Avoiding Asthma's Dangers

The number of Americans diagnosed with asthma has doubled over the past two decades, according to the Center of Disease Control and Prevention.

The incidence of allergies also has seen a tremendous rise, especially among pre-school children.

One of every 13 schoolchildren in the U.S. has asthma. While treatment for this ailment has seen vast improvements in recent years, children are often untreated or mistreated by their physicians.

Pediatric allergist Paul Ehrlich seeks to change the pattern with a new book for parents, titled, "What Your Doctor May Not Tell You About Children's Allergies and Asthma."

Ehrlich tells The Early Show co-anchor Hannah Storm the best thing is to have a specialist examine your child.

Parents should pay attention to the nose. He explains, "The airways goes from your lungs to the tip of your nose and often, with asthma people, the physicians tend to concentrate on the lungs and forget about the nose. So it's now recommended by all of us that a stuffy nose has to be taken care of, and not to be taken care of lightly. "

Ehrlich notes overuse of inhalers is very dangerous. He says, "If you're using the inhaler three or four more times a week, you have to look for medications that will work on a more chronic basis, like inhaled steroids, for instance, which people get scared of, but they do work."

Even though some doctors shy away from medicating kids for allergies, under age 2, Ehrlich says, "There are medications for nasal allergies. Claritin is a great medication and is available over-the-counter and you can use it for children in that age. Zyrtec does work at that age and even asthma medications down to age 6 months.

A thing that concerns a lot of parents right now is the flu. It has been reported that children with asthma should absolutely have flu shots.

Ehrlich says, "Anybody who has a respiratory problem should. This is probably going to be a horrendous season and they should really look to getting their flu vaccines quickly."

Read an excerpt from "What Your Doctor May Not Tell You About Children's Allergies and Asthma":

Chapter 1

Introduction to Allergy

If you are the parent of an allergic child, it is very likely that you are an allergy sufferer yourself. You know the misery that allergies can bring, on a scale from annoying itching of skin and eyes at one end, to debilitating sneezing fits, to life-threatening asthma attacks or anaphylactic shock at the other. You know how allergies can be misdiagnosed. You know about the drowsiness induced by some antihistamines, the inconvenience of carrying nebulizers and inhalers. You know how the joy of childhood can be diminished by eternal vigilance about foods, activities, and environments.

We know about them, too. We are both board-certified allergists. For some sixty years between the two of us, we have been treating children like yours, and from what we have seen, the prognosis for allergy treatment is troubling.

For one thing, allergies seem to be becoming more frequent.

Part of this is due to changes in the way we live. We live in homes that are sealed to trap heat in the winter and cool conditioned air in the summer. We have wall-to-wall carpeting and throw rugs on our floors. But this comfortable and energy-conscious approach creates an environment in which dust mites thrive. Energy efficiency means that there is less fresh air from outside being exchanged with stale air indoors, which means that dust builds up inside. Carpeting may be comfortable to walk on, insulating, and attractive, but dust that settles on it doesn't come out.

In a sense, allergy is a price we have paid for progress. The body's defenses—the immune system—evolved to help us fight off parasites that afflicted our ancestors when mankind had very little ability to influence either their environment or their diet. The first great impetus for the development of allergies may have been the invention of shoes, which kept worms or other parasites from entering our feet and thereby put parts of the immune system out of work.

Frank T. Vertosick, Jr., author of a recent book called The Genius Within: Discovering the Intelligence of Every Living Thing, advances the theory that the brain is not the only part of the body that can learn from experience. He writes, "The immune system must learn and recall billions, perhaps trillions, of different molecular patterns. Our lives depend on its ability to make instant discriminations between friend and foe, not an easy task." While our specialty is Allergy and Immunology, we will reserve judgment on whether this constitutes "intelligence" or not. However, we never cease to wonder at the resourcefulness of the immune system, not only its resiliency in combating disease, but also its potential for mischief when it goes awry.

Because of modern sanitation, climate control, and immunization, many of the original problems the immune system evolved to combat no longer exist routinely in advanced industrial countries like ours. However, the defenses are still within us. Like soldiers demobilized at the end of a war, they need time to adjust after the fighting stops, but in the case of immunity that has evolved over aeons, the adjustment hasn't begun. Idle hands make the devil's work. These are defenses in search of an enemy, and they spend their time attacking all kinds of things—molds, pollens, chemicals used in the construction of our homes—and in the process of attacking those irritants, they throw off toxins that make us sick.

There's a saying that what children need in their homes to keep allergies from developing is a pound of dirt, as would be the case on a farm. That theory recently gained support in a study published in the summer of 2002 saying that infants raised in homes with two or more cats and dogs developed allergies at roughly half the rate as children in pet-free homes. Moreover, they were less allergic not just to dogs and cats but to pollens and other common allergens as well.

If progress is causing all that trouble, is it worth it? Or should we all move into mud huts?

We'll leave that to philosophers. In the meantime, we have the obligation to try to keep ahead of our bodies' own defenses. The science allows us to give it a try. And what the science says is that the jury is still out on exposing children to cats and dogs to try to protect them against allergies, as the author of the study was among the first to point out. After all, the data cited in the above-mentioned study were contrary to long-established wisdom and practice on the subject. It may well be a statistical anomaly. The results must be repeatable. So, much to the consternation of animal-loving new parents in families with a history of allergy, we must advise that they not run out to the animal shelter and stock up on new pets.

Copyright © 2003 by Paul Ehrlich, M.D. and Larry Chiaramonte, M.D.