What are the common reactions to allergy shots. How do allergy shots work to reduce allergic symptoms. Can allergy immunotherapy trigger systemic reactions or fever. What precautions should patients take when receiving allergen immunotherapy.

Understanding Allergy Shots: Purpose and Mechanism

Allergy shots, also known as allergen immunotherapy, are a treatment option for individuals suffering from severe allergies that do not respond adequately to environmental changes or medications. This form of therapy aims to reduce sensitivity to specific allergens by gradually exposing the immune system to increasing doses of the allergen.

How do allergy shots work to desensitize the immune system? The treatment involves regular injections of small amounts of allergens, which over time can help the body build tolerance. While allergy shots do not cure allergies completely, they can significantly reduce symptoms and decrease reliance on allergy medications.

Conditions Treated by Allergy Shots

• Allergic rhinitis (hay fever)
• Allergic asthma
• Insect sting allergies
• Certain environmental allergies

Are allergy shots effective for all types of allergies? It’s important to note that allergen immunotherapy is not recommended for food allergies. For those conditions, other management strategies are typically employed.

The Two Phases of Allergy Shot Treatment

Allergy shot therapy consists of two distinct phases: the build-up phase and the maintenance phase. Understanding these phases is crucial for patients to set appropriate expectations and adhere to the treatment schedule.

Build-up Phase

During the build-up phase, patients receive injections with gradually increasing doses of allergens. This phase typically lasts 6-10 months for standard immunotherapy, though it may be shorter for specific treatments like venom therapy.

How often are shots administered during the build-up phase? Initially, patients may receive injections once or twice a week, with the frequency potentially decreasing as the dose increases.

Maintenance Phase

Once patients reach their “effective therapeutic dose,” they enter the maintenance phase. This phase involves less frequent injections, usually every 3-4 weeks, and can last for 3-5 years or longer, depending on the allergist’s recommendations.

Why is the maintenance phase so important? Consistent exposure to the therapeutic dose helps maintain the immune system’s tolerance to the allergen, providing long-term symptom relief.

Common Reactions to Allergy Shots

While allergy shots are generally safe, reactions can occur. These reactions range from mild local responses to more severe systemic reactions. Understanding the potential side effects is crucial for patients to recognize and respond appropriately to any adverse events.

Local Reactions

Local reactions are the most common type of response to allergy shots. These typically manifest as redness, swelling, or itching at the injection site.

• Mild swelling (dime-sized)
• Larger swelling (up to lemon-sized)
• Itching at the injection site

How should patients manage local reactions? Applying ice to the affected area and taking an antihistamine can help alleviate symptoms. If local reactions persist for more than 24 hours or occur frequently, patients should inform their allergist, who may adjust the treatment schedule.

Systemic Reactions

Systemic reactions, while less common, can affect the entire body and may be more serious. These reactions can range from mild to severe and potentially life-threatening.

• Stuffy or runny nose
• Sneezing or coughing
• Itchy or red eyes and ears
• Throat tightness
• Hives or flushing
• Lightheadedness
• Chest tightness or wheezing
• In rare cases, anaphylaxis

What should patients do if they experience a systemic reaction? Immediate medical attention is crucial. Patients are typically required to remain in the medical office for 30 minutes after each injection to monitor for such reactions. In severe cases, epinephrine may be administered, and the patient may need to be transported to an emergency department.

Can Allergy Shots Cause Fever?

While fever is not typically listed as a common side effect of allergy shots, it’s not entirely unheard of. Some patients may experience a mild increase in body temperature as part of a systemic reaction to the allergen injection.

Is fever a normal reaction to allergy shots? A slight temperature elevation might occur in some individuals as their immune system responds to the allergen. However, a high fever is not a typical reaction and could indicate an underlying infection or other health issue.

When should patients be concerned about fever after allergy shots? If a patient develops a fever following an allergy shot, especially if it’s accompanied by other symptoms like severe fatigue, body aches, or chills, they should contact their healthcare provider immediately. This could be a sign of a more serious reaction or an unrelated illness.

Precautions and Considerations for Allergy Shot Recipients

To ensure the safety and effectiveness of allergy immunotherapy, patients must adhere to certain precautions and inform their healthcare providers of any changes in their health status.

Pre-injection Health Check

Before receiving an allergy shot, patients should inform their provider if they are experiencing any of the following:

• Fever
• Asthma symptoms
• Increased allergy symptoms
• Rash or other skin conditions

Why is it important to report these symptoms? These conditions may increase the risk of adverse reactions to the allergy shot or indicate that the body’s immune system is already in a heightened state of activity.

Post-injection Precautions

After receiving an allergy shot, patients should:

1. Remain in the medical office for at least 30 minutes
2. Avoid strenuous exercise for 2 hours post-injection
3. Carry an epinephrine auto-injector (EpiPen®) on shot days
4. Be aware of potential delayed reactions and seek medical attention if necessary

How do these precautions help ensure patient safety? These measures allow for immediate medical intervention in case of a severe reaction and reduce the risk of exacerbating any potential side effects.

Long-term Benefits and Considerations of Allergy Immunotherapy

While allergy shots require a significant time commitment and carry some risks, they offer potential long-term benefits for many allergy sufferers.

Potential Benefits

• Reduced allergy symptoms
• Decreased reliance on allergy medications
• Improved quality of life
• Potential prevention of new allergies developing
• Possible prevention of asthma in children with nasal allergies

Do the benefits of allergy shots outweigh the risks for most patients? For many individuals with severe allergies that significantly impact their daily lives, the long-term benefits of allergen immunotherapy often outweigh the potential risks and inconvenience of the treatment regimen.

Factors Affecting Treatment Success

Several factors can influence the effectiveness of allergy immunotherapy:

• Consistency in receiving injections
• Duration of treatment
• Proper dosing and scheduling
• Individual immune system response
• Type and severity of allergies being treated

How can patients maximize the benefits of their allergy shot treatment? Adhering strictly to the recommended treatment schedule, communicating openly with healthcare providers about any reactions or concerns, and maintaining overall health can contribute to the success of allergen immunotherapy.

Special Considerations for Allergy Shot Recipients

Certain life events or health conditions may require adjustments to allergy shot regimens. It’s crucial for patients to keep their healthcare providers informed of any changes in their health status.

Pregnancy and Allergy Shots

Can pregnant women continue allergy shot treatments? Generally, it’s safe for women who are already on maintenance doses to continue their allergy shots during pregnancy. However, starting a new course of immunotherapy during pregnancy is typically not recommended.

Why is caution exercised with allergy shots during pregnancy? The primary concern is the small risk of anaphylaxis, which could potentially harm the fetus. Patients should discuss their individual situations with their allergist and obstetrician.

Medications and Allergy Shots

Certain medications may interact with allergy immunotherapy or affect the body’s response to the treatment. Patients should inform their allergist about all medications they are taking, including:

• High blood pressure medications
• Heart medications
• Certain antidepressants
• Beta-blockers
• ACE inhibitors

Why do some medications interfere with allergy shots? Some medications can alter the body’s immune response or affect its ability to handle potential allergic reactions. In some cases, the allergist may need to adjust the immunotherapy protocol or recommend alternative treatments.

New Medical Conditions

Patients should inform their allergist if they develop any new medical conditions during the course of their allergy shot treatment. This includes:

• Autoimmune disorders
• Cardiovascular conditions
• Respiratory diseases
• Any chronic illness

How might new medical conditions impact allergy shot treatment? Certain health conditions can affect the immune system’s response to allergen immunotherapy or increase the risk of adverse reactions. The treatment plan may need to be modified to ensure patient safety and optimize effectiveness.

Alternatives and Complementary Treatments to Allergy Shots

While allergy shots can be highly effective for many individuals, they’re not the only option for managing allergies. Some patients may explore alternative or complementary treatments, either in conjunction with immunotherapy or as standalone options.

Sublingual Immunotherapy (SLIT)

Sublingual immunotherapy involves placing drops or tablets containing allergen extracts under the tongue. This method is FDA-approved for certain allergens and offers an alternative for patients who prefer not to receive injections.

What are the advantages of SLIT over traditional allergy shots? SLIT can be administered at home, reducing the need for frequent office visits. It may also have a lower risk of severe systemic reactions compared to injections.

Medications

Various medications can help manage allergy symptoms, including:

• Antihistamines
• Decongestants
• Nasal corticosteroids
• Leukotriene modifiers
• Mast cell stabilizers

Can medications replace the need for allergy shots? For some individuals with milder allergies, medications may provide sufficient symptom relief. However, those with more severe allergies or those seeking long-term changes in their immune response may still benefit from immunotherapy.

Environmental Controls

Implementing strategies to reduce exposure to allergens can complement other treatments:

• Using air purifiers with HEPA filters
• Regularly cleaning and vacuuming
• Using allergen-proof bedding covers
• Keeping windows closed during high pollen seasons
• Avoiding outdoor activities during peak allergen times

How effective are environmental controls in managing allergies? While these measures can significantly reduce allergen exposure and alleviate symptoms, they may not be sufficient for individuals with severe allergies or multiple allergic triggers.

Complementary and Alternative Medicine

Some patients explore complementary approaches to allergy management, such as:

• Acupuncture
• Herbal remedies
• Probiotics
• Nasal irrigation
• Dietary changes

Are complementary treatments effective for allergy management? While some individuals report benefits from these approaches, scientific evidence supporting their effectiveness for allergy treatment is often limited. Patients should discuss any complementary treatments with their healthcare provider to ensure safety and avoid potential interactions with other therapies.

In conclusion, allergy shots remain a valuable treatment option for many individuals suffering from severe allergies. While they carry potential risks, including the rare possibility of fever or more serious systemic reactions, the long-term benefits often outweigh these concerns for many patients. As with any medical treatment, it’s crucial for individuals considering or undergoing allergy immunotherapy to maintain open communication with their healthcare providers, adhere to recommended precautions, and stay informed about their treatment options and potential side effects. By doing so, patients can maximize the benefits of allergy shots while minimizing risks, ultimately improving their quality of life and reducing the burden of allergic symptoms.

Allergy Shots – What You Need to Know

Allergy Shots

Allergen immunotherapy injections or “allergy shots” are a treatment for patients with allergic runny or stuffy nose, allergic asthma or life threatening reactions to insect stings. Allergy shots are for people who have serious allergy symptoms that are not helped by changes to their environment and/or medicines. Some studies have shown that allergy shots may stop asthma from developing in children with nasal allergies.

How They Work

Allergy shots may “turn down” your reactions to the things that you are allergic to. The shots do not cure your allergies, but you will have fewer symptoms and need to use less medicine.

It is important to stay on schedule with your allergy shots. If several weeks have passed since your last shot please call and speak to an allergy nurse, 203-432-8797. We may need to change your dose before your next shot.

How long to I have to keep getting my allergy shots?

There are two phases to allergy shot therapy: a build-up phase and a maintenance phase.

• Build-up phase: In this phase you will start with a low dose injection and build to a higher dose of allergens over time. For typical immunotherapy this phase lasts from 6 to 10 months, depending on how often you get your shots and how well you tolerate them. The build-up phase for venom therapy generally lasts for 10 weeks.
• Maintenance phase: When you reach your “effective therapeutic dose” you will begin the maintenance phase. During this phase you receive your allergy shots less often, usually every 3 to 4 weeks. The maintenance phase typically lasts 3-5 years (or longer if advised by your allergist).

Reactions to allergy shots

Reactions to allergy shots are common. Most reactions are local (redness and swelling where you got the shot). Rarely, reactions can affect your entire body. This is referred to as a systemic reaction, and it can be dangerous. For this reason you must stay in our office for 30 minutes following every shot appointment. Additionally, you should not exercise for 2 hours after your shots.

If you are having asthma symptoms when you are scheduled for an allergy shot it is important to tell your nurse. Allergy shots can worsen asthma symptoms.

Local reactions

Local reactions are the most common. They can vary from a dime-sized itchy spot to a large lemon-sized swelling. You may need to take an antihistamine (like Benadryl), and apply ice to reduce your reaction. If you have a local reaction tell your allergy nurse at your next visit. If a local reaction lasts longer than 24 hours or happens often your allergist may change your allergy shot schedule.

Systemic reactions

Systemic reactions include:

• stuffy or runny nose
• sneezing
• cough
• itchy or red eyes and ears
• itching or tightness of the throat
• hives
• flushing
• lightheadedness
• chest tightness
• wheezing,
• and rarely, life-threatening reactions (including difficulty breathing and/or a dangerous drop in blood pressure ).

Most systemic reactions are mild and improve with treatment, but these reactions may become life threatening. If you experience a systemic reaction in the office tell a nurse right away. The nurse may give you an injection of epinephrine (EpiPen^®) or another medication to quickly relieve the symptoms. You may need to be transported to the Yale New Haven Hospital Emergency Department for further treatment and observation.

We will prescribe an epinephrine auto-injector (aka EpiPen^®) for you to have with you on your allergy shot days. If you have a systemic reaction after you leave the office, you may need to use your EpiPen^® and go to Yale Health Acute Care or a local emergency room for further treatment.

Changes in your health

If at any time during the course of your immunotherapy you develop a new medical condition, you become pregnant, or you start a new medication, please tell the nurse. In particular, high blood pressure or heart medications and certain antidepressants cannot be taken with allergy shots. You should not get your allergy shot if you are have a fever, rash, asthma symptoms, or increased allergy symptoms.

Allergy Shots (for Parents) – Nemours KidsHealth

What Are Allergy Shots?

Allergy shots (allergen immunotherapy) can treat some types of allergies. They’re sometimes used for children with allergies to:

Allergy shots aren’t helpful for food allergies.

Why Are Allergy Shots Used?

An allergy is when the body’s immune system overreacts to a usually harmless substance. Things that cause allergic reactions are called allergens. Common allergens include dust mites, molds, pollen, pets with fur or feathers, stinging insects, and foods.

The body reacts to the allergen by releasing chemicals, one of which is histamine. This release can cause symptoms such as wheezing, trouble breathing, coughing, a stuffy nose, and more. Some allergic reactions can be serious.

The best way to prevent or control allergy symptoms is to avoid allergens. Allergists (doctors who identify and treat allergies) look for causes of an allergic reaction with skin tests and blood tests. Based on the test results, they can recommend treatments, including medicines and ways to avoid allergens.

If these treatments don’t help, the allergist might recommend allergy shots.

How Do Allergy Shots Help?

Allergy shots help the body build immunity to specific allergens, so it’s not as bothered by them. Allergy shots also can help kids who have allergies and asthma have fewer asthma flare-ups.

Allergy shots contain a tiny amount of a purified form of the allergen causing problems. Doctors increase the dose slowly over the first 3–6 months. This lets the immune system safely adjust and build immunity to the allergens. This is called the buildup phase.

The highest effective safe dose becomes a child’s monthly maintenance dose. Health care providers give this to the child for about 3 to 5 years. Most kids will need fewer shots over time.

Some kids’ allergy symptoms ease during the buildup phase. Others don’t feel better until they’re into the maintenance phase. After years of getting allergy shots, some may have lasting relief from symptoms.

Are Allergy Shots Safe?

Allergy shots given by a trained health professional are safe and effective. Kids as young as 5 years old can get them.

Kids may have a small reaction near the site of the injection. This can happen right away or within a few hours of the shot. Skin on the arm near the site may get a little red, itch, and swell. Applying an ice pack to the area and giving the child an antihistamine can help.

More widespread reactions, like hives and itching all over the body, are less common. And more severe reactions (like wheezing, breathing problems, throat swelling, and nausea) are rare. A serious reaction needs treatment right away. That’s why kids who get allergy shots are watched in the doctor’s office for about 30 minutes afterward.

Some other tips:

• Kids should get allergy shots only under the supervision of an allergist/immunologist.
• A child who is ill, especially with asthma or breathing trouble, should not have allergy shots until the doctor says it’s safe.

Before your child gets allergy shots, be sure to tell the doctor about any other medicines your child takes.

How Can I Find an Allergist/Immunologist?

Ask your primary care doctor to recommend an allergist/immunologist. If a family member or friend sees an allergist/immunologist, ask who they recommend. You also can search online at:

How Can Parents Help?

Doctors give allergy shots with needles that are smaller than those used for most childhood vaccinations, so they’re less painful. Still, for some kids a shot can seem scary. A parent’s positive and supportive attitude can help. Treatment goes much better when parents are confident and committed to the immunotherapy.

While getting a shot, your child can squeeze your hand, sing a song, watch a video, or use another distraction that will take the focus off the injection.

Understanding the benefits of allergy shots and how they work will help you and your child accept them as routine.

Dr. Jeffery Hallett | Allergy Shot Side Effects

In the same way that vaccines protect us from disease by introducing our bodies to small amounts of the very things that can make us sick, allergy shots can help the body develop resistances and tolerances to the substances that can trigger allergy symptoms. But, while allergy shots are designed to protect you from your allergies, there is a small risk that you can have an allergic reaction from your allergy shot. Reactions are rare and can range from mild symptoms such as itching and redness at the site, to a serious anaphylactic reaction. For this reason, allergy shots should be taken seriously and always be administered under medical supervision.

Subcutaneous allergen immunotherapy, or allergy shots, are the most widely used immunotherapy treatment in the United States. Patients follow a build-up phase of increasing doses and concentrations of individually prepared allergy extract for approximately three to six months. During this time, allergy shots are usually given once or twice a week. Once a patient reaches their maintenance dose, allergy shots can be taken less frequently – usually once a week or every other week.

Allergy shot side effects are usually mild

The side effects of allergy shots are usually mild, but as concentrations and doses increase, so can the risk of local or systemic reactions. Local reactions are usually mild in nature and can include redness, itching and/or swelling at the injection site. Systemic reactions can affect the entire body and involve symptoms such as a runny nose, sneezing or hives.

Anaphylaxis is a severe and potentially life threatening systemic allergic reaction marked by swelling in the throat, chest tightness, wheezing, nausea and dizziness. It can be similar to the serious reactions some people have to peanuts or bee stings. Anaphylaxis requires immediate medical treatment and could require the use of epinephrine, also known adrenaline, to reverse the reaction.

Precautions against potential side effects

Because exercise can increase blood flow to the body’s tissues, it can also cause allergy extract from the allergy shot to be absorbed into the body faster. For this reason, patients should avoid strenuous exercise for one hour before and two hours after receiving an allergy shot. Additionally, patients should talk to their physician about any other medications or supplements that they may be taking as these may interfere with allergy shot treatment. Women who are pregnant or planning to become pregnant should also consult their physician with respect to allergy shots. Allergy shots are covered by most insurance plans.

Dr. Jeffrey Hallett administers allergy shots on a walk-in basis during specified hours Monday through Thursday. While appointments are not required, patients are urged to check the Allergy Injection Calendar at www.drhallett.com to view the most up-to-date schedule. Just look for the button that says “Calendar.”

View the Injection Calendar

Allergy Shots (Immunotherapy) | AAAAI

Allergen immunotherapy, also known as allergy shots, is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy.

Allergy shots decrease sensitivity to allergens and often leads to lasting relief of allergy symptoms even after treatment is stopped. This makes it a cost-effective, beneficial treatment approach for many people.

Who Can Benefit From Allergy Shots?

Both children and adults can receive allergy shots, although it is not typically recommended for children under age five. This is because of the difficulties younger children may have in cooperating with the program and in articulating any adverse symptoms they may be experiencing. When considering allergy shots for an older adult, medical conditions such as cardiac disease should be taken into consideration and discussed with your allergist / immunologist first.

You and your allergist / immunologist should base your decision regarding allergy shots on:

•    Length of allergy season and severity of your symptoms

•    How well medications and/or environmental controls are helping your allergy symptoms

•    Your desire to avoid long-term medication use

•    Time available for treatment (allergy shots requires a significant commitment)

•    Cost, which may vary depending on region and insurance coverage

Allergy shots are not used to treat food allergies. The best option for people with food allergies is to strictly avoid that food.

How Do Allergy Shots Work?

Allergy shots work like a vaccine. Your body responds to injected amounts of a particular allergen, given in gradually increasing doses, by developing immunity or tolerance to the allergen.

There are two phases:

•    Build-up phase. This involves receiving injections with increasing amounts of the allergens about one to two times per week. The length of this phase depends upon how often the injections are received, but generally ranges from three to six months.

•    Maintenance phase. This begins once the effective dose is reached. The effective maintenance dose depends on your level of allergen sensitivity and your response to the build-up phase. During the maintenance phase, there will be longer periods of time between treatments, ranging from two to four weeks. Your allergist / immunologist will decide what range is best for you.

You may notice a decrease in symptoms during the build-up phase, but it may take as long as 12 months on the maintenance dose to notice an improvement. If allergy shots are successful, maintenance treatment is generally continued for three to five years. Any decision to stop allergy shots should be discussed with your allergist / immunologist. 

How Effective Are Allergy Shots?

Allergy shots have shown to decrease symptoms of many allergies. It can prevent the development of new allergies, and in children it can prevent the progression of allergic disease from allergic rhinitis to asthma. The effectiveness of allergy shots appears to be related to the length of the treatment program as well as the dose of the allergen. Some people experience lasting relief from allergy symptoms, while others may relapse after discontinuing allergy shots. If you have not seen improvement after a year of maintenance therapy, your allergist / immunologist will work with you to discuss treatment options.

Failure to respond to allergy shots may be due to several factors:

•    Inadequate dose of allergen in the allergy vaccine

•    Missing allergens not identified during the allergy evaluation

•    High levels of allergen in the environment

•    Significant exposure to non-allergic triggers, such as tobacco smoke

Where Should Allergy Shots Be Given?

This type of treatment should be supervised by a specialized physician in a facility equipped with proper staff and equipment to identify and treat adverse reactions to allergy injections. Ideally, immunotherapy should be given in your allergist / immunologist’s office. If this is not possible, your allergist / immunologist should provide the supervising physician with comprehensive instructions about your allergy shot treatments.

Are There Risks?

A typical reaction is redness and swelling at the injection site. This can happen immediately or several hours after the treatment. In some instances, symptoms can include increased allergy symptoms such as sneezing, nasal congestion or hives.

Serious reactions to allergy shots are rare. When they do occur, they require immediate medical attention. Symptoms of an anaphylactic reaction can include swelling in the throat, wheezing or tightness in the chest, nausea and dizziness. Most serious reactions develop within 30 minutes of the allergy injections. This is why it is recommended you wait in your doctor’s office for at least 30 minutes after you receive allergy shots.

Find out more about hay fever.

Do you want to start allergy shots? Find an allergist/immunologist here.

This article has been reviewed by Andrew Moore, MD, FAAAAI

Reviewed: 9/28/20

Allergy Shot Information — Advanced Allergy and Asthma Center

What are Allergy Shots/Allergen Immunotherapy?

Allergen immunotherapy is treatment regimen devised to decrease your sensitivity to what you those allergens that cause your symptoms. Your allergen sensitivities have been determined by your skin testing. The process involves subcutaneous administration off increasing quantities of purified natural allergen extracts. The administration is divided into a Build-up Phase and a Maintenance Phase. During the build up phase injections may be one to two times every 7-10 days. This phase typically lasts between 3-6 months and is determined by the frequency of the injections. The goal of the build up phase is to reach the effective therapeutic dose. This dose may vary from patient to patient and is determined by how sensitive you are to the allergen extract and your immune responses during the build up phase. In the maintenance phase the goal is to increase the time between shots to every 2-4 weeks. This will be determined by your symptoms and in consultation with your physician. When new vials are made the level of antigen is very high and thus you will have a short build up phase before going back to your regular schedule. The recommended time for the maintenance phase is between 3-5 years. Immunotherapy has been shown to prevent the development of new allergies and, in children, it can prevent the progression of the allergic disease from allergic rhinitis to asthma. Allergen immunotherapy can lead to the long-lasting relief of allergy.

How does immunotherapy work?

Mechanistically immunotherapy works like a vaccine to increase your immunity or tolerance to allergens. Patient responses vary depending on the initial severity of their symptoms but most patients show decreased, minimal to no allergy symptoms. Decreased symptoms can be observed during the build up phase but are typically seen a few months after being on the maintenance dose.

What are the possible side effects?

Allergen extracts are completely natural and do not typically have side effects. However there are two types of adverse reactions that can occur with allergen immunotherapy i.e. Local and Systemic reactions. Systemic reactions typically occur within 20 minutes of your shot administration and hence patients are required to wait in the clinic for 20 minutes after their allergy shot.
Local Reactions are common and occur at the site of injection. They include redness, slight swelling and itching. They can be treated with cold packs and topical Benadryl or Hydrocortisone creams along with an antihistamine by mouth. If the local reaction lasts longer than 24 hours and is very bothersome then please inform the staff prior to your next shot as it may require to change your build up regimen to a sensitive protocol

Systemic Reactions are less frequent than local reactions. They are typically mild and include symptoms like sneezing, nasal congestion and hives. They quickly respond to antihistamines.
Anaphylaxis is a serious systemic reaction and possible symptoms include the above plus dizziness, wheezing, throat swelling or chest tightness. This requires rapid treatment with intramuscular epinephrine and the staff is trained toresponds to such reactions. If you have any serious systemic reactions after you leave our office then you should call 911 or proceed to the nearest ER. Also notify our office prior as soon as possible and let the staff know again prior to your next shot.

Protocol for immunotherapy at AAAC

1) After you have signed your form authorizing us to make your vials it takes about 1-2 weeks to make up your vials. Your first shot will require a nurse visit to go over the shot process.
2) Immunotherapy begins with the weakest dilution and the concentration increases as the vials go from green to blue to yellow and finally to red.
3) You will be required to wait at least 20 minutes in the office after you receive your shot. No exceptions. If you do leave you are leaving against medical advice and we may not be able to administer your immunotherapy in the future.
4) The recommended time interval during the build up phase is between 3-10 days.
5) During the build up phase if greater than 10 days has passed between shots either the previous dose may have to be repeated, or a lower dose will be given so as to minimize the likelihood of a systemic reaction. After this dose the regular build up will continue.
6) If you are very sensitive to the allergy shots and have very large local reactions then you may be switched to a sensitive build up schedule that requires repeating each dose before advancement to minimize local and or systemic reactions.
7) If you are suffering from severe allergy symptoms, having an upper respiratory infection, fever, or an asthma exacerbation it is important to let the nurse know so that she can inquire with the physician if you can get yourimmunotherapy that day.
8) It is okay to get your immunotherapy about 48 hours after your fever has resolved.
9) It is crucial to let the doctor know if you become pregnant as this will require adjustment to your immunotherapy
10) If you start any new medications especially beta blockers it is very important to let the nurse know before your shot is administered. Beta blockers interfere with medications used to treat a systemic reaction and you will need to see the doctor before immunotherapy can be initiated or continued.
11) If you choose to receive immunotherapy at another physician’s office then you must sign our release form stating this. You will need a visit with your physician at AAAC prior to starting your red vial. Approximately 2-3 weeks prior to your receiving your last shot from your red vial or if your vials have expired you must contact us to get instructions on proceeding with immunotherapy.

Rheumatology and Allergy Institute of Connecticut, LLC: Rheumatology

If you’re one of the 30-40% of Americans who suffer from allergies and hay fever, you know allergic reactions are no fun. Whether it’s sneezing, rashes, sniffling, or hives, allergy and hay fever symptoms range from inconveniencing to life-threatening.

Many patients know they react to various allergens, but they don’t know if their reactions are due to allergies or hay fever. While hay fever is a type of allergy, not all allergic reactions come from hay fever.

Keep reading to learn from Dr. Reinhard Kage and Dr. Barbara Kage of Rheumatology and Allergy Institute of Connecticut about the differences between allergies and hay fever, and how to thrive with both conditions. 

What are allergies?

Your body develops allergies when it views a foreign substance, or allergen, as harmful and attacks it. Unlike most pathogens your body attacks, an allergy is a reaction to a substance not harmful to most people.

It’s possible to develop an allergy to nearly anything. Some of the most common allergies include pollen, food, mold and dust, insects, and pet dander.

When you come into contact with the substance you’re allergic to, your body will have a reaction while trying to fight off harmful pathogens. Reactions can range from mild, such as rashes, hives, nausea, and fatigue, to severe anaphylactic shock.

What is hay fever?

Hay fever is a specific type of chronic allergic reaction. When you get hay fever, your symptoms are similar to when you have a cold, such as a runny nose, sore throat, congestion, and watery eyes. You might even initially mistake hay fever symptoms for a cold.

Unlike other allergic reactions, which typically go away after you’re no longer exposed to the substance, hay fever is often chronic and can last for months. The most common substances that cause hay fever include pollen, mold, and dust.

How to treat allergies

In some cases, the best way to manage allergic reactions is to completely avoid the allergen triggering substance. But when the allergen is impossible to avoid, or allergic reactions are getting in the way of your life, our doctors offer solutions that will help you manage them.

Allergy shots help desensitize your body to allergens by exposing your body to a small amount of the allergen, slowly increasing the amount over time. Our doctors develop a treatment course to your triggering allergens, starting with weekly shots and moving to monthly over time.

Other allergy treatments our doctors prescribe include medication, inhalers, and sublingual immunotherapy tablets, a tablet form of allergy shots. For certain life-threatening allergies, our doctors prescribe an epinephrine auto-injector for you to carry with you in case of exposure to the allergen.

How to treat hay fever

If our doctors diagnose you with hay fever, they’ll develop an individualized treatment plan based on the severity of your symptoms, allergen triggers, and medical needs. Like other allergies, in some cases, you can manage hay fever by avoiding contact with the allergen.

Other treatments our doctors offer for hay fever include antihistamines, nasal corticosteroids, decongestant medications, allergy shots, and eye drops. Your treatment might include a combination of these interventions.

Whether you have allergies, hay fever, or both, it’s possible to thrive with the right treatment. With two convenient offices in Manchester and Middletown, our specialized doctors treat patients throughout Connecticut. 

To schedule your consultation, please request an appointment online, or call your preferred practice location. 

Allergy Shots | The MetroHealth System

Immunotherapy, also known as allergy shots, allows your body to get used to the allergens that cause symptoms of hay fever, asthma or allergic reactions to insect bites or stings. Once you’ve had allergy testing, your allergist will know exactly what’s causing your symptoms. With this information, your physician prescribes personalized immunotherapy based on your symptoms, medical history and physical exam.

How Immunotherapy Works

Immunotherapy works like a vaccine. Each shot contains a small amount of the allergens that are causing your symptoms. The shots start at a low dosage and increase with time. The goal is to get your body to tolerate the allergen. A higher tolerance means fewer symptoms.

Allergy shots are effective over time, as they require three to six months for symptoms to improve, and some people need shots for longer to get the maximum benefit. Your doctor works with you and monitors your progress. We develop an individualized plan and meet with you periodically to review your treatment. If your allergic symptoms are constant, you might need to see us every six to 12 months. Patients who are doing well can have treatment reviews once a year.

After your shot, we ask that you stay in our office for 20 to 30 minutes to ensure that there are no reactions. On the off chance of a reaction, we ease your discomfort and adjust your dose so you have a smaller risk of reaction in the future.

To make an appointment, call 216-778-2213.  Referrals are not required.

Common Questions about Allergy Shots

• Do I really have to stay at the clinic for 20 to 30 minutes each time I get an allergy shot?
  Yes. We do this for your safety. Don’t come for your shot if you don’t have time to wait. Come another day when you have time.
• What if I’m sick on the day I get my shot?
  If you aren’t feeling well, call us before you come in. We might want to postpone your shot.
• What else can I do to treat my allergies?
  First things first: Avoid allergens if you can. Then, take medications as directed by your doctor.

• Do I still need to avoid things I’m allergic to if I’m getting allergy shots?
  Some things—like mold—can’t be avoided. But it’s always best to avoid allergens when you can.

• Should I keep taking my allergy medications during immunotherapy?
  Yes, but you might need smaller doses when your immunotherapy starts to work. Talk to your doctor before reducing or stopping any medications.

• When should I have allergy testing done again?
  We recommend getting tested every three to five years. If you have new problems, get tested sooner.

• Should I tell the doctor or nurse if I’m on a new medication?
  Yes. Some medications don’t mix well with immunotherapy, especially beta-blockers and ACE inhibitors. Talk to your doctor or nurse.

• What happens if I become pregnant?
  Visit the allergist to review your allergy treatment plan together. Allergy shots won’t cause or prevent allergies in your baby, and we won’t increase your dose during pregnancy. However, immunotherapy during pregnancy might mean you need less of other medications. This is a benefit for moms trying to keep medications at a minimum.

• What should I do about my allergy shots if I go on vacation?
  You can skip shots if you’re gone less than three weeks. If you’re going to be gone longer, talk to your nurse. We’ll help you come up with a plan.

• Will my maintenance dose always be the same amount? Will the timing stay the same?
  No. You might be able to space your shots further apart. The amount of allergen in your maintenance dose might increase during peak pollen and mold seasons. Let us know what’s working—and what isn’t—and we’ll tweak your treatment plan as needed.

ASIT – Science – Kommersant

Allergen-specific immunotherapy (ASIT), that is, the introduction into the body of gradually increasing doses of the allergen responsible for the manifestations of the disease, is the only method that not only relieves symptoms, but helps to get rid of allergies for a long time.

According to the supervision of an allergist-immunologist, medical director of the “Allergotop” project, candidate of medical sciences Elena Shuvatova, more than half of the patients who come to the reception have never heard of ASIT.Meanwhile, this method has been practiced for over 100 years.

True, Western scientists, not devoid of a sense of humor, trace the history of immunotherapy to the ancient king Mithridates of Pontus, who all his life took poison in small doses, fearing poisoning. And when an uprising broke out in the country and the ruler decided to commit suicide so that he would not be torn apart by the crowd, the poison did not work! I had to use the sword.

But seriously, they started thinking about treating allergies with ASIT in the late 19th – early 20th centuries, when vaccination against dangerous diseases became, as they say, the norm.In 1900, for example, American physician Henry Holbrooke Curtis injected his patients subcutaneously with aqueous extracts of pollen from various plants, including ragweed. Treatment failed due to serious adverse reactions.

In Germany, the director of the Hamburg Institute of Hygiene, William Dunbar, treated hay fever with serum from horses immunized with pollen extracts. His drug, Polantine, also left sad memories: many of the patients nearly died of anaphylactic shock.By the way, the first death from ASIT was registered in 1910.

The modern method of allergen-specific immunotherapy was described in 1911 in the medical journal The Lancet by the British microbiologist Leonard Noon. Together with colleague John Freeman, he treated patients for hay fever, or hay fever (pollen allergy), with subcutaneous injections of aqueous pollen extracts. In the same year, Freeman also reported the results of “hay fever vaccinations.” The result exceeded all expectations: the sensitivity of allergy sufferers to pollen after injections decreased by 100 times, and the effect lasted for a year.

In the Soviet Union, ASIT has been used since the 1960s thanks to the founder of Russian allergology, a member of the USSR Academy of Medical Sciences, Andrei Ado.

How ASIT is carried out

ASIT start with small doses, gradually increasing them to a certain level. When the desired concentration of the allergen is reached, the dose is no longer increased, but injected regularly for three to five years. As a result, a person with allergies may stop using their usual medications or significantly reduce their intake.According to the observations of doctors, remission (weakening or disappearance of the symptoms of the disease) lasts from five to ten years, and sometimes longer.

ASIT is injectable and sublingual (it is also called sublingual). With the injection, everything is clear: the injections are given by the doctor at the medical center. First, you need to go for injections one to three times a week, after reaching the maintenance dose – once a month. It is very important not to skip the injections, otherwise the treatment will be ineffective. Sometimes there is an accelerated intensive course, but here you need to go to the hospital for two weeks.

Injections should be started in December-January to catch the dose before the flowering season. If the reaction is only to household allergens, ASIT can be started at any time of the year.

Sublingual ASIT – drops or tablets under the tongue. The first time they are taken in the presence of a doctor, and then at home, from time to time they report to the doctor about the course of treatment. This method is considered safer. However, injectable vaccines treat a much wider variety of allergy causes than sublingual vaccines.

The effect of all these methods is approximately the same, therefore, when choosing, you must proceed from whether you can come for injections, whether they do injectable ASIT in your city, what allergic vaccines are on sale. Sublingual ASIT is better for children: they rarely agree to injections.

Russian OMS policy gives the opportunity to pass ASIT “free of charge”. This requires the appointment of an allergist. In Moscow, treatment with allergens is carried out at the Center for Allergology and Immunology of the City Clinical Hospital No. 52, the Institute of Immunology of the Federal Medical and Biological Agency of Russia, the Mechnikov Research Institute of Vaccines and Serums, and private clinics.

Allergic vaccines

Allergic vaccines have now been developed in the world for almost any allergy: in addition to allergens that have existed since the last century to pollen from trees, cereals and weeds, there are also house dust mites, bee and wasp venom, mold fungi, animal dander. “The pharmaceutical industry first turned to allergens that cannot be avoided (house dust, mold fungi, birch and other plants), and then there were“ excesses, ”explains Elena Shuvatova.However, many people opt for an animal, and this is not a medical, but a social problem, which is why vaccines have been developed and they are very popular. True, many of these allergy vaccines are not certified in Russia. ”

Already in the 1930s, experts began to understand that the quality of water-salt extracts leaves much to be desired. “There are such concepts as allergenicity and immunogenicity,” continues Dr. Shuvatova. “Allergenicity is the ability to cause an allergic reaction, immunogenicity is the ability to effectively influence the immune response.There are a number of ways in the world to transform the allergen molecule so that the allergenicity decreases sharply, ensuring the safety of the patient, and the immunogenicity increases due to various additives. This is how modern foreign vaccines are made. ”

Deposited and recombinant allergic vaccines, hybrid molecules – these preparations for ASIT are not available to the domestic consumer. The only Russian manufacturer of vaccines for ASIT, JSC NPO Microgen, produces mainly water-salt extracts for injections.In 2019, the corporation released a series of allergoids, but so far very few of them have been manufactured and it is not always possible to “obtain” a vaccine for treatment.

As for the available water-salt allergens, they are effective; they can be used to form individual allergy vaccines by mixing several components, and this is their undoubted advantage. However, they are not safe enough compared to the drugs that exist in developed countries. For fear of side effects, doctors often do not adjust to high doses, which reduces the quality of therapy.And the spectrum of water-salt allergens is small: trees, grasses and weeds, house dust mite.

It is not surprising that Russian doctors are rejecting injectable ASIT in favor of sublingual. This is largely the merit of foreign pharmaceutical companies that have registered such drugs in Russia. The danger is that pharmacies often sell these prescription drugs … without a prescription. Everyone can buy and self-medicate. “These are health risks, which leads to discrediting of the ASIT method,” sums up Elena Shuvatova.

Elena Tueva

Good to know about ALLERGY VACCINATIONS (allergivaksinasjon)

ALLERGY VACCINATIONS ( allergivaksinasjon )

Useful Information on Allergy Vaccinations – Fact Sheet of the Norwegian Asthmatics and Allergy Association

Vaccination is an alternative form of treatment for prolonged and acute allergies, when the use of conventional medications does not give a satisfactory effect.Treatment is also called hyposensitization or special immunotherapy. The principle of treatment is to reduce allergy symptoms by injecting the allergy-causing substance.

This should not be confused with allergy cortisone injections. Cortisone injections should only be used when it is necessary to respond quickly to severe symptoms and other treatments fail.

Antiallergic vaccination is performed by injecting small doses of an allergen extract under the skin, to which the body reacts.Initial doses should be small enough not to cause an allergic reaction. Doses are gradually increased until the level of tolerance is reached. This optimal dose is usually given at intervals of 6-8 weeks over a period of 3-5 years. Thus, it is possible to achieve the development in the body of the tolerance of the allergen used in the course of treatment.

When is this treatment used?

Vaccination can be used for most types of pollen allergy (birch, hazel, grass).Allergic vaccination is also used to reduce the risk of life-threatening reactions in people who are acutely allergic to bee and wasp stings. In some cases, vaccination is used for allergies to animals and house mites. Research has shown that allergy vaccination can prevent asthma from developing later or provide more control over allergic asthma. However, people with acute asthma should not be vaccinated against allergies.

Pollen allergy vaccination based on Grazax tablets is an approved treatment for adults and children over 5 years of age who suffer from pollen allergy. The medicine is a lozenge containing extracts of timothy pollen allergens.

Who is the vaccine for?

Before considering vaccination, treatment with conventional antiallergic medications, antihistamines and topical medications should be carried out for symptoms in the eyes and nose.If symptoms persist after this treatment, vaccination may be a good alternative.

Allergy vaccination is not recommended for children under 5 years of age, as well as for people with uncontrolled asthma, serious cardiovascular or cancer diseases. Vaccination should not be started during pregnancy.

Allergy vaccination should not start during pollen season and dose escalation should be completed prior to pollen season. For example, an increase in the dose of birch allergen should be completed between July and February, herbs – between September and April, and wormwood – between October and April.

Allergy vaccination involves proven allergy using a skin test or blood test. Also, pulmonary function tests should be performed prior to starting treatment.

The costs of vaccinations against allergies are covered by the public insurance fund or the blue prescription. Other vaccines may only be covered on an individual basis.

For allergy vaccination with Grazax tablets, the lozenge is taken every day for three years, and treatment should begin four months before the start of the pollen season.

Grazax qualifies for a reimbursement of costs for moderate to severe seasonal pollen allergy for at least two years, in cases where other treatment has not helped to establish sufficient control over the disease, or has led to side effects. The reimbursement also provides that the patient does not receive vaccines containing extracts of other allergens. The right to reimbursement applies to children over the age of five and also to adults.

Where is the vaccination carried out?

Allergy vaccinations should only be given by a lung specialist, otolaryngologist or pediatrician with an allergy specialization.

Danger of side effects

Allergy vaccination is associated with a certain risk of side effects. These can include mild symptoms such as a runny nose, itchy eyes and throat, or serious, sometimes life-threatening symptoms such as shortness of breath or anaphylactic shock. This is especially true of the initial phase of vaccination and the moment immediately after the injection. Therefore, vaccination should be carried out in specially designated places where there are means of providing assistance in case of possible serious complications.Also, therefore, you should not leave the vaccination site within 30 minutes after taking the last dose of the drug. During the first days after the injection, local reactions may occur, such as edema on the skin, therefore physical activity should be avoided for the first 24 hours after vaccination.

The most common side effects of vaccination with Grazax tablets are local allergic reactions in the mouth in the form of burning or swelling of the sublingual region.In most cases, these reactions resolve within a few weeks from the start of vaccination.

What is the effect of the treatment?

There is documented evidence that vaccination is an effective form of treatment that can relieve allergic symptoms, improve the quality of life of the allergic sufferer, and thereby significantly reduce the use of other medications. For most patients, the effect will be final. However, some patients may not experience significant improvement in their condition.It is not possible to determine in advance whether vaccination will have an effect on a particular patient.

Allergy vaccination itself is a time-consuming and expensive form of treatment. The risk of side effects and the fact that not everyone will feel better after treatment makes it necessary to weigh the pros and cons before starting vaccination.

The development of new and more effective forms of immunotherapy gives reason to hope for more reliable treatments and improved results in the future.

Allergy vaccination facts developed in collaboration with the Medical Council of the Norwegian Asthmatics and Allergy Association.

What is hay fever or hay fever?

Mukharayeva Elza Vasilievna

Allergologist

March 11, 2021

Pollinosis (hay fever) is a disease caused by sensitization (sensitivity) to pollen of various plants and characterized by inflammation of the mucous membranes, mainly of the respiratory tract and the eyes.

This term was coined in 1819 by the English physician John Bostock, who every year at the same time in the summer, when he was making hay, developed similar symptoms: sneezing, runny nose, watery eyes. Hay fever is a misnomer. Firstly, with this disease, there is almost never a fever (increase in body temperature), and secondly, hay is not the only cause of such symptoms. In fact, hay fever is a common term used in everyday life for seasonal allergic rhinitis or hay fever (from the Greek.Pollin – pollen).

It manifests itself:

• sneezing,
• watery nasal discharge,
• tearing,
• itching,
• and sometimes swelling of the eyes,
• unpleasant painful sensations in the mouth and throat.

The cause of allergic rhinitis is the wind-blown pollen of trees, various ear-bearing grasses and weeds, as well as mold spores that are present in the atmosphere at certain times of the year.

The role of pollen in the development of hay fever was finally proved by the English physician Blackley, who himself suffered from allergies.His experiments not only revealed the true cause of this disease, but also formed the basis for the development of skin and provocative tests.

Three groups of plants are known, the pollen of which causes the development of hay fever: trees, grasses and weeds.

There are similarities between the allergens of different types of pollen. Antigens are present not only in food grains, but also in other parts of plants (seeds, leaves, etc.). This is the reason for the appearance of cross food allergies and intolerance to phytopreparations in patients with pollinosis.

Some foods to which cross-allergies occur in people with hay fever:

To tree pollen: nuts (especially hazelnuts and almonds), apples, cherries, cherries, peaches, nectarines, plums, carrots, parsley, celery, tomatoes (tomatoes), kiwi, raw potatoes.

To the pollen of cereal grasses: bread, bread kvass, flour products, semolina, bran, cereal sprouts, bread crumbs, ice cream, sorbet, rolled oats and some cereals (oats, wheat, barley, etc.)etc.), corn, sorghum, sausages, coffee substitutes, malt, beer, wheat vodka, sorrel.

To weed pollen: melon, sunflower seeds, sunflower oil, halva, mayonnaise, watermelon, zucchini, eggplant, mustard, spinach, beets, absinthe, vermouth, Jerusalem artichoke, chicory, citrus fruits, honey

Skin or prick test is one of the most informative diagnostic tests for allergies, including hay fever. The essence of the method is that droplets containing allergens are applied to the skin of the forearm or back.Then, in the places where the droplets are located, the skin is pierced in such a way that the solution with the allergen penetrates inside. In a similar study called the Scarification Test , the patient’s skin is scarified.

If the patient is allergic to any substance, then redness or swelling occurs at the site of application of the allergen. The reaction develops within 15 minutes.

But it is necessary to carry out a test with pollen allergens outside the flowering season – preferably in winter.The test results are used by the doctor not only to confirm the preliminary diagnosis, but also to decide whether to conduct allergen-specific immunotherapy for a given patient.

For the treatment of hay fever, elimination therapy, drug treatment, ASIT therapy are used. Next, we will analyze what these terms mean.

• Partial elimination measures (to reduce contact with the allergen) involve limiting walking in dry windy weather, banning trips to the countryside, wearing sunglasses outside.To prevent the ingress of plant pollen into living quarters, it is necessary to close the vents and windows with damp gauze, change clothes and take a shower with washing your hair when returning from the street. It is also necessary to follow a hypoallergenic diet that excludes foods with cross-allergenic properties.
• Medicines in this case do not cure the disease itself, but only relieve the symptoms of hay fever. Depending on the age, severity of the condition, the characteristics of the manifestation of hay fever in a particular patient, the doctor prescribes drugs for local or internal use, sometimes in combination, in order to help a person survive this period with less discomfort.
• ASIT method or allergic immunotherapy involves injections containing allergens. The patient receives a series of injections with hostile allergens in a gradually increasing concentration. As a result, the body’s resistance to these allergens increases. To achieve a lasting effect, 3-5 courses of therapy are carried out or one course before the season. Its effect on hay fever reaches 90%. In recent years, ASIT therapy can also be carried out with preparations in the form of oral solutions.

More details about ASIT-therapy can be found in the article about this technique.

High temperature in a child

Ambulance for children : 8 (812) 327-13-13 More details

Fever is the most common parental concern about the health of children. Often, it is the measurement of body temperature that helps to determine what is happening with the child – he is simply in a bad mood or the baby is still ill.

Where, how and how should the temperature be measured?

Body temperature can be measured in various places – in the armpit, in the rectum, in the mouth, in the external auditory canal (by the way, this is not theoretical reasoning – in different countries the temperature is measured differently).In Russia, it is customary to measure the temperature under the armpit – this is exactly what should be done, since there are normal numbers for each option for measuring temperature, and your Russian doctor is used to focusing on the armpit temperature. In turn, being in another country, it makes sense to inform the doctor that the temperature was measured exactly under the arm.
Today, along with the usual mercury thermometers, electronic thermometers are widely used. If you are not a very tidy person, it is better to use just such a thermometer – one broken mercury thermometer will not create problems, but if you are used to beating them regularly, the level of mercury vapor in your apartment can reach numbers that are dangerous to health.Many people complain about the incorrect operation of an electronic thermometer – there are several tricks that will help you cope with this problem. First, having bought an electronic thermometer, you should check it by measuring your temperature with both an electronic and a mercury thermometer – the permissible difference should not exceed 0.2 º. Secondly, especially when measuring the temperature in children, the sound of the buzzer should be ignored and the thermometer should be held for another minute – the result will be more reliable.
A few words about the so-called infrared ear thermometers: one of their undoubted advantages is the speed of measurement – only two seconds.However, at best, you get the temperature of the eardrum – enough to track the temperature dynamics, but it may not satisfy your doctor, because the difference between ear and axillary temperature is not constant and an exact conversion is not possible. In the worst (and very common) case, the ear canal is filled with sulfur – while the numbers on the display of your thermometer will have a very distant relationship to the child’s body temperature. The same can be said for remote infrared forehead thermometers – their accuracy is also far from ideal.
From the “advanced” new products, you can pay attention to the so-called. “Xiaomi smart baby thermometer – a review of this fashionable device can be found here https://news.rambler.ru/other/38877929-obzor-detskogo-termometra-xiaomi-vse-zhivy/
reviews of real users about convenience and accuracy are not bad … It is not difficult to buy this device today, but everything sold is “gray” supplies, since this device does not have mandatory certification in accordance with Russian requirements today.

Thus, the most accurate is the good old mercury thermometer.Everyone knows how to use it, however, I would like to dwell on a few points. First, if the child is sweating, the armpit should be dried first. Secondly, after placing the thermometer, you should make sure that its tip is under the arm, and not sticking out from the outside. Thirdly, keep the thermometer under your arm for at least five minutes. Sometimes these five minutes can be an ordeal for the parent’s psyche – some children absolutely do not like the thermometry procedure. In this case, you can use the old grandmother’s way – put the thermometer not from front to back, but from back to front.At the same time, the child does not see the protruding thermometer and often behaves calmer.
There is a known method for measuring temperature that does not require a thermometer at all – many parents (and especially grandmothers) often claim that they are able to determine the temperature of a child with an accuracy of tenths by touching it with their hand or lips. I strongly advise against using this method – the point is not only that such statements, to put it mildly, are somewhat exaggerated. Unfortunately, this method gives maximum errors precisely when knowledge of the exact body temperature is especially necessary – with the so-called “pale” fever (we will talk more about this unpleasant condition later).

Which temperature should be considered elevated?

Formally, this is considered to be a temperature above 37º. However, in healthy children of any age, after anxiety, physical exertion, or just after eating, the temperature can rise to 37.5 or even 38º. Healthy children of the first month of life also do not differ in accuracy in regulating their own temperature, and in premature babies and children with neurological problems, temperature instability can be observed at an older age.In these cases, the temperature measured after an hour is usually normal.
Another condition that can lead to an increase in temperature in a healthy child is teething (or, in other words, dentition). In this condition, the temperature can rise to 38 degrees or more and last for more than a day. However, parents should not independently decide whether a prolonged increase in temperature is associated with teething. In this case, the child should be shown to the doctor – after all, the child’s teeth are being cut almost continuously from 4 months to 2 years, and, considering any temperature rise as dentition, you can skip the onset of a serious illness, the only symptom of which is visible to you (but not to the doctor) there was a fever.
General overheating of the body can also lead to an increase in temperature, while after a few hours of being in comfortable conditions, the temperature becomes normal and does not rise anymore.
Fever often rises after prophylactic vaccinations. Although a moderate rise in temperature after some vaccinations is considered a normal vaccine reaction, it is best to show your child to a doctor in this case.

High fever in a child without symptoms

The body temperature of a sick child is usually elevated. Drawing your attention to this well-known truth, I just want to emphasize that if a fever in a “healthy” child is a reason for serious concern and going to a doctor, then a fever (or, in other words, a fever) in a sick child, examined by a doctor and receiving treatment is a completely normal situation that parents are usually able to cope with on their own (of course, using medical prescriptions). The danger of a high temperature for a child is greatly exaggerated – stories that the heart can not withstand and many other horror stories are related not to medicine, but to folklore.
Certain medical problems, however, may indeed be associated with high fever. The first (and most frequent) of them is the poor health of a fever child. Indeed, although children usually tolerate fever more easily than adults, prolonged fever can impair a baby’s mood, sleep and appetite. Another problem is a high temperature in children with vomiting or diarrhea: in such children, the main danger is the risk of dehydration, and against the background of a high temperature, fluid loss associated with breathing increases significantly (fluid is spent on humidifying the exhaled air).A third problem (relatively rare) is the problem of febrile seizures (i.e. seizures associated with high fever).

Indeed, some children may develop a convulsive seizure against a background of high temperature. However, this problem is not as bad as it might seem – firstly, an attack of febrile seizures is always short, goes away on its own and never gives serious complications, and secondly, children over three years of age do not have febrile seizures, and thirdly, if Your child has already been ill with a high fever and without seizures, this problem has nothing to do with him at all.

Is the degree of temperature rise an absolute criterion for the severity of the child’s condition?
Certainly not – the usual uncomplicated ARVI can be accompanied by a temperature above 39º, at the same time, many serious and dangerous diseases can occur with a moderately high or even normal temperature.

How to bring down a high temperature in a child

Should the high temperature be dealt with? If so, how should this be done?
The answer to these questions depends not only on the specific temperature figures, but also on the characteristics of your child, on the nature of the disease that caused the fever and many other factors known only to you and your pediatrician
(the author of this article is unfamiliar with your child).In any case, the appointment of a doctor who examined the child will be much more valuable than any absentee recommendations.
However, you may find yourself in a situation where an emergency doctor’s consultation is not possible. To do this, you do not have to go to a desert island – it is enough to be in a compartment of a long-distance train or in a garden area with a disabled mobile phone. In addition, knowledge of the rational principles of lowering the temperature will help you to correctly assemble a home first-aid kit: medical recommendations expressed orally or written down on paper do not have an independent antipyretic effect, and you still need to get to the nearest pharmacy on duty.
In most cases, the temperature below 38º is not dangerous, does not affect the well-being of the child and does not need to be lowered. The desire of parents to achieve a normal temperature in a sick child is completely unjustified – the point is not even that one of the natural factors of the body’s resistance is turned off, just unnecessary use of antipyretic drugs is undesirable, because absolutely safe and harmless drugs do not exist.
Temperatures above 38º should be lowered if the child does not tolerate it well (he often does).The temperature above 39º certainly needs to be reduced, while you still have to use antipyretic drugs, so I will have to tell you more about them.

When you look at the pharmacy shelf with the inscription “antipyretic” you will be surprised by the number of bottles and boxes with different names. In fact, this is an apparent variety – the fact is that the name on the package is a trade name and does not reflect the composition of the drug. So, for example, PANADOL, EFFERALGAN, TAYLENOL, CALPOL, DALERON, PARAMOSHA, CEFEKON D (all these drugs are found in our pharmacies) are ordinary paracetamol.While abroad, you can find the same paracetamol under the names DOLIPRAN, ALVEDON, PARAMOL and others (by the way, you should not expect that the local doctor will explain everything in detail – in many countries this is simply not accepted). Only good eyesight will help you to sort out this confusion – the fact is that on each package there is necessarily an international name of the drug written in small letters: for paracetamol it will be “paracetamol”, “acetomiphen” or “acetominophen”. Today, paracetamol is the most common antipyretic drug for children.
Regular doses of paracetamol are harmless for most children, but if your child has chronic liver disease, hepatitis or persistent neonatal jaundice, you should not use this drug without consulting a doctor. Allergic reactions to paracetamol are rare, much more often the child reacts to dyes and taste-improving substances that are part of paracetamol preparations for children. Therefore, if a child develops a rash after taking Panadol, it makes sense to try Efferalgan or Tylenol – perhaps everything will be fine.
NUROFEN FOR CHILDREN is an ibuprofen-based antipyretic drug (look abroad for the word “ibuprofen” on the packaging). In its antipyretic effect, ibuprofen differs little from paracetamol, but it lasts a little longer. This drug in usual doses is of little toxicity and is widely used in modern pediatrics. Unfortunately, ibuprofen preparations are only available for oral administration; rectal suppositories are not produced on its basis. It should only be remembered that ibuprofen is not approved for children weighing less than 5 kg.In addition, ibuprofen preparations should not be used if the child has ever had a decrease in the number of leukocytes in the peripheral blood.
Acetylsalicylic acid (ASPIRIN) is one of the oldest antipyretic drugs. However, today this drug is prohibited for use until the age of 15 – the age-related characteristics of metabolism determine the higher toxicity of this drug specifically for children. It is especially dangerous to use aspirin in children in the first two years of life, as well as those suffering from bronchial asthma or those who are prone to nosebleeds.
ANALGIN (international name – metamizole) is a very effective antipyretic drug. A feature of this drug is the rapid onset of antipyretic effect (especially with intramuscular administration), but the duration of this effect is short. In many countries, this drug is not approved for use – with prolonged and frequent use, analgin can disrupt hematopoiesis, leading to a decrease in the number of leukocytes. In Russia, this drug is used mainly as an emergency aid – leukopenia (a decrease in the number of leukocytes) – a very rare complication and with episodic use of analgin is practically not found.Conclusions: firstly, analgin can be used in children, but only as an additional antipyretic drug, and secondly, if you intend to use analgin when traveling abroad, you will have to take it with you. An additional argument in favor of the use of analgin can be considered the following consideration: if you cannot reduce the temperature to acceptable figures with the help of paracetamol, you will have to call an emergency aid, whose doctor will certainly help your child – by injecting the same analgin intramuscularly.Of course, analgin should not be used in children with leukopenia of any origin.

How to use antipyretic drugs?

Most of them are available in child-friendly forms – fruit-flavored syrups. However, if your child suffers from food allergies, it may be better to separate, crush and give the child part of the tablet with a little water – this way you avoid the risk of allergic reactions to dyes and flavorings. It should not be forgotten that in addition to the mouth, the child also has other physiological openings suitable for the administration of drugs – I mean the use of rectal suppositories.Most antipyretic drugs are available in various dosages of suppositories. If there are only suppositories with a too large dose of the drug, they are treated in the same way as with tablets – the required part of the suppository (naturally, the front, pointed) is separated with a knife and inserted into the anus, not forgetting to pre-lubricate with baby cream or the anus , or the candle itself. Which is preferable, mouth or butt? There are no fundamental differences in the action of the drug or the rate of absorption, choose what is more convenient for you.

How often can antipyretic drugs be used?

Paracetamol is recommended to be taken no more than four times a day, however, if necessary, the interval between doses can be shortened to four hours. Analgin and ibuprofen (nurofen) should not be taken more than three times a day.
How to calculate the dose of an antipyretic drug? You should not do this yourself, a child’s illness is not the best time for math exercises, you should consult with your doctor in advance.Of course, there is a leaflet with dosage instructions in every box of antipyretic medicine, but these instructions are not specific to your child. By the way, in these leaflets there is often an instruction that completely disorients parents: “it is not recommended to take the drug for more than three days” – you can safely ignore this instruction. It is intended for countries where it is not customary to show the child to the doctor in the first days of the disease, and it makes the following sense – if after three days of self-treatment the temperature has not become normal, you should stop amateur activities and show the baby to the pediatrician.

What to do if four hours have not passed yet, and the temperature starts to rise again and exceeds 38º?

In this case, rubbing with water at room temperature will help your child. A large piece of cotton wool soaked in the mixture should be (like a brush) moisten the entire skin of the child from the neck to the heels, while it is desirable to cover the perineum, and the axillary and groin areas (the location of large vessels) should be processed several times. After wiping, the child must be left open for 1-2 minutes, after which it can be gently blotted.When done correctly, rubdown is quick and effective, but this effect is rather short-lived. It’s not scary, because rubdowns can be done as often as you like. But against the background of severe chills, pallor, cold feet (signs of pale fever), you should not wipe yourself off, you first need to transfer the pale fever to pink, which will be discussed a little later.

What to do if antipyretic drugs do not work?

The fact is that high temperature (fever) in children can occur in two variants: pink fever and pale fever.With pink fever in a child, the skin looks brighter than in a healthy child, they are hot to the touch, including on the hands and feet, in children over a year old, pink fever is usually accompanied by increased sweating. With pink fever, there is no disturbance in heat transfer, so taking antipyretics is usually effective.
In pale fever, only the head and natural folds are usually hot, and the feet or hands may be especially cold. Pale or marbled skin (i.e.,that is, with an uneven color). Chills and goose bumps are also signs of pale fever. The causes of this condition are a spasm of the skin vessels, the consequences are a violation of heat transfer, the inability to determine the temperature “by touch”, the lack of response to conventional antipyretic drugs and rubdowns.
Pale fever is a very unpleasant condition: vasospasm is not limited to the skin, while blood circulation in the tissues is impaired, pathological changes in metabolism increase, and the acid-base balance is disturbed.Therefore, the primary task in pale fever is the elimination of vascular spasm, i.e. transfer of pale fever to pink. This can be achieved by using vasodilating drugs – NO-SHPA tablets or PAPAVERIN suppositories (by the way, you will not find NO-SHPU abroad either, take it with you). You can mask the disgusting bitter taste of NO-SHPA by giving it in one spoonful with antipyretic syrup. An additional measure to eliminate vascular spasm is to warm the feet. There is no need to be afraid of this procedure – a heating pad applied to the feet will not lead to an additional increase in temperature; due to the removal of vascular spasm and improvement of heat transfer, the temperature can only decrease.In no case (despite the chills) should you wrap the child warmly – this will further worsen the heat transfer. In general, the ideal clothing for a feverish child is one’s own skin plus woolen socks.

What to do if you do not understand if your child has signs of pale fever?

In this case, follow a very simple rule – it is better to give vasodilators when they are not needed (these drugs are practically harmless in age-related doses) than to skip taking them when they are needed.By the way, a fever above 39º should always be considered pale (without disturbances in heat transfer, the temperature will simply not rise to such figures).
All of the above recommendations can be presented in the form of a short diagram, which is convenient to rewrite and put in a children’s first-aid kit.

DIAGRAM OF APPLICATION OF ANTI-REDUCING AND VASCULAR PREPARATIONS AT HIGH TEMPERATURE IN CHILDREN.

1. Temperature below 38º – does not need to be lowered.

2. Temperature 38 – 39º

2.1 PINK FEVER
Signs: pink skin, warm feet, no chills.
Preparations: PARACETAMOL or NUROFEN

2.2 PAIN FEVER
Signs: Pale or marbled skin, cold feet, chills or goose bumps.
Preparations: PARACETAMOL or NUROFEN + NO-SHPA or PAPAVERIN

3. Temperature above 39º
Preparations:
PARACETAMOL or NUROFEN + NO-SHPA or PAPAVERIN + ANALGIN

Note: this scheme cannot be used if:
1.A child under three months old.
2. The child suffers from a serious chronic illness.
3. The child has had an unusual reaction to one of the recommended drugs in the past.
4. There are contraindications to the use of one of the recommended drugs.
5. The attending physician prescribed a different procedure for the use of drugs.

What to do if, despite following all the recommendations, the thermometer does not drop below 39º or signs of vascular spasm (pale fever) persist?

In this case, you still have to call emergency help .An emergency examination by a doctor in this situation is absolutely necessary – it may be time to change something in the treatment regimen.

In conclusion, I would like to give an approximate list of antipyretic drugs for your home medicine cabinet. A first-aid kit should be completed in advance – children often fall ill at the most inopportune moment, when there is no time and no one to run to the pharmacy.

1. Any syrup with PARACETAMOL or NUROFEN FOR CHILDREN.
2. Suppositories with PARACETAMOL or IBUPROFEN in the dose recommended by the attending physician.
3. Tablets NO-SHPA 40mg.
4. Suppositories PAPAVERIN 20mg.
5. Tablets ANALGIN 500mg.
6. Emergency telephone number.

Kanter M.I.
Pediatrician of the highest category

90,000 03/13/2017 Caution: hay fever!

Spring is a long-awaited time of the year. Nature is awakening. The sun warms up. Everything is flowering. But for some, this wonderful time of the year is not at all a joy. Since there are those who, with the flowering season, begin to sneeze, nasal congestion, watery eyes.This is how hay fever manifests itself – seasonal allergic rhinoconjunctivitis or hay fever.

This seasonal illness develops in sensitized people as a result of contact with pollen. Sensitization is understood as the increased sensitivity of the body to the effects of irritants (allergens), which cause an allergic reaction. An allergen, while harmless to most of us, is considered by the immune system as a danger in sensitized people, therefore an allergic reaction occurs as a result.

Svetlana Budnyak, an allergist-immunologist of our clinic, spoke about the symptoms of the disease, its prevention and methods of treatment:

“Symptoms of seasonal allergies appear at practically the same time every year in the form of a cold; nasal congestion; sneezing attacks; burning or itching sensations in the nose and mouth; conjunctivitis, characterized by red eyes, gritty eyes, itching, or burning; and also in the form of a cough, in some cases, asthma attacks.In addition to the characteristic signs of allergies, frequent companions of hay fever are sleep disorders, fatigue, and increased fatigue. This leads to a significant deterioration in the quality of life of patients and significantly affects their daily activities, professional activities and studies. The most common symptoms of hay fever in central Russia develop in April-May during the flowering of birch trees: birch, alder, hornbeam, hazel. In the southern regions of our country, cypress trees cause allergies: cypress, juniper, thuja.

It is worth saying a few words about birch pollen. Its distinctive feature is that it is lighter than the pollen of other trees. In addition, birch pollen has a non-sticky surface, which allows the wind to carry it over long distances. And even a small amount of pollen in the air can be enough to cause allergy symptoms in sensitized people.

In case of allergy to tree pollen, allergic reactions to certain types of food can also occur: the so-called “cross-allergy”.It occurs because the structure of some food and inhalation allergens is very similar. Because of these similarities, the immune system reacts not only to pollen, but also to similar molecules found in food.

Diagnosis of seasonal allergies is based on an assessment of the clinical picture of the disease and a special examination. It includes a blood test for specific immunoglobulins, skin allergy tests. During this skin allergy test, a small amount of tree pollen extracts are placed in solution on the forearm or back.Swelling and redness of the skin in the area of ​​application indicate the presence of an allergy. Based on the information received, a decision is made on further treatment tactics.

Treatment of seasonal allergies includes symptomatic therapy. That is, the patient can be prescribed antihistamines, local anti-inflammatory and anti-allergic drugs. Pathogenetic treatment is also used. It is aimed at eliminating the cause of the disease. To date, the only pathogenetic treatment for seasonal allergies is allergen-specific immunotherapy (ASIT).

ASIT consists in the sequential introduction of certain doses of allergens into the human body. The doses administered are gradually increased. Then the same dose of the allergen is administered over three years. After a full course of treatment, the patient has a long-term remission, that is, immunity to the allergen. There are two main methods of administering the allergen: subcutaneous and sublingual. Subcutaneous injections are given by a doctor in the outer shoulder area. Sublingual drops or tablets are taken under the tongue and then swallowed.ASIT allows you to reduce or completely stop the symptoms of the disease, to avoid subsequent allergic reactions, and prevents the transition of rhinitis to asthma.

The key factors for successful therapy are the initiation of treatment at the early stages of the development of hay fever, regular admission and adherence to doctor’s prescriptions. ”

Svetlana Sergeevna stressed that great attention should be paid to the prevention of the disease. So the primary prevention of hay fever is aimed at preventing the development of pollen allergy.At the same time, it is important to follow the rules of a balanced diet, exercise, and hardening. Secondary prevention of the disease prevents the deterioration of the condition in those patients who already suffer from hay fever. During the flowering period, it is important to ensure that pollen does not enter the room. Use an air conditioner, humidifiers and air purifiers, and vacuum cleaners.