Allergy season has arrived again this year. If you’re one of the 81 million Americans who suffer from hay fever, spring brings many benefits. The days are longer, sure, but they come with itchy eyes, runny noses, and a never-ending search for antihistamines.
Seasonal allergies are like an attack from the outside world on days when pollen counts are highest, but our own body’s immune system is also overworked. The number of allergy sufferers is also increasing. In 1997, about 0.4 percent of U.S. children were reported to have a peanut allergy. By 2008, this figure he was 1.4%. In the UK, hospitalizations for severe food allergies tripled between 1998 and 2018. Also, while the prevalence of asthma, which is often caused by allergies, has leveled off in the United States, it continues to rise globally due to rising prevalence in developing countries. We are also seeing an increase in unusual allergies, such as alpha-gal syndrome, where some people who have been bitten by the lone star tick have a strong reaction to red meat.
When you see an increase in allergies, it’s hard to shake off the feeling that something is wrong. Whether it’s the outside world, our bodies, or the complex interaction between the two, something is going wrong. The question is why and what can be done about it.
Let’s start by understanding what allergies really are. Medical anthropologist Teresa McPhail tries to do just that in her book Allergies: How Our Immune Systems Respond to a Changing World. One theory is that allergic reactions evolved as a way for the body to eliminate carcinogens and toxins, from insect bites to snake bites. Even centuries ago, an extreme immune response to a potentially fatal snake bite could have been a useful way for the body to respond, one researcher told McPhail. As the world changes, our overstretched immune system is starting to look visibly out of touch with the threats we face.
It doesn’t make sense that the growing season for crops is getting longer and that people are being exposed to pollen earlier each spring. At the same time, changes in diet and lifestyle are disrupting our microbiome, possibly making our children more susceptible to food allergens. Stress can also affect our susceptibility to allergies. Stress hormones have been found to induce responses in mouse cells similar to those of allergic stressors.
You might think this is a bit inconclusive, but you’d be right. As McPhail found, pinpointing the cause of an increase in allergies is difficult, and even doctors completely agree on what an allergy is or how best to diagnose it. not. But McPhail has good reason to delve into these complex issues. In August 1996, her father and his girlfriend were driving down a New Hampshire road on their way to the beach. A bee flew through an open sedan window and stung him on the side of his neck. Soon after, her father died of anaphylactic shock.
“You’re here today because you want to know why her father died,” an allergist told McPhail during an interview. But there are no easy answers in the world of allergy research. Perhaps it was a genetic thing, the fact that her father didn’t have a potentially life-saving EpiPen, the pharmacist on duty at the drug store wasn’t allowed to inject him with adrenaline, and the fact that her father didn’t have a potentially life-saving EpiPen was not allowed. Or maybe it was the fact that his father was prone to bee stings when he was two years old. Tour of duty in Vietnam. Maybe he was just unlucky. This is a thread going through allergies. The answers we arrive at tell us all about how we see the world.
In the early 19th century, some researchers at Harvard University thought that asthma in children might be caused by “the fixation of hatred unconsciously directed at the mother.” Allergy sufferers tended to be Caucasian, urban, educated, and were often young boys and women considered prone to neuroticism and imbalance. Some of this prejudice still lurks in people who accuse allergy sufferers of being “fake” or roll their eyes when flight crew announce they won’t serve nuts on board.
Our own biases also emerge when considering solutions to the rise of allergies. Until recently, the world of allergy treatments moved at a glacial pace. Antihistamines were discovered in 1937 and have been used as a primary treatment for allergies since the 1940s, even though researchers acknowledged that antihistamines have significant drawbacks. New treatments are now emerging. In January 2020, the U.S. Food and Drug Administration approved Parforzia, the first oral immunotherapy allergy drug that works by exposing people to gradually increasing amounts of peanut allergens over time. A new “vaccine” has also been developed to immunize against bee stings, but this requires 50 injections over an extended period of time.
We need more than just new drugs. We need to change the world in which new drugs exist. Alpha-Gal syndrome is becoming more common as tick ranges expand as the world warms. The lengthening of the pollen season is a result of climate change and the introduction of plant species where they were previously absent. Money matters too. Injectable adrenaline, marketed under the brand name “EpiPen,” helps people survive severe allergy attacks, but the pen is very expensive (about $600 for two syringes) and requires you to carry an auto-injector. Many people who have to can’t afford it. Improving food labeling and manufacturing can reduce the risk of children having fatal reactions to prepackaged foods, but only if companies are part of the change.
“Allergies are ultimately about biological and social human vulnerability,” writes McPhail. It’s about our own self-created problems and spiraling risks that no one could have foreseen. How we respond is entirely in our hands.