The rise of allergies in China
By Yuan Yuan  ·  2024-04-15  ·   Source: NO.16 APRIL 18, 2024
The willow trees by Daming Lake in Jinan City of Shandong Province greet visitors in the spring breeze on March 21. The catkins they produce can cause allergic reactions for some people (XINHUA)

Spring brings little joy for Cheng Mingxia, a 24-year-old resident of Hangzhou, Zhejiang Province. Each year, she faces a recurring battle with nasal congestion, sneezing and a relentless runny nose—signs informing her that spring has arrived.

"Before the flowers even start to bloom, the symptoms kick in and can last for several weeks. I'm forced to carry tissues with me at all times," Cheng told Hangzhou Daily. These allergic reactions have plagued her since childhood. Despite numerous visits to doctors over the years and multiple tests at allergy clinics, a cure remains elusive.

Her only recourse is to take medication, which offers minimal relief. "I can sneeze seven or eight times in quick succession, leaving me dizzy and with a sensation that my eardrums might burst," she said.

Doctors tell Cheng she is afflicted with allergic rhinitis, and she endures the discomfort it brings every spring and autumn. While others eagerly make travel plans to enjoy the season's beauty, she finds herself unable to partake in the joys of spring and autumn excursions due to her condition.

A growing concern

Trends in allergy prevalence and onset are changing across China. "We have observed a distinct trend of more patients with allergies and the trend of these conditions manifesting at younger ages," said Gao Xiang, a physician in the Department of Allergy at the Affiliated Hospital of Qingdao University in Shandong Province, during an interview with Lifeweek magazine.

When her department was established in 2018, its clinic saw only 10 to 15 patients during each half-day session. Currently, that figure has almost tripled, with 35 to 45 patients seeking consultation within the same timeframe. She attributes the surge in allergy sufferers to what is known as the "hygiene hypothesis." This theory posits that the increased use of disinfectants and sterilizing agents has led to higher levels of cleanliness in modern society, inadvertently affecting the development of people's immune systems.

Luo Xiaoqun, head of the Department of Allergy at Huashan Hospital, affiliated with Fudan University in Shanghai, concurs with Gao's observations. He pointed out that the escalation in allergy rates is intimately linked with lifestyle changes, especially the proliferation of compounds and chemicals that people encounter on a daily basis, which incessantly challenge the immune system. "When the immune system is thrown off balance, allergic reactions can ensue," he said.

Luo noted the growing incidence of allergies has outpaced the medical community's understanding of them, as well as their prevention and treatment.

The concept of "allergies" was first introduced to China in 1906, but it took until 1956 for Peking Union Medical College Hospital in Beijing to establish the nation's first allergy department.

The Allergy Department at Tongji Hospital, affiliated with the Tongji Medical College of Huazhong University of Science and Technology in Wuhan, Hubei Province, evolved from its origins within the respiratory department to become a standalone entity in 1997.

Zhu Rongfei, head of the department, shared with Lifeweek that back in the early days, the department was staffed by just one doctor and one technician. "Back then, we only operated for a few half-days each week, and we saw fewer than 10 patients per day," he said.

The development of allergy departments in Chinese hospitals has predominantly occurred in the last decade, from 2010 to 2020, signifying a burgeoning interest in addressing this growing health issue. Nevertheless, the allergy department is often not the initial stop for patients with symptoms and many are referred there by specialists from other fields.

"I've had allergic rhinitis since my teens, but for many years, my parents misdiagnosed it as a common cold or regular rhinitis," a patient in his 30s, surnamed Ma, told Beijing Television. "It wasn't until an ear, nose and throat specialist suggested my parents take me for allergy testing that we realized it might be allergic rhinitis."

A report by newspaper People's Daily in 2022, citing research from the Allergy Branch of the Chinese Medical Association, estimated that in China, fewer than 3,000 physicians are able to diagnose and treat allergic conditions, and that fewer than 300 of them are specialists. Peking Union Medical College stands alone as the only medical institution in China authorized to confer master's or doctoral degrees in the field of allergies.


Diagnosis and treatment

Zhu highlighted the intricate nature of allergic diseases, noting that they often present with a wide array of symptoms that can be caused by vastly different allergens. With tens of thousands of allergens identified to date, the most common culprits are limited to approximately 60 or 70.

"Patients' self-assessments often don't align with their actual conditions," he said. For example, some people thought they're allergic to cold air because they experience nasal congestion and itching when exposed to it, even though cold air isn't a recognized allergen, but the real offenders are often dust mites, mold or pollen.

For those with allergies, pinpointing the allergen is essential for implementing targeted prevention and treatment strategies. Zhai Lingxian, an allergy specialist from the No.1 People's Hospital in Xining, Qinghai Province, said in an interview with Guangming Daily that allergens typically enter the body via inhalation, ingestion or contact. "Blood tests can identify inhalant and ingestant allergens, while patch testing, among other methods, is useful for detecting contact allergens," she said.

"Prevention of allergic conditions takes precedence over treatment, and the identification of allergens is key to prevention," she added. She said effective allergy management strategies include avoiding allergens, and treating symptoms with medication and specific immunotherapy.

Currently, allergy departments are predominantly established in major cities such as Beijing, Shanghai and Guangzhou, as well as in coastal cities and regional medical centers. However, there is a significant gap in the professional diagnosis and treatment of allergic diseases in a wider range of regional and rural areas.

"More work should be done to raise awareness of allergies to prevent cases, particularly in places where patients are unable to receive timely treatment," Zhai said.

Copyedited by G.P. Wilson

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