Hay fever

Hay fever is an allergic reaction. Allergic Rhinitis, the medical term for hay fever means irritation of the nose. Hay fever usually starts during childhood or early adulthood and often diminishes slowly over decades. Hay fever is brought about by allergic reaction to outdoor or indoor contaminants, such as plant pollen, dust mites or chemicals. Anyone can develop hay fever especially those who are exposed to years of repeated inhalation of allergic substances. People who suffer from asthma and eczema are more prone to hay fever. It also tends to run in families. Passive smoking increases risk of developing hay fever.

Symptoms

Some people have symptoms all round the year. For others hay fever symptoms worsen at specific times of the year. Spring and fall are considered as main hay fever seasons. In severe cases nose bleeding may occur. Otherwise, the common symptoms of hay fever are:

• Repeated sneezing
  
• Runny or itchy nose
  
• Itchy or watery eyes
  
• Itchy, irritation in the throat, palate and ears
  
• Inability to concentrate
  
• Loss of sense of taste and smell
  
• General feeling of being unwell
  
• Feeling exhausted
  

Diagnosis

Skin prick test: After determining possible allergy-causing substances, a small amount of suspected allergy-causing substance is placed on the skin. Depending on patient's preference it could be on the forearm, upper arm or the back. The skin is pricked so the allergen goes under the skin's surface. The health care provider observes the skin for possible reactions like swelling, itchy feeling and redness of the skin. Reactions, if any can be noticed within 15-20 minutes which confirms hay fever. Skin prick test is not recommended for people with eczema or those taking certain medications like antihistamines as it will interfere in responding to allergic reaction. In such cases, blood test is done.

Blood test: Blood test is recommended when skin prick test cannot be done or if the results of skin prick test are not useful. A sample of blood will be taken from a vein in the arm and tested for the presence of the Immunoglobulin E (IgE) antibody. If the blood test is positive, it confirms the presence of hay fever.

Treating hay fever

The aim of treatment would be to stop exposing the body to allergic substances or preferably avoid it completely. There are a plethora of options to treat hay fever. The choice of treatment depends on the severity of hay fever and the symptoms. Age, occupation and life style is also given due consideration.

• Antihistamines medicines
  
• Antiallergic nasal sprays or eye drops
  
• Antihistamines sprays or drops for nose or eyes
  
• Steroid sprays or drops for the nose only
  
• Decongestant sprays
  
• Decongestant tablets
  
• Steroid tablets or injections
  
• Desensitizing injections
  

Some medications do not require prescription and are sold over-the-counter as non-prescription medications. It is best to seek health care provider's opinion taking into account the possible side effects.

• Know triggers and keep away from allergens
  
• keep environment clean
  
• Eat a healthy oil-free diet
  
• Include a lot of vitamin C
  
• Increase protein intake
  
• Drink boiled, filtered water
  
• Don't miss to drink herbal tea
  
• Avoid venturing out when pollen count is high
  
• Don't skip medications
  

Fever

Fever is an elevation of body temperature and defined as a core temperature higher than 38 C (100.4 F) in infants and higher than 38.3 C (100.9 F) in adults. Normal body temperature range is between 36 and 37.8 degree C (96.8 and 100.4 degree F). If a person has an oral temperature above 98.6 F (37 C), it is considered as fever. In some cases, there is a variation of up to 1 F (0.6 C). Fever is a symptom and not a disease. Fever, by itself is an indicator that the body is building an immune response to an infection. Most viruses and bacteria cannot survive at higher temperatures and fever is the body's fighting mechanism. Any body temperature up to 100 F is considered low grade fever. It is usually noticed along with sore throat, cough, joint pain, chills and nausea. Most fevers of this nature are self-limiting; and medication is given to provide comfort to the patient. Most of the time fever is only a symptom which can be treated symptomatically with antipyretics. Acetaminophen and ibuprofen are prescribed to control fever.

Fever results from the production of prostaglandin E2 (PGE2) in the hypothalamus due to endogenous or exogenous pyrogens. The cause is identified by physical examination and a thorough history - the onset of fever, level, duration, pattern if any and other symptoms.

Normally a person can sustain a body temperature of up to 104 degree F (40 degree C) with relative safety. But when the fever temperature rises above 104 ° it may cause cellular damage to brain, blood and internal organs. To prevent damage from high fever cooling treatments may be of help. Cold compresses, cold packs or sponge baths or ice bags /chemical cold packs are used to bring down the high fever.

Do not swathe a patient with fever in blankets but keep him comfortable. Bath in tepid water can help, but never ice cold water. The patient must be well hydrated. Some immunosuppressed or elderly patients might not exhibit a big rise in temperature in spite of a serious infection. Most often , CBC (complete blood count) is done to look for raised WBC count. Other useful indicators are urine test, gram stains and chest x-ray. If fever is also accompanied by abdominal pain, CT scan of the abdomen is suggested to look for possible appendicitis, diverticulitis and Cholecystitis.

The degree of fever elevation is not an indicator of the severity of the illness. Fever can be due to dengue, chikungunya, chicken pox, measles, malaria or other infections. Metabolic disturbances can cause body temperature to be elevated. In rare cases, fever is due to heart disease, serious illness, AIDS or cancer. Toxic shock, meningitis and peritonitis are other serious causes for high fever.

In some cases, the cause for fever is not easy to diagnose. Fever due to upper respiratory tract infection usually lasts for about 3-5 days.

Do not confuse fever with Hyperthermia, where the body temperature rises due to external sources. Here fever is also accompanied by palpitations, fainting, shivering, aches and confusion or hallucinations. When fever rises, the respiratory rate and heart rate rise. When children below 1 year suffer fever, they should be examined by a healthcare professional. Never use aspirin in children during a viral infection.

Rheumatic Fever

Rheumatic fever is an inflammatory disease caused by streptococcus bacteria. Typically rheumatic fever tends to affect children in the age group 6 - 15 years. Often rheumatic fever tends to follow a strep throat or scarlet fever or any other streptococcus infection. Rheumatic fever is characterized by symptoms such as fever and skin rash. The joints tend to get swollen and painful. Rheumatic fever damages the heart valves and can lead to severe disabling problems. Persons who have suffered a case of rheumatic fever have a tendency to develop flare-ups with repeated strep infections. The patient may experience chest pain, fatigue and shortness of breath. The patient suffers heart inflammation accompanied by weakness or chest pain. There may be involuntary jerky movements of hands and legs. Rheumatic fever can lead to Sydenham's chorea - a temporary nervous system disorder.

Blood counts, ESR and ECG help in diagnosing rheumatic fever. A physician will check joints for pain and inflammation and listen for any abnormal rhythms in your heart. It is essential that persons suffering from strep infection treat it without delay lest it manifest into rheumatic fever. Any nodules over swollen joints and red rashes on the chest, back and abdomen must not be ignored. Treatment for rheumatic fever involves reduction of inflammation and antibiotics such as penicillin, sulfadiazine or erythromycin. Persons suffering from rheumatic fever can suffer heart damage and attacks. Treatment for rheumatic fever usually includes anti-infective agents and anti-inflammatory agents. Sometimes cardiac medications are also prescribed for patients suffering from rheumatic fever.