allergy.

What the doctors say

Dr Sandeep Nayar, Head of Chest and Respiratory Diseases at BLK-Max Super Specialty Hospital told News18, “Recently, we see a lot of patients coming to us with allergies, in the forms of sneezing, coughing which is despite taking all medications. , and sometimes tears of the eyes and skin reactions. There is a sudden increase in the number of these patients. Some of them may be related to pollution and some pollutants that cause allergies or pollen due to changes in the weather. People come with respiratory problems, shortness of breath, and an increase in asthma And rhinitis, runny nose, sneezing, etc. are more protected as they have been for the past two or three years.

Another expert, Dr Gaurav Jain, Senior Consultant in Internal Medicine at Delhi-based Dharamshila Narayana Superspeciality Hospital, echoed a similar sentiment.

Seasonal changes, especially in April and September, are characterized by an increase in cases of allergic bronchitis, rhinitis and dermatitis. He said that many people with high IgE levels are present during this month.

This month, due to the continuous rains and cold weather, cases kept coming up. Immunoglobulin E (IgE) is an antibody that is produced during a type I hypersensitivity reaction to an allergen.

“One of the reasons why symptoms such as persistent coughing, sneezing, etc. may occur, is the change in season where pollen or insects trigger allergies in people,” said Jain.

He added that more and more people show allergic phenomena because the immune system is overactive due to viral infections and other infections that the body suffers from recently.

In fact, Dr. Manisha Arora, Consultant Internal Medicine at Sri Balaji Action Medical Institute said, “Normally, Delhi does not see flu cases in the month of April, but this time, it was different. Flu was very common in the past few months, It has resulted in a persistent, irritating cough in many patients that lasts for weeks to months even after other symptoms of influenza have settled.”

She pointed out that this sensitivity may be a side effect of viral infections in the previous months. “It is hypothesized that the virus usually causes some type of reaction or inflammation in the upper airways or below the alveoli that may be of an allergic or inflammatory nature.”

How symptoms are managed

Experts say the best way to manage allergies or allergic reactions is to take prescribed medications.

According to Dr. Anirvan Karmakar, Consultant Critical Care Medicine, Narayana Super Specialty Hospital, people can take preventive measures like wearing protective clothing and limiting their exposure to certain allergens, but the best way to avoid symptoms is to “take necessary medications”.

Another expert, Dr. Sourabh Bahoja, Consultant, Department of Pulmonary Medicine at Amrita Hospitals in Faridabad, explained how different allergic conditions are handled differently.

For example, patients with allergic rhinitis — an allergy related to the nose — complain of sneezing and a runny nose. Patients with allergic bronchitis or bronchial asthma – an allergy related to the lungs – also present with complaints of coughing, shortness of breath and chest tightness.

“Allergy treatment depends on the particular system of the body involved. So, if it is allergic rhinitis that involves the nasal system, you give these patients anti-allergy medications in the form of nasal sprays as well as anti-allergy tablets,” Bauga said.

Bahoja explained that if a person has allergies in their lungs, such as allergic bronchitis or bronchial asthma, children and the elderly are usually treated with the help of nebulizers. “In the case of the little ones, they are given inhalers. These are all antiallergic drugs.”

Of course, there is no harm in maintaining a structured diet and schedule to strengthen the body’s immune system.

Experts suggest that a diet rich in antioxidants and phytonutrients can help boost the body’s immune system. Also, one can avoid exercising outside and use a mask especially while doing any housework outdoors.

Most importantly, doctors advise patients to avoid certain allergens that are expected to be the culprits.

For example, an allergic person can reduce symptoms of airborne allergens by simply washing their nose daily or simply removing sources of allergens from the home and workplace to avoid allergic reactions.

Perform laboratory tests

Jain of Dharamshila Narayana Super Specialty Hospital said doctors are now in a better position to detect more allergic reactions due to yearly experience with weather and conditions along with better testing facilities.

Several pathology laboratories have announced susceptibility panel tests and have noted an increase in demand. However, Jain and many other experts believe that not all patients are required to undergo the tests.

“Laboratories offer allergy tests. A lot of these tests show mild reactions to certain things like silica or pollen, which means these allergies may not need a lot of treatment,” Jin said.

Detailing more tests, Dr. Avi Kumar, Senior Consultant Pulmonologist, at Fortis Escorts, Okhla, New Delhi, said there are two types of susceptibility tests available. The first is the skin prick test and the second test is the vadiatop (sero) test.

Allergies to dust, pollen, insect bites, and house and pet mites can be detected with a skin prick test. “These tests are very expensive and sensitive,” Kumar said.

According to the attending physician, these tests give an early indication of allergy.

Do not undergo tests without the consent of the attending physician

However, Bagoja of Amrita Hospitals advised patients not to take allergy tests based on prescription. “I would say that patients should not be encouraged to go straight to the lab and get an allergy test done. It should be done after consulting a doctor or a pulmonologist.”

To date, he explained, as many as 60 allergen tests are available in labs, and sometimes these tests do not give meaningful answers to patient management.

“The test is done when the patient does not respond to the anti-allergy medication. Because there are many tests available, the patients do not understand which test they have to undergo,” Bajuja said.

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