DR NASSER Al-Ahmed is an allergist and clinical immunologist at Al-Rashed Allergy Centre of Kuwait. He says that, although allergies are considered a new occurrence in the region, the problem and its symptoms are noticeably increasing around the world, including Kuwait.
This is due to the advancement of medications, vaccinations and antibiotics that have increased the standard of living and reduced exposure to microbes, the doctor says.
Surprisingly to many people, the allergy season in Kuwait is before and after the summer holiday period. That’s when Al-Rashed Allergy Center gets busy. The most common reaction in Kuwait is against pollens.

There are desert plants in Kuwait, most importantly the Bermuda Grass and the ‘Salsula’ wheat, which become allergens. Each has its own season. The Grass season is during spring, March and April, and the Salsula season is the fall, September and October.
An allergist is a qualified doctor to treat these allergic diseases and Dr Al-Ahmed advises everyone to get tested in order to determine whether they have an allergy or not.
Once allergy triggers are identified, a treatment program can be established that includes minimizing exposure to the allergens causing the problems, and giving medications to reduce allergy symptoms.
Read on to learn more about allergies, their symptoms and treatment methods...

Q: What is an allergic reaction or an allergy?
A: Antibodies are substances produced by the body for neutralization, engulfment, and destruction of pathogens. Many people are predisposed to create certain antibodies, which in normal healthy people are not a problem. However, in people with allergies, these antibodies react to common and benign materials around them. Those materials can be pollen, chemicals, and excretions from animals or insects; anything in their surroundings.
When the antibodies react to those benign materials they develop what is called an allergic reaction. Such allergic reaction can take place according to the exposure; they can take place in the eyes where you can have itchy and red eyes. They can take place in the nose where you can have a congested or watery nose. They can take place in the lungs, so you can have wheezing, chest tightness or whistling sounds while breathing. It can take place in the skin, it can take place in the stomach when you eat food or it can take place when you are exposed to drugs or any other chemical.

Q: What makes the antibodies react this way?
A: People who have allergies have an antibody called Immunoglobulin E (IgE). This is produced as a result of genetic and environmental interaction. There are two things that can cause antibodies to react this way. Firstly, the genetic makeup of the person, which is inherited from the parents.
If a parent has an allergy, he/she will give a percentage of this problem to the children. If a person has a sibling, brother or sister, with the same problem, there is a high risk of developing an allergy as well.
This genetic background interacts with the environment and there are plenty of theories about what makes such an interaction occur and what makes it such a high risk. The most prominent theory regarding allergies is called the ‘Hygiene Theory’.
This theory states that if people are not exposed to dirt in their daily life, they are more likely to develop allergies. This is because those people do not stimulate their immune system at an early age so it will become dormant and the negative part of the immune system which makes allergies dominate becomes more active.
If you stimulate your immune system at an early age by having infections and playing around, you know a standard rearing, not a hygienic one by getting unnecessary antibiotics, then the immune system will be able to recognize dangerous microbes and fight them. But if you don’t stimulate that immune system, then the other immune system which works with it in equilibrium and generates allergies will become the dominant one. It does not recognize those dangerous and benign particles.

Q: So are most human beings susceptible to developing allergies?
A: Anyone who has these two features - genetic background and environmental risk factors - is at risk of developing allergies. It can happen at any age, usually it starts in childhood, but allergies can also become apparent later on in life.

Q: What are the types of allergies people can develop?
A: Allergies are divided under many headings. There are ‘respiratory allergies’ or ‘airway allergies’ and that includes eye allergies, nose allergies, sinus allergies and asthma as well as allergies towards animals. These are the most common allergies in Kuwait and worldwide.
The other most important allergies are ‘skin allergies’, such as eczema. Other sub-types of allergies are called ‘food allergies’ and ‘drug allergies’. So those are the main types.
There is another type actually called the ‘stinging insect allergies’ but it is not very common in Kuwait. It is more apparent in Europe and the United States.

Q: What are the indoor and outdoor allergens and how can one reduce them?
A: Some patients with allergic diseases react to certain substances inside their homes. The most commonly incremented are related to House Dust Mites, animal dander, cockroaches, & molds.
House dust is composed of many things, including insect debris, debris from small mammals as well as humans, food remnants, fibrous materials from plants, and inorganic substances.
In this dust, a major source of allergy is dust mites. These are microscopic 8-legged organism that feed on human skin scales & debris. The droppings of these mites are the main trigger of allergy and asthma symptoms.
Dust mites are found throughout the house, especially in mattress, but also in bedding, stuffed toys, curtains, carpets, and furniture. They especially thrive in humidity of more than 95 percent, and temperatures of 18 to 27C. It should be known that meticulous housekeeping does not influence the mite load.
Measures to reduce dust mites include keeping humidity below 50 percent throughout the home by using a dehumidifier or air conditioning. Carpets should also be removed as much as possible, especially if it is laid over concrete floors. Hardwood, tile or linoleum is better for people with allergies.
Airborne pollens and mold spores are outdoor allergens that commonly trigger allergy symptoms, and are generated by trees, grass, or weeds. Measures to reduce outdoor allergen exposure include keeping windows closed to prevent pollens or molds from entering your home. Air conditioning should be used instead.
The person should also minimize early morning outdoor activity when pollen is usually emitted between 5-10 am and when outdoors, he/she should keep their car windows closed when inside. Try to stay indoors when windy or when humidity is reported to be high and take the medications prescribed by your allergist as recommended.

Q: What are the most prevalent allergies in Kuwait?
A: The most important allergies in Kuwait are the ‘respiratory allergies’ and the most prevalent is hay fever. After that comes asthma, then eczema. These are most common among the local population, but we haven’t done studies on the expatriate population because most of them are not permanent residents. However, some expatriates experience these allergies when they are in the country.

Q: Why do you think these particular allergies are prevalent in Kuwait?
A: There are many reasons actually. I think any country in the world has a percentage of people with allergies; there has been a huge problem with allergic diseases since the 1960s. The problem was really rare before that, in the 1800s lets say, but it was recognized after the industrialization era.
This is not due to pollution, however, industrialization brought about a better quality of life, and people were not dying from illnesses we consider now easier to overcome because they were getting vaccinated. People now have a healthy life, a westernized life as they say.
It is mentioned that since the 60s, allergies have increased decade after decade, the same goes for Kuwait because since then it has become westernized. The cleaner lifestyle, the advancement of medicine, vaccinations and the rise of antibiotics, resulted in less exposure to microbes. The cleaner lifestyle decreased the microbe load and so suppressed the immune system that fought them and activated the immune system that allowed them in.
When you have allergies, you have to have what is called ‘sensitization’, which means that you have to react against something. The most common reaction in Kuwait is against pollens. We have some desert plants in Kuwait, most importantly the Bermuda Grass and the ‘Salsula’ which is a kind of wheat. They are the most important allergens and they have their own seasons. The Grass season is the spring, March and April, and the Salsula season is the fall, September and October.
Those are the two allergy seasons we have in Kuwait including any dust storm weather conditions. In between those two seasons, during the summer, we have low grade allergy season. So these are what we call ‘sensitizers’, meaning that if people are sensitive to those particles, they will react to them and develop allergies.
But there are other particles, apart from sensitizers, which are called ‘irritants’. Irritants include dust, which are composed of silica particles that, when they are inhaled, usually cause congestion and difficulty in breathing.
The difference between ‘sensitizers’ and ‘irritants’ is that if you are exposed to only a small amount of ‘sensitizer’ particles, you will have an immediate allergic reaction. But if you are exposed to little amounts of ‘irritants’ nothing will happen to you, unless you are exposed to a very large amount of those particles. ‘Irritants’ include dust, incents, smoke and perfume among others.

Q: What are the best cures for the most common allergies?
A: When we see a patient for the first time, we take samples, examine him, then we conduct our own investigations. So we specify what the reason for the allergy is by doing a skin test to specific allergens in Kuwait that we know of, or a blood test against these allergies.
There are specific allergens responsible for every allergic reaction. In cats, for example, there are specific allergens or proteins that will be responsible for the allergic reaction in the people who are sensitive to them. These allergens can be put in an agent for testing and we put the sample on the person’s arm and do a skin test. According to the results (there are ways to measure the reaction) we determine if the person is allergic or not.
Once we’ve diagnosed a person, there are two ways to solve the problem. One way, is to give medication, allergy pills or sprays, and we will see if we can offer him something to boost his immune system. This is called immunotherapy and many patients benefit from such therapy.
We treat people who have asthma the same way. We take their history, examine them and do breathing tests. According to these tests, we assign the medication; the doses are different according to how severe the asthma is. We give our patients action plans during follow up sessions that advise them on how to react to severe symptoms as well as what to do when they are better.

Q: What are the measures a person can do to prevent developing an allergy?
A: There aren’t prevention methods that are 100 percent effective. However, there are ways that may help decrease the occurrence of allergies in those who are high risk, especially starting from childhood. The people who are high risk are those who have parents with allergies or a sibling with allergies.
There are many studies that have been done to decrease the occurrence of allergies in the future for high risk children. Most important intervention for those children is not to expose them to cigarette smoke during pregnancy and early childhood. It is important as well to give them normal breast feeding for the first six month of life.
Other interventions include delaying the introduction of solid food, especially cow milk after age one, eggs after age two and nuts and fish after age three.
Apart from that, there are other theories that advise giving probiotics among other things. But the points I mentioned are the most important methods that help in lowering the likelihood of developing allergies. Immunotherapy can also be given to children who have picked up allergies very early on. The therapy, which is comprised of allergy shots, can decrease the likelihood of a child developing asthma or advancing the apparent allergies.
People who are at low risk of developing allergies can eat certain healthy foods that can boost the immune system further and prevent the occurrence of an allergy. The most important types of food are antioxidants that include fruits. The other method is to increase their intake of vitamin C.
If people are concerned about having allergies, it is very easy just to get tested and find out. The allergy center is well-equipped and has cooperation with European doctors and anyone is more than welcome.