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I have hay fever. How can I tell what I’m allergic to?

<a href="https://theconversation.com/profiles/ryan-mead-hunter-1480189">Ryan Mead-Hunter</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> When we think of spring we think of warming weather, birdsong and flowers. But for many people, this also means the return of their seasonal hay fever symptoms. Around <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/health-conditions-prevalence/latest-release">24% of Australians</a> get hay fever, with sneezing, a runny or blocked nose, and itchy or watery eyes the most common symptoms. In <a href="https://www.healthdirect.gov.au/hay-fever#:%7E:text=Key%20facts,dust%20mites%2C%20and%20animal%20fur">severe cases</a>, this may impact sleep and concentration, or be linked to increased frequency of sinus infections. The exact timing of the symptoms depends on your exposure to an allergen – the thing you’re allergic to. Those impacted by tree pollen (from plane trees or cypress pine, for example) may experience symptoms at different times of the year than those impacted by grass pollen (such as rye grass). This will also vary around the country. In Perth, for example, tree pollen (cypress pine) is generally present in August to October, while grass pollen counts tend to be highest in October to November. Other cities and regions may have longer pollen seasons, which may extend further into summer. <h2>Remind me, how does hay fever impact the body?</h2> What we know colloquially as hay fever is called allergic rhinitis. Exposure to a specific allergen (or allergens) triggers an immune response in the body. This leads to inflammation and swelling of the tissue lining the nasal passages in the nose. A range of <a href="https://www.healthdirect.gov.au/hay-fever#:%7E:text=Key%20facts,dust%20mites%2C%20and%20animal%20fur.">allergens</a> may trigger such a response: pollen (from trees, grass or weeds), dust mites, pet fur, dander, mould and some air pollutants. Those with allergies that are only present for part of the year, such as pollen, experience what we call seasonal hay fever, while those with allergies that may be present at any time, such as dust mites and pet dander, experience perennial hay fever. <h2>Getting a diagnosis</h2> Many people with hay fever self-manage their symptoms by limiting exposure to allergens and using over-the-counter <a href="https://theconversation.com/how-do-hay-fever-treatments-actually-work-and-whats-best-for-my-symptoms-213071">antihistamines and steroid nasal sprays</a>. But this may require assistance from your GP and confirmation that what you’re experiencing is hay fever. Your GP can assess your symptoms and medical history, provide a diagnosis, and help with treating and managing your symptoms. Your GP may also be able help you identify potential allergens, based on when you experience symptoms and the environments to which you’re exposed. If symptoms persist, your GP may suggest allergy testing. They may refer you to a specialist called an immunologist, to determine what particular allergen is causing your symptoms, using <a href="https://www.allergy.org.au/patients/allergy-testing/allergy-testing">skin prick tests or blood tests</a>. Tests typically involve controlled exposure to small quantities of suspected allergens. But note, there are a number of tests marketed online that are unproven and not recommended by reputable bodies. <h2>How else can I work out what I’m allergic to?</h2> For those with seasonal hay fever, resources are available to help manage exposures, based on the flowering seasons for common allergy-related species or through pollen forecasting services. The Australian Society of Clinical Immunology and Allergy provides a <a href="https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/guide-to-common-allergenic-pollen">useful pollen guide</a> for each species and when they’re most likely to cause symptoms, broken down for each state and territory. Pollen monitoring and forecasting services – such as <a href="https://www.perthpollen.com.au/">Perth Pollen</a>, <a href="https://www.melbournepollen.com.au/">Melbourne Pollen</a> and <a href="https://www.sydneypollen.com.au/">Sydney Pollen</a>, as well as for other cities – can help you plan outdoor activities. There are also associated phone apps for these services, which can give notifications when the pollen count is high. You can down load these apps (such as <a href="https://airrater.org/">AirRater</a>, Perth Pollen, Melbourne Pollen and Sydney Pollen) from your preferred app store. Apps such as <a href="https://airrater.org/">AirRater</a> also allow you to enter information about your symptoms, which can then be matched to the environmental conditions at the time (pollen count, temperature, smoke, and so on). Using statistical modelling, the app may be able to establish a link between symptoms and exposure. If a sufficiently high correlation is established, the app can send you notifications when the <a href="https://airrater.org/how-does-it-work/">exposure risk</a> is high. This may prompt you to limit outdoor activities and have any medication readily available. <hr /> Further information about managing allergic rhinitis is available from <a href="https://www.healthdirect.gov.au/hay-fever">healthdirect</a> and <a href="https://allergyfacts.org.au/__interest/allergic-rhinitis/">Allergy and Anaphylaxis Australia</a> <a href="https://theconversation.com/profiles/ryan-mead-hunter-1480189">Ryan Mead-Hunter</a>, Senior lecturer, School of Population Health, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-have-hay-fever-how-can-i-tell-what-im-allergic-to-240450">original article</a>.

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Why do I have hay fever? I didn’t have it as a child

<a href="https://theconversation.com/profiles/janet-davies-103598">Janet Davies</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/joy-lee-1480523">Joy Lee</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Hay fever (or allergic rhinitis) is a long-term inflammatory condition that’s incredibly common. It affects about <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-state-and-territory-findings/latest-release">one-quarter</a> of Australians. Symptoms vary but <a href="https://www.allergy.org.au/patients/fast-facts/hay-fever-allergic-rhinitis">can include</a> sneezing, itchy eyes and a runny or blocked nose. Hay fever can also contribute to sinus and ear infections, snoring, poor sleep and asthma, as well as lower performance at school or work. But many people didn’t have hay fever as a child, and only develop symptoms as a teenager or adult. Here’s how a combination of genetics, hormones and the environment can lead to people developing hay fever later in life. <h2>Remind me, what is hay fever?</h2> Hay fever is caused by the nose, eyes and throat coming into contact with a substance to which a person is allergic, known as an allergen. Common sources of outside allergens include airborne grass, weed or tree pollen, and mould spores. Pollen allergens can be carried indoors on clothes, and through open windows and doors. Depending on where you live, you may be exposed to a range of pollen types across the pollen season, but grass pollen is the most common trigger of hay fever. In <a href="https://www.sciencedirect.com/science/article/abs/pii/S0013935122010891?via%3Dihub">some regions</a> the grass pollen season can extend from spring well into summer and autumn. <h2>How does hay fever start?</h2> Hay fever symptoms most commonly start in adolescence or young adulthood. <a href="http://dx.doi.org/10.2147/JAA.S170285">One study</a> found 7% of children aged six had hay fever, but that grew to 44% of adults aged 24. Before anyone has hay fever symptoms, their immune system has already been “sensitised” to specific allergens, often allergens of grass pollen. Exposure to these allergens means their immune system has made a particular type of antibody (known as IgE) against them. During repeated or prolonged exposure to an allergen source such as pollen, a person’s immune system may start to respond to another part of the same allergen, or another allergen within the pollen. Over time, these new allergic sensitisations can lead to development of <a href="https://www.jacionline.org/article/S0091-6749(12)00959-1/fulltext">hay fever</a> and possibly other conditions, such as allergic asthma. <h2>Why do some people only develop hay fever as an adult?</h2> 1. Environmental factors Some people develop hay fever as an adult simply because they’ve had more time to become sensitised to specific allergens. Migration or moving to a new location can also change someone’s risk of developing hay fever. This may be due to exposure to different <a href="https://www.sciencedirect.com/science/article/abs/pii/S0048969722076884">pollens</a>, <a href="https://www.sciencedirect.com/science/article/pii/S0048969724060194?via%3Dihub">climate and weather</a>, green space <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.14177">and/or</a> air quality factors. A number of studies <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0105347">show</a> people who have migrated from low- and middle-income countries to higher-income countries may be at a higher risk of developing hay fever. This may due to local environmental conditions influencing expression of genes that regulate the immune system. 2. Hormonal factors <a href="http://dx.doi.org/10.1016/j.anai.2015.04.019">Hormonal changes</a> at puberty may also help drive the onset of hay fever. This may relate to sex hormones, such as oestrogen and progesterone, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392967/#R55">affecting</a> histamine levels, immune regulation, and the response of cells in the lining of the nose and lower airways. 3. Genetic factors <a href="https://www.nature.com/articles/ng.3985">Our genes</a> underpin <a href="https://www.ncbi.nlm.nih.gov/books/NBK542187/">our risk</a> of hay fever, and whether this and other related allergic disease persists. For instance, babies with the skin condition eczema (known as atopic dermatitis) have a <a href="https://www.annallergy.org/article/S1081-1206(21)00172-1/abstract">three times greater risk</a> of developing hay fever (and asthma) later in life. Having a food allergy in childhood is also a risk factor for developing hay fever later in life. In the case of a peanut allergy, that risk is more than <a href="https://pubmed.ncbi.nlm.nih.gov/27542726/">2.5 times greater</a>. <h2>What are the best options for treatment?</h2> Depending on where you live, avoiding allergen exposures can be difficult. But <a href="https://auspollen.edu.au/auspollensitesmap/">pollen count forecasts</a>, if available, can be useful. These can help you decide whether it’s best to stay inside to reduce your pollen exposure, or to take preventative medications. You may also find <a href="https://www.health.vic.gov.au/environmental-health/epidemic-thunderstorm-asthma-risk-forecast">alerts on thunderstorm asthma</a>, where pollens combine with specific weather conditions to trigger <a href="https://theconversation.com/we-could-see-thunderstorm-asthma-in-south-eastern-australia-this-season-heres-how-to-prepare-215793">breathing difficulties</a>. If you have mild, occasional hay fever symptoms, you can take non-drowsy antihistamines, which you can buy at the pharmacy. However, for more severe or persistent symptoms, intranasal steroid sprays, or an intranasal spray containing a steroid with antihistamine, are the <a href="https://theconversation.com/can-i-take-antihistamines-everyday-more-than-the-recommended-dose-what-if-im-pregnant-heres-what-the-research-says-228390">most effective treatments</a>. However, it is important to use these <a href="https://allergyfacts.org.au/allergic-rhinitis-treatment/">regularly and correctly</a>. Allergen immunotherapy, also known as desensitisation, is an <a href="https://onlinelibrary.wiley.com/doi/10.1111/all.13201">effective treatment</a> for people with severe hay fever symptoms that can reduce the need for medication and avoiding allergens. However, it involves a longer treatment course (about three years), usually with the supervision of an allergy or immunology specialist. <h2>When should people see their doctor?</h2> It is important to treat hay fever, because symptoms can significantly affect a <a href="https://bmjopen.bmj.com/content/10/11/e038870.long">person’s quality of life</a>. A GP can: <ul> <li> recommend treatments for hay fever and can guide you to use them correctly </li> <li> organise blood tests to confirm which allergen sensitisations (if any) are present, and whether these correlate with your symptoms </li> <li> screen for asthma, which commonly exists with hay fever, and may require other treatments </li> <li> arrange referrals to allergy or immunology specialists, if needed, for other tests, such as allergen skin prick testing, or to consider <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-immunotherapy">allergen immunotherapy</a> if symptoms are severe. </li> </ul> <hr /> More information about hay fever is available from the <a href="https://www.allergy.org.au/patients/fast-facts/hay-fever-allergic-rhinitis">Australasian Society of Clinical Immunology and Allergy</a> and <a href="https://allergyfacts.org.au/">Allergy & Anaphylaxis Australia</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239409/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/janet-davies-103598">Janet Davies</a>, Respiratory Allergy Stream Co-chair, National Allergy Centre of Excellence; Professor and Head, Allergy Research Group, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/joy-lee-1480523">Joy Lee</a>, Respiratory Allergy Stream member, National Allergy Centre of Excellence; Associate Professor, School of Translational Medicine, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-have-hay-fever-i-didnt-have-it-as-a-child-239409">original article</a>.

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I have a stuffy nose, how can I tell if it’s hay fever, COVID or something else?

<a href="https://theconversation.com/profiles/deryn-thompson-1449312">Deryn Thompson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Hay fever (also called allergic rhinitis) affects <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-state-and-territory-findings/latest-release">24%</a> of Australians. <a href="https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/allergic-rhinitis-or-hay-fever">Symptoms</a> include sneezing, a runny nose (which may feel blocked or stuffy) and itchy eyes. People can also experience an itchy nose, throat or ears. But COVID is still <a href="https://theconversation.com/xec-is-now-in-australia-heres-what-we-know-about-this-hybrid-covid-variant-239292">spreading</a>, and <a href="https://theconversation.com/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">other viruses</a> can cause cold-like symptoms. So how do you know which one you’ve got? <h2>Remind me, how does hay fever cause symptoms?</h2> <a href="https://www.allergy.org.au/hp/papers/allergic-rhinitis-clinical-update">Hay fever</a> happens when a person has become “sensitised” to an allergen trigger. This means a person’s body is always primed to react to this trigger. Triggers can include allergens in the air (such as pollen from trees, grasses and flowers), mould spores, animals or house dust mites which mostly live in people’s mattresses and bedding, and feed on shed skin. When the body is exposed to the trigger, it produces IgE (immunoglobulin E) antibodies. These cause the release of many of the body’s own chemicals, including histamine, which result in hay fever symptoms. People who have asthma may find their asthma symptoms (cough, wheeze, tight chest or trouble breathing) worsen when exposed to airborne allergens. Spring and sometimes into summer can be the worst time for people with grass, tree or flower allergies. However, animal and house dust mite symptoms usually happen year-round. <h2>What else might be causing my symptoms?</h2> Hay fever does not cause a fever, sore throat, muscle aches and pains, weakness, loss of taste or smell, nor does it cause you to cough up mucus. These symptoms are likely to be caused by a virus, such as COVID, influenza, respiratory syncytial virus (RSV) or a “cold” (often caused by rhinoviruses). These conditions can occur all year round, with some overlap of symptoms: <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=582&fit=crop&dpr=1 600w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=582&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=582&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=731&fit=crop&dpr=1 754w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=731&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=731&fit=crop&dpr=3 2262w" alt="" /></a><figcaption><a class="source" href="https://theconversation.com/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">Natasha Yates/The Conversation</a></figcaption></figure> COVID still <a href="https://theconversation.com/xec-is-now-in-australia-heres-what-we-know-about-this-hybrid-covid-variant-239292">surrounds</a> us. <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/health+statistics/surveillance+of+notifiable+conditions/respiratory+infections+dashboard">RSV and influenza</a> rates appear higher than before the COVID pandemic, but it may be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10888990/#:%7E:text=Increases%20in%20RSV%20patient%20volume,with%20an%20RSV%20diagnosis%20occurred">due to more testing</a>. So if you have a fever, sore throat, muscle aches/pains, weakness, fatigue, or are coughing up mucus, stay home and avoid mixing with others to limit transmission. People with COVID symptoms can take a rapid antigen test (<a href="https://www.health.gov.au/sites/default/files/2024-04/coronavirus-covid-19-rapid-antigen-tests.pdf">RAT</a>), ideally when <a href="https://www.cochrane.org/CD013705/INFECTN_how-accurate-are-rapid-antigen-tests-diagnosing-covid-19">symptoms start</a>, then isolate until symptoms disappear. <a href="https://www.mja.com.au/journal/2023/219/11/covid-19-rapid-antigen-tests-approved-self-testing-australia-published">One negative RAT alone</a> can’t rule out COVID if symptoms are still present, so test again 24–48 hours after your initial test if symptoms persist. You can now test yourself for COVID, RSV and influenza in a <a href="https://www.tga.gov.au/sites/default/files/2024-02/covid-19-rapid-antigen-self-tests-are-approved-australia-ifu-406813.PDF">combined RAT</a>. But again, a negative test doesn’t rule out the virus. If your symptoms continue, <a href="https://www.tga.gov.au/sites/default/files/2024-02/covid-19-rapid-antigen-self-tests-are-approved-australia-ifu-406813.PDF">test again</a> 24–48 hours after the previous test. <h2>If it’s hay fever, how do I treat it?</h2> Treatment involves blocking the body’s histamine release, by taking antihistamine medication which helps reduce the symptoms. Doctors, nurse practitioners and pharmacists can develop a <a href="https://www.allergy.org.au/images/pc/ASCIA_Allergic_Rhinitis_Treatment_Plan_2024.pdf">hay fever care plan</a>. This may include using a nasal spray containing a topical corticosteroid to help reduce the swelling inside the nose, which causes stuffiness or blockage. Nasal sprays need to delivered <a href="https://allergyfacts.org.au/are-you-using-your-nasal-spray-correctly/">using correct technique</a> and used over several weeks to work properly. Often these sprays can also help lessen the itchy eyes of hay fever. Drying bed linen and pyjamas inside during spring can <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-minimisation">lessen symptoms</a>, as can putting a <a href="https://www.nps.org.au/consumers/managing-hay-fever">smear of Vaseline</a> in the nostrils when going outside. Pollen sticks to the Vaseline, and gently blowing your nose later removes it. People with asthma should also have an <a href="https://asthma.org.au/manage-asthma/asthma-action-plan/">asthma plan</a>, created by their doctor or nurse practitioner, explaining how to adjust their asthma reliever and preventer medications in hay fever seasons or on allergen exposure. People with asthma also need to be <a href="https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/factsheets/thunderstorm-asthma">alert for thunderstorms</a>, where pollens can burst into tinier particles, be inhaled deeper in the lungs and cause a severe asthma attack, and even death. <h2>What if it’s COVID, RSV or the flu?</h2> Australians aged 70 and over and others with underlying health conditions who test positive for COVID are <a href="https://www.healthdirect.gov.au/covid-19/medications#at-home">eligible for antivirals</a> to reduce their chance of severe illness. Most other people with COVID, RSV and influenza will recover at home with rest, fluids and paracetamol to relieve symptoms. However some groups are at greater risk of serious illness and may require additional treatment or hospitalisation. For <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/respiratory-syncytial-virus.aspx">RSV</a>, this includes premature infants, babies 12 months and younger, children under two who have other medical conditions, adults over 75, people with heart and lung conditions, or health conditions that lessens the immune system response. For influenza, people at <a href="https://www.health.nsw.gov.au/Infectious/Influenza/Pages/at-risk.aspx">higher risk</a> of severe illness are pregnant women, Aboriginal people, people under five or over 65 years, or people with long-term medical conditions, such as kidney, heart, lung or liver disease, diabetes and decreased immunity. If you’re concerned about severe symptoms of COVID, RSV or influenza, consult your doctor or call 000 in an emergency. If your symptoms are mild but persist, and you’re not sure what’s causing them, book an appointment with your doctor or nurse practitioner. Although hay fever season is here, we need to avoid spreading other serious infectious. For more information, you can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria); use the <a href="https://www.healthdirect.gov.au/symptom-checker">online Symptom Checker</a>; or visit <a href="http://healthdirect.gov.au/">healthdirect.gov.au</a> or the <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-minimisation">Australian Society of Clinical Immunology and Allergy</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/240453/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/deryn-thompson-1449312">Deryn Thompson</a>, Eczema and Allergy Nurse; Lecturer, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-have-a-stuffy-nose-how-can-i-tell-if-its-hay-fever-covid-or-something-else-240453">original article</a>.

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Parents under fire for taking their sick toddler on a long-haul flight

A couple has come under fire after documenting their experience online of boarding a long-haul flight with their toddler, despite the child being sick. Alina and her husband were excited to go on their long-awaited holiday to Thailand with their one-year-old son in tow, taking off on their first big family trip. However, shortly before they were set to take off, their child developed a raging fever, and they decided to go on the trip anyway. Taking the experience to social media, Alina said her son’s temperature soared to around 40 degrees, with their little boy’s condition escalating so rapidly that the parents were considering calling off their entire trip. “My husband and I even wanted to cancel the flight,” she confessed in the video, which has received around 1.4 million views. However, after realising they would be out of pocket by several thousands of dollars if they cancelled the trip at such short notice, they decided to take the risk and board the plane. “Our tickets would have been wasted, and the trip that cost us $3,000 would have been wasted,” the mum wrote. "One plus of this flight was that the flight was at night, and the child could sleep and recover.” In the clip, the parents were seen walking their son around the plane, cradling the sick toddler as he cried uncontrollably. Luckily, the parents “managed to bring down the temperature”, but they weren’t convinced their son would keep quiet for the rest of the trip. “We were so worried about how the baby would feel on an eight-hour flight,” she continued, walking the baby up and down the corridors of the airport, trying to calm him down. As they tried to settle the child, they realised that their hopes that he would sleep the whole way were misguided. “The flight turned out to be difficult,” Alina confessed. “The baby kept waking and crying.” In the middle of the night, their son’s fever returned, which forced the parents to “bring the temperature down again” and left them “very worried” about their son’s health. Their baby’s fever took a toll on the parents as well, who complained of feeling “squeezed like a lemon” while trying to keep his temperature down, as Alina recalled, “We took turns looking after the baby so each of us could sleep.” In a later video, the parents defended their choice to take their son on the flight despite his intense fever and blamed it on his teething, not sickness. “Our baby wasn’t sick, he was teething, and that’s why he had a fever,” she said. “If our child had been sick, we would have cancelled everything … I consider myself a wonderful mother.” Despite the mother's clarification of her son's fever, the parents were slammed for even considering taking a sick child on such a long flight. “It’s OK, don’t worry about making anyone else on that flight sick,” a sarcastic comment read. “This is so tremendously selfish, you are appalling for doing this to him and others.” “I was in the same situation,” another parent said. “I lost all bookings, but who cares, my daughter comes first always and forever, no matter the amount of money!” “Trips come and go; your baby’s health is priceless!” read another comment. “Forty degrees is a hospital admission! Not a flight to Thailand!” However, not everyone was as judgmental, with many parents extending their sympathies to the first-time parents, as one person wrote, “You know what’s best for your baby. Everyone will say things. But only you will know when you are in that situation.” “Everyone is a first-time parent,” another defended. “This was a lesson learned. A baby’s health is of utmost importance. No holiday is more important than that. I hope he is OK now.” Image credits: TikTok

Travel Trouble

Heading to Bali or somewhere tropical these holidays? Here’s what you need to know about dengue fever

<a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> If you’re looking to escape the Australian winter for your next holiday, don’t forget where there’s warmth, there will also be mosquitoes. In turn, tropical destinations can be hot spots of mosquito-borne diseases such as dengue. In fact, Australian health authorities have warned travellers to Bali <a href="https://www.health.wa.gov.au/Media-releases/2024/May/Dengue-fever-warning-for-Western-Australian-travellers">to be aware</a> of the risk of dengue, with cases surging in the region. So here’s how to protect yourself and your family on holidays. <h2>What is dengue?</h2> <a href="https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue">Dengue virus infection</a> (commonly known as dengue fever, or just dengue) is caused by viruses spread by the bite of a mosquito. The mosquito species that typically transmit dengue are Aedes aegypti and Aedes albopictus. There are four strains of dengue virus. Each has the potential to cause illness that can range from <a href="https://www.cdc.gov/dengue/signs-symptoms/index.html">mild to severe and potentially life threatening</a>. Symptoms <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/dengue.aspx">typically include</a> rash, fever, chills, headache, muscle and joint pain, and fatigue. People also often report abdominal pain, nausea and vomiting. While infection with just one of these viruses can make you sick, subsequent exposure to other strains can have more <a href="https://theconversation.com/explainer-what-are-antibodies-and-why-are-viruses-like-dengue-worse-the-second-time-68227">serious health implications</a>. In these cases, symptoms can also include the presence of blood in vomit, bleeding gums and breathing difficulties. Dengue infection must be confirmed via a blood test, but there are <a href="https://www.healthdirect.gov.au/dengue-fever">no specific treatments</a>. Most people will recover on their own however <a href="https://www.cdc.gov/dengue/treatment/index.html">staying hydrated is crucial</a> and pain relief can help with symptoms. If more severe illness occurs, seek urgent medical care. <h2>Are travellers at risk?</h2> The disease is now endemic in around 100 countries and <a href="https://www.cdc.gov/dengue/areas-with-risk/index.html">an estimated 4 billion people</a> are considered at risk. Asian countries represent <a href="https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue">around 70%</a> of the global disease burden. Even <a href="https://theconversation.com/how-the-paris-olympics-could-become-a-super-spreader-event-for-dengue-231853">Europe is at risk</a>. <a href="https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498">One of the worst years</a> on record was 2023, but the burden of dengue continues to grow. In the first four months of 2024, Indonesia reported <a href="https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON518">three times as many cases</a> of dengue compared to the same period in 2023. Dengue is not a new risk to Australian travellers. Before COVID disrupted international travel, the number of Australians returning from tropical destinations with dengue <a href="https://europepmc.org/article/med/23692160">was steadily increasing</a>. For example, between 2010 and 2016, there was an average <a href="https://www.mdpi.com/2414-6366/3/1/9">annual increase of 22%</a> of travellers returning to Victoria with dengue. Almost half of these people contracted the illness in Indonesia. Bali is well documented as posing <a href="https://academic.oup.com/jtm/article/25/1/tay061/5065180?login=false">a risk of dengue</a> to travellers. International travel restrictions due to COVID <a href="https://academic.oup.com/jtm/article/31/2/taae014/7577676">abruptly stopped this trend</a>. But now Australians are again embracing international travel, <a href="https://www.dailymail.co.uk/news/article-13303747/Worrying-reason-Aussie-travellers-Bali-coming-sick.html">cases are rising once more</a>. Bali isn’t the only destination with <a href="https://www.washingtonpost.com/health/2024/06/30/dengue-puerto-rico-mosquito-climate-change/">a surge in dengue</a>, but we know it’s a popular holiday destination for Australian travellers. There’s little doubt plenty of families will be heading to Bali these school holidays. <h2>How about the risk in Australia?</h2> Not all mosquitoes can spread dengue viruses. This is why the risk is different in Bali and other tropical regions compared to Australia. Although there are more than 40 Australian mosquito species known or suspected to be transmitting local pathogens, such as <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005070">Ross River virus</a>, Australia is generally free of local dengue risk due to the limited spread of Aedes aegypti and Aedes albopictus. While Aedes aegypti is found in <a href="https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/diseases/mosquito-borne/dengue/virus-fever">parts of Queensland</a>, thanks to interventions by the <a href="https://www.worldmosquitoprogram.org/en/global-progress/australia/cairns-and-surrounds">World Mosquito Program</a> and local authorities dengue risk is low. These interventions include the release of laboratory-bred mosquitoes that prevent mosquitoes in the environment <a href="https://www.worldmosquitoprogram.org/en/work/wolbachia-method">spreading viruses</a>, as well as <a href="https://www.sciencedirect.com/science/article/pii/S2221169115309096">community education</a>. But <a href="https://theconversation.com/after-decades-away-dengue-returns-to-central-queensland-117821">local cases</a> occasionally occur. Aedes albopictus is not currently found <a href="https://theconversation.com/how-we-kept-disease-spreading-asian-tiger-mozzies-away-from-the-australian-mainland-72873">on the Australian mainland</a> but is present in the islands of the Torres Strait. A dengue outbreak <a href="https://www.torres-cape.health.qld.gov.au/about-us/news/further-cases-of-dengue-fever-on-mer">has occurred</a> there this year. <h2>Keep mozzies away during the day, not just at night</h2> While there is a vaccine available, it’s not recommended for <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50471">short-term travellers</a>. There are <a href="https://www.health.gov.au/resources/publications/atagi-advice-on-the-use-of-dengvaxiar-for-australians">strict eligibility criteria</a> for its use, so speak to a health professional for advice. For the majority of travellers, preventing mosquito bites is the only way to prevent disease. But there are differences in the behaviour of dengue mosquitoes that mean the normal measures to avoid mosquito bites may not be as effective. During the Australian summer, mosquitoes found in local wetlands can be <a href="https://theconversation.com/the-worst-year-for-mosquitoes-ever-heres-how-we-find-out-68433">incredibly abundant</a>. We tend to need to reach for the repellent and cover up to stop bites as soon as the sun starts going down. Aedes aegypti and Aedes albopictus <a href="https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0010818">can aggressively bite people</a> but they’re not as abundant as the swarms of summer mosquitoes back home. They also bite during the day, not just at night. So for those travelling to Bali or other areas at risk of dengue, putting insect repellent on <a href="https://www.smartraveller.gov.au/news-and-updates/global-dengue-fever-outbreaks">throughout the day</a> is recommended. <h2>What to pack for protection</h2> If you’re staying in a major resort, there’s likely to be a mosquito control program in place. This may include minimising available water for mosquito breeding in combination with insecticide use. Mosquitoes are also less likely to be an issue in air-conditioned accommodation. But if you’re planning to spend time out and about visiting local villages, markets, or in nature, it’s best to protect against bites. Light coloured and <a href="https://www.health.wa.gov.au/Media-releases/2024/May/Dengue-fever-warning-for-Western-Australian-travellers">loose fitting clothing</a> will help stop mosquito bites (and help keep you cool). Covered shoes can help too – dengue mosquitoes <a href="https://www.npr.org/sections/goatsandsoda/2016/02/22/465594861/why-zika-spreading-mosquitoes-love-ankles">love smelly feet</a>. Finally, it’s best to take some insect repellent with you. There may not be any available at your destination, and formulations on sale might not have been through the same thorough testing as products <a href="https://www.apvma.gov.au/">approved in Australia</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/233670/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, Clinical Associate Professor and Principal Hospital Scientist, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/heading-to-bali-or-somewhere-tropical-these-holidays-heres-what-you-need-to-know-about-dengue-fever-233670">original article</a>.

Travel Tips

Hello hay fever – why pressing under your nose could stop a sneeze but why you shouldn’t

<a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/jessica-nealon-1481995">Jessica Nealon</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> If you have <a href="https://theconversation.com/sniffles-sneezing-and-cough-how-to-tell-if-its-a-simple-allergy-rather-than-the-virus-139657">hay fever</a>, you’ve probably been sneezing a lot lately. Sneezing is universal but also quite unique to each of us. It is a protective reflex action outside our conscious control, to remove irritants from inside our nose. The <a href="https://www.healthline.com/health/holding-in-a-sneeze">pressure in the airways</a> during a sneeze is more than 30 times greater than heavy breathing during exercise. Estimates of how fast a sneeze travels range from <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0059970">5 metres a second</a> to <a href="https://pubmed.ncbi.nlm.nih.gov/19617285/">more than 150 kilometres per hour</a>. You can sometimes stop a sneeze by holding your nose or pressing underneath it. This is related to the <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/gate-control-theory">gate control theory of pain</a> and the idea you can change neural responses with external stimulation. But given the velocity of a sneeze, it might not be a good idea to stop it after it has started. <h2>An involuntary reflex</h2> A sneeze is initiated when sensory nerves in our nose are <a href="https://journals.sagepub.com/doi/10.1177/1753465809340571?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">stimulated by an irritant</a> such as allergens, viruses, bacteria or even fluid. The sensory nerves then carry this irritant information to the brain. When a threshold amount of irritant signals reach the brain, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077498/">sneeze reflex is triggered</a>. A sneeze first involves a deep intake of breath and a <a href="https://www.scientificamerican.com/article/why-do-we-sneeze/">build-up of pressure inside the airways</a>. This is then followed by <a href="https://www.healthline.com/health/back-pain/back-pain-when-sneezing#sneezing-as-a-cause">contraction of the diaphragm</a> and rib muscles, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077498/">reflex closing of the eyes</a> and a strong exhalation. These are the “ah” and the “tchoo” phases of a sneeze. On the exhalation of a sneeze, your tongue is lifted to the roof of your mouth. This <a href="https://www.atsjournals.org/doi/10.1164/rccm.202004-1263PP">closes off the back of the mouth</a> so the air is forced mostly through your nose. The air expelled through the nose flushes out the irritants that caused the sneeze. The “tch” sound of a sneeze is the reflexive touching of the tongue to the roof of your mouth. <h2>The trigeminal nerves</h2> The trigeminal nerves are the <a href="https://my.clevelandclinic.org/health/body/21998-cranial-nerves">largest of our 12 pairs of cranial nerves</a> and the largest sensory nerves in the body. The left and right trigeminal nerves carry sensory information from the face to the brain. This includes touch, pain and irritation sensory information from the facial skin and from inside the nose and mouth. Within each trigeminal nerve are thousands of individual nerve branches that each carry a <a href="https://journals.sagepub.com/doi/full/10.1177/1744806920901890">specific type of sensory information</a>. <h2>Sensory nerves communicate in the spinal cord</h2> <figure class="align-right zoomable"><a href="https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=631&fit=crop&dpr=1 600w, https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=631&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=631&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=792&fit=crop&dpr=1 754w, https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=792&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/555217/original/file-20231023-25-1lg691.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=792&fit=crop&dpr=3 2262w" alt="drawing of face with nerves labelled" /></a><figcaption>Henry Gray’s anatomical illustration of the trigeminal nerve. <a class="source" href="https://upload.wikimedia.org/wikipedia/commons/8/83/Gray778.png">Gray's Anatomy/Wikimedia Commons</a></figcaption></figure> Sensory nerves travel to the brain via the spinal cord. The sensory nerves that carry pain and irritant signals are narrow, whereas those that carry touch information are wider and faster. In the spinal cord, these nerves communicate with each other via interneurons before sending their message to the brain. The interneurons are the “gates” of the <a href="https://www.physio-pedia.com/Gate_Control_Theory_of_Pain#:%7E:text=and%20trigger%20%E2%80%A2-,Introduction,be%20let%20through%20or%20restricted.">gate control theory of pain</a>. A nerve carrying a pain signal tells the interneuron to “open the gate” for the pain signal to reach the brain. But the larger nerves that carry touch information can “close the gate” and block the pain messages getting to the brain. This is why rubbing an injured area can reduce the sensation of pain. <a href="https://www.frontiersin.org/articles/10.3389/fphys.2018.01037/full">One study</a> showed stimulating the trigeminal nerves by moving the jaw reduced tooth pain. We can observe this in action when babies instinctively <a href="https://chaimommas.com/2013/11/05/what-to-expect-with-teething-and-tooth-development-chart/">bite on things or pull their ear</a> when they are teething. These actions can stimulate the trigeminal touch nerves and reduce pain signals via the gate control mechanism. <h2>So does putting your finger under your nose stop a sneeze?</h2> There are <a href="https://www.healthline.com/health/how-to-stop-sneezing">many suggestions</a> of how to stop a sneeze. These include pulling your ear, putting your tongue to the roof of your mouth or the back of your teeth, touching your nose, or even sticking your finger in your nose. All of these stimulate the trigeminal touch nerves with the goal of telling the interneurons to “close the gate”. This can block the irritant signals from reaching the brain and triggering a sneeze. <h2>But should you stop a sneeze?</h2> What if an irritant in your nose has triggered a sneeze response, but you’re somewhere it might be considered inappropriate to sneeze. Should you stop it? Closing your mouth or nose during a sneeze increases the pressure in the airways <a href="https://pubmed.ncbi.nlm.nih.gov/26914240/">five to 20 times more than a normal sneeze</a>. With no escape, this <a href="https://journals.sagepub.com/doi/10.1177/1945892418823147#:%7E:text=The%20high%20Valsalva%20pressure%20generated,to%20all%20people%20who%20sneeze.">pressure has to be transmitted elsewhere</a> and that can damage your eyes, ears or blood vessels. Though the risk is low, brain aneurysm, ruptured throat and collapsed lung have been <a href="https://www.healthline.com/health/holding-in-a-sneeze#can-holding-a-sneeze-kill-you">reported</a>. So it’s probably best to try and prevent the sneeze reflex by treating allergies or addressing irritants. Failing that, embrace your personal sneeze style and <a href="https://theconversation.com/handkerchief-or-tissue-which-ones-better-for-our-health-and-the-planet-213065">sneeze into a tissue</a>. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215265/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/jessica-nealon-1481995">Jessica Nealon</a>, Lecturer in Medical Sciences (Neuroscience), <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/hello-hay-fever-why-pressing-under-your-nose-could-stop-a-sneeze-but-why-you-shouldnt-215265">original article</a>.

Body

How do hay fever treatments actually work? And what’s best for my symptoms?

<a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Spring has sprung and many people are welcoming longer days and more time outdoors. But for <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/allergic-rhinitis-hay-fever/contents/allergic-rhinitis">almost one in five Australians</a>, spring also brings the misery of watery, itchy red eyes, a runny, congested nose, and sneezing. Hay fever (also known as allergic rhinitis) is caused when an allergen enters the nose or eyes. Allergens are harmless airborne substances the body has incorrectly identified as harmful. This triggers an immune response, which leads to the release of inflammatory chemicals (mediators) – one of which is histamine. Allergens that trigger hay fever differ from person to person. Common seasonal allergens include tree, grass and weed pollens (year-round allergens include dust mites, mould and pet dander). It’s now <a href="https://www.sciencedirect.com/science/article/pii/S132602002302191X">pollen season</a> in many parts of Australia, with pollen counts at their highest and hay fever cases surging. So what medicines can prevent or reduce hay fever symptoms, and how do they work? <h2>Antihistamines</h2> Knowing the release of histamine is a cause of hay fever symptoms, it’s unsurprising that anti-histamines are one of the most frequently recommended medicines to treat hay fever. Antihistamines block histamine from binding to histamine receptors in the body and having an effect, reducing symptoms. In Australia, we broadly have two types. The older sedating (introduced in the <a href="https://www.tga.gov.au/news/safety-alerts/first-generation-antihistamines-winter-warning">1940s</a>) and newer, less-sedating (introduced in the 1980s) antihistamines. Less-sedating antihistamines used to treat allergic rhinitis include bilastine (Allertine), cetirizine (Zyrtec), loratadine (Claratyne) and fexofenadine (Telfast). Bilastine, which came onto the Australian market only last year, is only available from a pharmacy, on recommendation from a pharmacist. The others have been around longer and are available at supermarkets and in larger quantities from pharmacies. Cetirizine is the <a href="https://www.tga.gov.au/resources/publication/scheduling-decisions-interim/scheduling-delegates-interim-decisions-and-invitation-further-comment-accsacms-november-2016/35-cetirizine-hydrochloride#:%7E:text=Risks%20of%20cetirizine%20hydrochloride%20use,significant%20at%20the%20proposed%20doses.">most likely</a> (of the less-sedating antihistamines) to cause sedation. The older sedating antihistamines (such as promethazine) cross the blood-brain barrier, causing drowsiness and even brain fog the next day. They have lots of side effects and potential drug interactions, and as such have little place in the management of hay fever. The newer less-sedating antihistamines are <a href="https://australianprescriber.tg.org.au/articles/antihistamines-and-allergy.html#:%7E:text=Less%20sedating%20antihistamines%20are%20equally,an%20ongoing%20good%20safety%20profile">equally effective</a> as the older sedating ones. Antihistamines are usually taken orally (as a tablet or solution) but there are also topical preparations such as nasal sprays (azelastine) and eye drops. Antihistamine nasal sprays have <a href="https://www.sciencedirect.com/science/article/abs/pii/S108112061000743X">equal to or better efficacy</a> than oral antihistamines. The individual response to antihistamines varies widely. For this reason, you may need to trial several different types of antihistamines to see which one works best for you. Increasing the dose of an antihistamine, or combining an oral and topical antihistamine, does not provide any additional benefit. Paying extra for a brand name doesn’t offer any more or less effect than the generic (both have the same active ingredient and are <a href="https://www.tga.gov.au/news/news/generic-prescription-medicines-fact-sheet">bioequivalent</a>, which means they have the same outcomes for patients). <h2>Steroid nasal sprays</h2> If your symptoms don’t improve from antihistamines alone, a nasal spray containing a corticosteroid is often recommended. Corticosteroids prevent the release of several key chemicals that cause inflammation. How they work is complex: in part, corticosteroids “turn off” the production of late phase inflammatory mediators (cytokines and chemokines). This reduces the future release of more inflammatory mediators, which reduces inflammation. Corticosteroids and antihistamines have different mechanisms of action. Research shows corticosteroid nasal sprays are <a href="https://journals.sagepub.com/doi/full/10.2500/ajra.2016.30.4397">more effective</a> than antihistamines in controlling an itchy, runny, congested nose. But when instilled into the nose, corticosteroids <a href="https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1016/j.otohns.2007.10.027">also reduce</a> the eye symptoms of hay fever. There are also nasal sprays that contain both an antihistamine and corticosteroid. While there are a range of corticosteroid nasal sprays containing different active ingredients, a large study published this year shows they are all <a href="https://www.frontiersin.org/articles/10.3389/fphar.2023.1184552/full">about as effective as each other</a>, and work best when they have been taken for several days. <h2>Sodium cromoglycate</h2> Another medicine used to treat hay fever symptoms is sodium cromoglycate, which is available as an eye drop and over-the-counter in pharmacies. This medicine is known as a mast cell stabiliser. As the name suggests, it stabilises or prevents mast cells from breaking down. When mast cells break down, they release histamine and other chemicals that cause inflammation. This eye drop is both a preventative and treatment medicine, usually used before allergies strike. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375451/">Evidence shows</a> it is effective at reducing the symptoms of allergic conjunctivitis (eye inflammation from allergies). <h2>Decongestants</h2> Decongestants constrict blood vessels. They can be taken orally, administered as a nasal spray, or instilled into the eyes. When administered into the eyes it will reduce redness, and when administered into the nose, it will stop it from running. However, decongestants should be used for a short duration only and are not for long term use. In fact, if a nasal spray decongestant is used for more than five days, you can experience something called “rebound congestion”: a severe stuffy nose. <h2>Saline</h2> Saline (saltwater) nasal sprays or irrigation products are also available to flush out the allergens and provide hay fever relief. While there are not many studies in the area, there is evidence that saline irrigation <a href="https://www.cochrane.org/CD012597/ENT_nasal-saline-allergic-rhinitis#:%7E:text=Saline%20irrigation%20may%20reduce%20patient,any%20outcomes%20beyond%20three%20months">may reduce hay fever symptoms</a>. Saline is safe and is not associated with adverse effects. If you’re suffering from hay fever symptoms and unsure what to try, talk to your prescriber or pharmacist, who can guide you through the options and identify the best one for your symptoms, medical conditions and medicines. Allergen immunotherapy (or allergen shots) is another option hay fever sufferers <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-immunotherapy-faqs">may discuss</a> with their doctors. However it’s not a quick fix, with therapy taking three to five years.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/213071/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-hay-fever-treatments-actually-work-and-whats-best-for-my-symptoms-213071">original article</a>.

Body

John Travolta’s iconic suit snatches a sweaty sum at auction

John Travolta’s sweat stains have hit the market, snagging a staggering sum, alongside the iconic Saturday Night Fever white three-piece suit. The look rose to international fame when Travolta - as Tony Manero - took to the dancefloor in the 1977 classic, joining Stephanie Mangano for an intense disco dance competition. But it was the film’s promotional imagery that truly immortalised the suit - despite popular, yet incorrect, belief that Travolta had flaunted it during his solo ‘Night Fever’ dance. In posters - as well as on VCR, DVD, and CD covers - Travolta can be seen with his right arm in the air, on a dancefloor, white polyester front and centre. As Costume designer Patrizia von Brandenstein explained to the New York Post, they were looking for “a white, three-piece suit: dressy, inexpensive and polyester. There was a producer who thought a black suit would be more elegant. But heroes wear white; it’s as simple as that. “The pastel suits were nice and pretty, but John’s character is very much a hero. Plus, it needed to be something that a boy who works in a paint store would be able to afford. I think the suit sold for $150 or $200.” Initially purchased off the rack in Brooklyn for $100, the jacket - with matching waistcoat, flared trousers, black shirt, and Travolta’s 45-year-old sweat stains - was expected to fetch up to $250,000 USD (~$374,000 AUD) when it went under the hammer at Los Angeles’ Julien’s Auctions. Despite its distinct lack of a thorough cleaning, the suit did find a new home, with a buyer dishing out a total of approximately $388,692 AUD to call it their own. As a spokesperson for the auction house explained, “This suit is considered to be one of the most iconic costumes in cinema history. It is one of only two known to exist that was used during production. It has never been exhibited or sold at auction before. “It has become emblematic of not only the film but of the whole disco era.” The suit in question was actually one of a few purchased by the film’s costume designer - two were used on set, rotated in and out while the other dried, and another was used for promotional material - and was given to Julien’s Auctions by an anonymous collector who had received it from Saturday Night Fever’s director, John Badham in 1991. As for why the iconic outfit was being sold in its unique condition, the executive director of Julien’s Auctions had a simple explanation. “The sweat is how you know it’s authentic,” Martin J Nolan told The Guardian. “It was incredibly hot during filming, so you can still see the sweat marks around his waist. We never wash memorabilia. People want the stains, the DNA, particularly when a suit like this one hasn’t been auctioned before.” Images: Getty

Movies

Sneezing with hay fever? Native plants aren’t usually the culprit

Hay fever is a downside of springtime around the world. As temperatures increase, plant growth resumes and flowers start appearing. But while native flowering plants such as wattle often get the blame when the seasonal sneezes strike, hay fever in Australia is typically caused by introduced plant species often pollinated by the wind. <h2>A closer look at pollen</h2> Pollen grains are the tiny reproductive structures that move genetic material between flower parts, individual flowers on the same plant or a nearby member of the same species. They are typically lightweight structures easily carried on wind currents or are sticky and picked up in clumps on the feathers of a honeyeater or the fur of a fruit bat or possum. Hay fever is when the human immune system overreacts to allergens in the air. It is not only caused by pollen grains but fungal spores, non-flowering plant spores, mites and even pet hair. The classic symptoms of hay fever are sneezing, runny noses, red, itchy, and watery eyes, swelling around the eyes and scratchy ears and throat. The problem with pollen grains is when they land on the skin around our eyes, in our nose and mouth, the proteins found in the wall of these tiny structures leak out and are recognised as foreign by the body and trigger a reaction from the immune system. <h2>So what plants are the worst culprits for causing hay fever?</h2> Grasses, trees, and herbaceous weeds such as plantain are the main problem species as their pollen is usually scattered by wind. In Australia, the main grass offenders are exotic species including rye grass and couch grass (a commonly used lawn species). Weed species that cause hay fever problems include introduced ragweed, Paterson’s curse, parthenium weed and plantain. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102629/" target="_blank" rel="noopener">problematic tree species</a> are also exotic in origin and include liquid amber, Chinese elm, maple, cypress, ash, birch, poplar, and plane trees. Although there are some native plants that have wind-spread pollen such as she-oaks and white cypress pine, and which can induce hay fever, these species are exceptional in the Australian flora. Many Australian plants are not wind pollinated and <a href="https://blog.publish.csiro.au/austpollinatorweek/" target="_blank" rel="noopener">use animals</a> to move their clumped pollen around. For example, yellow-coloured flowers such as wattles and peas are pollinated by insect such as bees. Red- and orange-coloured flowers are usually visited by birds such as honeyeaters. Large, dull-coloured flowers with copious nectar (the reward for pollination) are visited by nocturnal mammals including bats and possums. Obviously Australian plant pollen can still potentially cause the immune system to overreact, but these structures are less likely to reach the mucous membranes of humans. <h2>What can we do to prevent hay fever attacks at this time of the year?</h2> With all of this in mind, here are some strategies to prevent the affects of hay fever: <ol> <li>stay inside and keep the house closed up on warm, windy days when more pollen is in the air</li> <li>if you must go outside, wear sunglasses and a face mask</li> <li>when you return indoors gently rinse (and don’t rub) your eyes with running water, change your clothes and shower to remove pollen grains from hair and skin</li> <li>try to avoid mowing the lawn in spring particularly when grasses are in flower (the multi-pronged spiked flowers of couch grass are distinctive)</li> <li>when working in the garden, wear gloves and facial coverings particularly when handling flowers consider converting your garden to a native one. Grevilleas are a great alternative to rose bushes. Coastal rosemary are a fabulous native replacement for lavender. Why not replace your liquid amber tree with a fast growing, evergreen and low-allergenic lilly pilly tree?</li> </ol> <h2>If you do suffer a hay fever attack</h2> Sometimes even with our best efforts, or if it’s not always possible to stay at home, hay fever can still creep up on us. If this happens: <ul> <li>antihistamines will reduce sneezing and itching symptoms</li> <li>corticosteroid nasal sprays are very effective at reducing inflammation and clearing blocked noses</li> <li>decongestants provide quick and temporary relief by drying runny noses but should not be used by those with high blood pressure</li> <li>salt water is a good way to remove excessive mucous from the nasal passages.</li> </ul> Behavioural changes on warm, windy spring days are a good way of avoiding a hay fever attack. An awareness of the plants around us and their basic reproductive biology is also useful in preventing our immune systems from overreacting to pollen proteins that they are not used to encountering. This article first appeared on <a href="https://theconversation.com/sneezing-with-hay-fever-native-plants-arent-usually-the-culprit-190336" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Body

Tragedy as Aussie boy dies from mosquito bite

A nine-year-old boy from Western Australia has tragically died from dengue fever while on holiday with his family. Glenn Pulgadas had been on holiday with his parents, Glenn and Ryza, in the Philippines to see extended family when he was bitten by a mosquito. According to the <a title="www.abc.net.au" href="https://www.abc.net.au/news/2022-08-30/wa-boy-dies-dengue-fever-in-philippines-warning-travellers/101386032">ABC</a>, the boy began feeling unwell on August 12th and was admitted to hospital. He was described as being “weak in appearance” with headaches, fever, abdominal pain, vomiting and nose bleeds. Glenn then went into dengue shock syndrome which typically includes clamminess, a rapid weak pulse and narrowing of pulse pressure. These symptoms then led to organ failure, with Glenn tragically passing away on August 25th. The young boy is being remembered as "bright and bubbly" by all who knew him. “Glenn was a bright, bubbly, young boy who was so full of life and always had a smile on his face,” said family friend Danielle Zarzycki. Glenn's hometown community of Harvey has launched a <a title="www.gofundme.com" href="https://www.gofundme.com/f/glenn-pulgadas-memorial">GoFundMe</a> page to raise money for funeral expenses which has so far reached more than $9000. One of the top donators, who gave $1,000 to Glenn's family, is local St Anne’s School, where Glenn was a year three student. Dengue fever is spread via the bite of some species of mosquito. Three out of four people who contract dengue won’t even get sick, and for those who do the symptoms can be mild and they often recover in a matter of days. About one in 20 people who become sick with dengue will be hit by a severe form and in the worst cases, the disease can lead to shock, internal bleeding and death. Image credits: Facebook

Caring

Could pain and fever medication affect our reaction to Covid?

New research has made some surprise findings about common pain and fever medication and its impact on infections like COVID-19. A team of Australian pain researchers combed through studies that evaluated the effects of these medications - which include morphine, paracetamol, and aspirin - on the immune system, as well as the effects they have on a person’s risk of infection. Dr Christina Abdel-Shaheed, the lead author on the review and a pain researcher at the University of Sydney, said the team were initially interested in studying the possible impacts of paracetamol during the coronavirus pandemic as people began hoarding the medication during the early months of the pandemic. Instead, they made several findings related to several other conditions, including chicken pox and Covid, and in relation to vaccination. “Our review shows some of the common pain and fever medications may work with the immune system to fight infection, whereas others work against it and increase the risk of contracting or responding badly to infectious diseases,” Dr Abdel-Shaheed <a href="https://www.scimex.org/newsfeed/are-medicines-affecting-our-response-to-infections-like-covid-19">said</a>. For example, they found that aspirin could be an affordable and accessible treatment option for tuberculosis, while morphine increases the risk of infection, particularly after cancer surgery, because it suppresses key cells in the immune system. Dr Justin Beardsley, an infectious disease researcher at Westmead Hospital and the Sydney Institute for Infectious Diseases, said this was an important finding as morphine is one of the most commonly used drugs in post-surgical care. He noted that its effect of increasing the risk of infection is particularly important for cancer patients and immunocompromised patients in general “who are already vulnerable to COVID-19”. “Taking paracetamol or ibuprofen before or immediately after vaccination - for example for COVID-19 - to try and prevent mild fever or headache is not recommended, because this could reduce the body’s desirable immune response to the vaccine,” Dr Abdel-Shaheed explained. “For chickenpox, the use of ibuprofen is not recommended as it might increase the risk of secondary bacterial skin infections.” Professor Ric Day, a co-author from UNSW and St Vincent’s Hospital, said research in this area was still catching up and that investigating these medications could have considerable impacts. “One of the problems is that widely used medicines - such as paracetamol, nonsteroidal and anti-inflammatory drugs like ibuprofen, and corticosteroids such as prednisone - have been around for decades and in the past we didn’t tend to consider their impacts on the immune system because it has been an under-recognised area,” he said. “From community use to hospital and acute care, these classes of pain and fever medications are among the most popular drugs worldwide but we need to consider the significant impact these can have on our immune system and our response to infectious diseases, including COVID-19.” The clinical review was published in the <a href="https://doi.org/10.1111/bcp.15281" target="_blank" rel="noopener">British Journal of Clinical Pharmacology</a>. Image: Getty Images

Body

Health Check: How to tell the difference between hay fever and the common cold

You wake up with a runny nose and, come to think of it, you’ve been sneezing more than usual. It feels like the start of a cold but it’s October – the start of hay fever season – so what is the more likely affiliation? Hay fever and colds are easy to confuse because they share the clinical category of <a href="https://www.mayoclinic.org/diseases-conditions/nonallergic-rhinitis/symptoms-causes/syc-20351229">rhinitis</a>, which means irritation and inflammation of the nasal cavity. The mechanisms share some similarities too, but there are some key differences in symptoms – notably, itchiness and the colour of your snot. Similar mechanisms The <a href="https://www.sciencedirect.com/science/article/pii/S0140673603121629?via%3Dihub">common cold</a> is a viral infection of the upper respiratory tract, usually caused by rhinoviruses. Colds spread easily from one person to the other via coughing, sneezing and touching infected surfaces. Hay fever, on the other hand, can’t spread from person to person. It’s an allergic response to an environmental irritant such as <a href="https://www.canberrapollen.com.au/">pollen</a> or dust. The nasal cavity contains cells that recognise foreign substances such as bugs and pollen. Once the body detects a bug or irritant, it activates an army of T cells that hunt down and destroy the substance. This is known as an immune response. In hay fever, the irritant triggers the same immune cells as viruses. But it also causes the release of IgE antibodies and histamines to produce an ongoing blocked nose, impaired sense of smell, and nasal inflammation. How you tell the difference Both hay fever and the common cold causes sneezing, runny or stuffy nose and coughing. One of the key differences is the colour of the nasal discharge (your snot): it’s more likely to be yellowish/green in colour in colds; while in hay fever, it’s clear. Facial itchiness – especially around the eyes or throat – is a symptom typically only seen with hay fever. If someone is allergic to a seasonal environmental trigger such as pollen, their symptoms may be restricted to particular seasons of the year. But if you’re allergic to dust or smoke, symptoms may last all year long. Hay fever, like asthma, is an allergic disease and can sometimes cause similar symptoms, such as coughing, wheezing and shortness of breath. A sore throat, on the other hand, is generally a precursor to cold. If you have cold-like symptoms and a sore throat or have had one in the last few days, your condition is more likely to be the common cold. What if you’ve never had hay fever before? You’re more likely to catch viral infections during winter when more bugs are circulating, but it’s possible to <a href="https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072727/">catch a cold any time</a> of the year. It’s possible to develop hay fever in adulthood. This may be due to genetic predisposition that manifests only when certain other contributing factors are present, such as a high level of airborne pollen. Or it may be due to a major change in lifestyle, such as a move to a different location or change in diet. Most adults will get two to three colds per year, while hay fever affects <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/allergic-rhinitis-hay-fever-in-australia/contents/summary">nearly one in five</a> Australians. Around 10-20% of hay fever sufferers grow out of hay fever at some point in their lives and about half find their symptoms get less severe as they get older, which means that for the majority of sufferers, hay fever can <a href="https://www.allergy.org.au/patients/about-allergy/common-myths-about-allergy-and-asthma-exposed">last a long time</a>. How are they treated? An allergy test, using a skin prick or blood test, for allergen-specific IgE could inform you of the <a href="https://www.allergy.org.au/patients/allergy-testing/allergy-testing">specific irritants that trigger your condition</a>. These tests can be organised through your GP or pharmacist. Oral antihistamines are effective in hay fever patients with mild to moderate disease, particularly in those whose main symptoms are palatal itch, sneezing, rhinorrhoea or eye symptoms <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1112773/">hay fever treatments</a>. Generally, treatment isn’t necessary for a cold but over-the-counter medications such as paracetamol and ibuprofen can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928210/">help relieve some of the symptoms</a>. Written by Reena Ghildyal and Cynthia Mathew. Republished with permission of <a href="https://theconversation.com/health-check-how-to-tell-the-difference-between-hay-fever-and-the-common-cold-104755">The Conversation</a>.

Body

3 tips to beat hay fever

If you have hay fever, you know that it can be the bane of spring – or even autumn, winter and summer, too, if you have a bad case. If you’re not a sufferer, imagine having a cold that could flare up when at the turn of a corner. Thankfully, there are ways around it. Here are three that don’t involve expensive antihistamines. 1. Find out what sets you off You can do this one of two ways. You could a) either stick to a close process of trial and error or b) get yourself an allergy test. These are used to determine which particular allergens are responsible for provoking an allergic reaction. It will usually involve skin and blood tests or an oral food allergen challenge. Note: If your symptoms mainly start in spring or summer, you may have “seasonal” allergic rhinitis, which is usually triggered by higher pollen counts during these seasons. 2. Minimise exposure This might sound impossible when it comes to pollen and other allergens that float around in the air, but there are ways you can reduce or even stop exposure. <ul> <li>Check out a pollen calendar: this helps you identify plants that trigger your hay fever and when they’re most likely to be flowering.</li> <li>Smear petroleum jelly (like Vaseline) inside your nose when you are outdoors: this helps trap pollen and stops it reaching the inner lining of your nose.</li> <li>Wear sunglasses and frequently splash your eyes with water.</li> <li>Stay away from parks and gardens while lawns are being mowed.</li> <li>Shower after playing sport and other outdoor activities to rinse off any pollen you’ve been exposed to.</li> <li>Use re-circulated air in the car: especially when pollen levels are high, or keep the windows closed.</li> </ul> 3. Evaluate your current medication Are you currently spending upwards of a few dollars a tablet on medications that only last a day? You may be using the wrong one. For example, decongestant nasal sprays or drops, syrups or tablets may help reduce nasal stuffiness or “congestion”. But they don’t work on other hay fever symptoms, and oral forms often cause side effects like insomnia and irritability, and aren’t suitable if you have a heart condition or high blood pressure. Related links: <a href="http://www.oversixty.co.nz/health/body/2015/12/7-common-lies-about-fat/">7 common lies about fat</a> <a href="http://www.oversixty.co.nz/health/body/2015/12/bloating-food/">The best and worst foods for bloating</a> <a href="http://www.oversixty.co.nz/health/body/2015/11/what-your-food-cravings-mean/">What your body’s cravings really mean</a>

Body

NSW farmer set to lead convoy of 120 trucks to help drought-stricken farmers in Qld

A whole lot of hay, hope and a helping hand. Fourth-generation NSW farmer Brendan Farrell has been thinking about his Queensland counterparts, particularly those in the west, where the state's worst-ever drought has hit hundreds. Farrell is set to lead a convoy of 120 trucks travelling more than 1800km north to deliver over 150 trailers full of hay to drought-stricken farmers in Queensland. The act of kindness has required donations of all kinds such as trucks, drivers, and hay, as well as catering and accommodation and petrol money. For each truck there’s an estimated $2000 in fuel needed to complete the journey. Mr Farrell’s message was to make sure everyone knows that the drought is still happening. A record 86 percent of Queensland is currently stricken by drought. The hay will reportedly assist more than 200 drought-affected properties. Donations can be made to the Burrumbuttock Hay Runners via the Rotary Club of Sydney Drought Appeal. This will be the tenth hay run for the Burrumbuttock Hay Runners led by Brendan Farrell. Related links: <a href="http://www.oversixty.co.nz/news/news/2015/12/abandoned-puppy-rescued-on-christmas-eve/">Abandoned puppy rescued on Christmas Eve doesn’t look like this anymore</a> <a href="http://www.oversixty.co.nz/news/news/2015/12/new-twisting-plane-seat-design/">New twisting plane seat design could banish discomfort</a> <a href="http://www.oversixty.co.nz/news/news/2015/12/6-clever-uses-for-silica-gel-bags/">6 clever uses for silica gel bags</a>

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John Travolta’s iconic suit snatches a sweaty sum at auction

Sneezing with hay fever? Native plants aren’t usually the culprit

Tragedy as Aussie boy dies from mosquito bite

Could pain and fever medication affect our reaction to Covid?

Health Check: How to tell the difference between hay fever and the common cold

3 tips to beat hay fever

NSW farmer set to lead convoy of 120 trucks to help drought-stricken farmers in Qld