UNDERSTANDING FOOD ALLERGIES How to Prevent a Peanut Allergy and More

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1 BetterSafe WELCOA S ONLINE BULLETIN FOR YOUR FAMILY S SAFETY UNDERSTANDING FOOD ALLERGIES How to Prevent a Peanut Allergy and More Have you noticed food allergy warnings at restaurants? Maybe you ve heard about peanut-free classrooms and flights. People who have serious reactions to certain foods must be careful about what they eat, and what others eat around them. There s no cure for food allergies. But researchers are learning more about how to prevent and treat this condition. Allergic reactions happen when your immune system your body s defense against germs and foreign substances overreacts to something that s normally harmless. In the United States, most food allergies are caused by peanuts, tree nuts, fish, shellfish, eggs, milk, wheat, and soy. Allergies show up most often in children. But they can develop at any age. If you think that you or your child may have a food allergy, see your health care provider. Your doctor will take a detailed medical history and perform a physical examination. If a diagnosis of food allergy seems likely, they may recommend a blood test or skin prick test. These results will help determine if you or your child has a food allergy. WHAT THE LATEST RESEARCH IS SAYING Researchers recently carried out a large clinical trial called Learning Early About Peanut Allergy (LEAP). The study looked at infants chances of developing an allergy if they ate peanut-containing foods at an early age. Six hundred and forty infants who were at high risk of developing a peanut allergy were enrolled in the trial. The infants were randomly placed in either a peanut-eating or peanut-avoiding group. They continued these diets until they were 5 years old. Infants who ate peanut-containing foods beginning early in life had an 81% lower chance of developing a peanut allergy. Based on the strength of these findings, an expert panel sponsored by the National Institutes of Health (NIH) recently issued updated guidelines to help WELCOA.ORG 1 of 2

2 BetterSafe health care providers work with families to introduce peanut-containing foods to infants to help prevent the development of peanut allergy, Sicherer says. The panel provided 3 guidelines that describe when and how to give these foods. The recommendations are based on how likely a baby is to develop peanut allergy. Talk with your doctor before you introduce any peanut-containing foods to your infant. The doctor may tell you when and how to start feeding peanut to your baby or recommend doing allergy testing first. The new guidelines may come as a surprise to some people. Almost 20 years ago, experts recommended that babies at high risk for developing peanut allergy avoid peanut-containing foods until age 3. But nearly 10 years ago, experts withdrew this recommendation. There was no proof that it worked. FOOD ALLERGY SYMPTOMS Pay attention to how you feel after you eat and learn how to recognize the symptoms of a food allergy. Symptoms may include: coughing tingling in the mouth skin reactions like hives or itching nausea and vomiting stomach pain diarrhea If you have a potentially life-threatening reaction trouble breathing, dizziness, and fainting seek immediate medical care by calling 911. The most recent change in guidance was prompted by the very compelling results of the LEAP study, says Dr. Marshall Plaut, a food allergy expert at NIH. The new guidelines are based on these results and the clinical knowledge of the expert panel who developed them. Food allergy studies have to be done very carefully because reactions can be life threatening. It s important to understand how much careful thought goes into ethically designing research studies, particularly those involving vulnerable populations like children, Plaut says. Sometimes answers take longer than we would all like. But it s critical to find them in a way and at a pace that is thoughtful and safe. For now, there are no treatments for food allergies. But avoiding allergy-causing foods can help prevent symptoms. Read food labels carefully. Wash your hands and surfaces you touch to prevent accidental contact. Talk with your health care provider to learn more about preventing and treating food allergies. WELCOA.ORG 2 of 2

3 DayInDayOut WELCOA S ONLINE BULLETIN FOR YOUR LIFESTYLE COUGH CULPRITS What s the Difference Between Bronchitis and Pneumonia? Coughs help your body clear your airways of irritants and prevent infection. But a deep cough from your chest may signal bronchitis or pneumonia. Although they may have different underlying causes, their symptoms can be similar and both can be serious enough to send you to the doctor. Bronchitis and pneumonia both involve inflammation in the chest. Both can cause coughs that bring up a slimy substance called phlegm to help clear out germs and pus. And both can cause shortness of breath and wheezing. Bronchitis is a condition in which the bronchial tubes that lead to the lungs become inflamed. Viruses, bacteria, and even toxins like tobacco smoke can inflame the bronchial tubes. Most of the time, though, bronchitis is caused by an infection with one of several types of viruses. If you develop bronchitis during flu season, a likely culprit may be the flu virus. Cold viruses are also common causes at this and other times of year. Pneumonia is caused by an infection of the lungs. About 1/3 of cases are caused by viruses, but most of them are bacterial related, says Dr. Kenneth Olivier, a lung infection expert at NIH. They re from bacteria that are quite common, like Streptococcus pneumoniae, which is the leading cause of bacterial pneumonias in all ages in the U.S. If you get a fever with bronchitis, it is usually mild (below 101 degrees Fahrenheit). In more serious cases, you may have chest pain, feel short of breath, or wheeze when you breathe in. Pneumonia, on the other hand, typically is associated with fever, sometimes very high, spiking fever, Olivier says. Breathing problems, chest pain, and other symptoms also tend to be more severe with pneumonia. If you have a fever and chills, trouble breathing, or a cough that is bringing up thick phlegm especially if it s yellow or green go see your doctor. WELCOA.ORG 1 of 2

4 DayInDayOut Your doctor can listen to your lungs by placing a stethoscope on your chest. Frequently, the physician can hear areas where the breath sounds are altered, Olivier says. If you have pneumonia, your doctor may hear bubbling, crackling, or rumbling sounds from the lungs. You may be sent for a chest X-ray, which can show whether the lungs contain fluid or pus from an infection. An X-ray is the best way to diagnose pneumonia and rule out bronchitis. It can take 1 to 4 weeks to recover from pneumonia. GUARD AGAINST AIRWAY INFECTIONS Wash your hands often with soap and water. Use alcohol-based hand gel if you re unable to wash them. Cough into a tissue, your elbow, or your sleeve. Ask your doctor about vaccines for you and your children. Certain vaccines can prevent airway infections caused by harmful viruses and bacteria. Avoid people who are coughing or showing signs of infection. Avoid tobacco smoke. Whichever illness you have, resting and drinking plenty of fluids are important ways to care for yourself. If you re diagnosed with bronchitis, your doctor probably won t give you antibiotics. Because viruses are the usual cause of bronchitis, antibiotics are seldom helpful. If you re wheezing, however, you may be given medicine to open your airways. Your cough may last 10 to 20 days. Because bacteria are often the cause of pneumonia, your doctor may prescribe antibiotics. It can take 1 to 4 weeks to recover from pneumonia. Some people require treatment in the hospital. Germs that cause colds, the flu, and lower airway infections are contagious. The best way to prevent getting bronchitis or pneumonia is to avoid getting these infections. And when you re sick, take care not to spread your germs to others. WELCOA.ORG 2 of 2

5 TakeCharge W E L C O A S S E L F - C A R E B U L L E T I N TO SCREEN OR NOT TO SCREEN? The Benefits and Harms of Screening Tests Catching chronic health conditions early even before you have symptoms seems like a great idea. That s what screening tests are designed to do. Some screenings can reduce your risk of dying from the disease. But sometimes, experts say, a test may cause more harm than good. Before you get a test, talk with your doctor about the possible benefits and harms to help you decide what s best for your health. Screening tests are given to people who seem healthy to try to find unnoticed problems. They re done before you have any signs or symptoms of the disease. They come in many forms. Your doctor might take your health history and perform a physical exam to look for signs of health or disease. They can also include lab tests of blood, tissue, or urine samples or imaging procedures that look inside your body. I wouldn t say that all people should just simply get screening tests, says Dr. Barnett S. Kramer, a cancer prevention expert at NIH. Patients should be aware of both the potential benefits and the harms when they re choosing what screening tests to have and how often. Choosing whether you should be screened for a health condition isn t always easy. Screening suggestions are often based on your age, family health history, and other factors. You might be screened for many conditions, including diabetes, sexually transmitted infections, heart disease, osteoporosis, obesity, depression, pregnancy issues, and cancers. POSSIBLE RISKS Every screening test comes with its own risks. Some procedures can cause problems like bleeding or infection. A positive screening test can lead to further tests that come with their own risks. WELCOA.ORG 1 of 2

6 TakeCharge Most people who feel healthy are healthy, says Kramer. So a negative test to confirm that you re healthy doesn t add much new information. But mistakenly being told that you do or don t have a disease can be harmful. It s called a misdiagnosis. A false negative means that you re told you don t have the disease, but you do. This can cause problems if you don t pay attention to symptoms that appear later on because you think you don t have the disease. A false positive means that you re told you may have the disease, but you don t. This can lead to unnecessary worry and potentially harmful tests and treatments that you don t need. Even correctly finding a disease may not improve your health or help you live longer. You may learn you have an untreatable disease long before you would have. Or find a disease that never would have caused a problem. This is called overdiagnosis. Some cancers, for example, never cause symptoms or become life-threatening. But if found by a screening test, it s likely to be treated. Cancer treatments can have harsh and long-lasting side effects. There s no way to know if the treatment will help you live longer. ASK YOUR DOCTOR ABOUT SCREENING TESTS What s my chance of dying of the condition if I do or don t have the screening? What are the harms of the test? How often do they occur? How likely are false positive or false negative results? What are possible harms of the diagnostic tests if I get a positive screening result? What s the chance of finding a disease that wouldn t have caused a problem? How effective are the treatment options? Am I healthy enough to take the therapy if you discover a disease?»» What are other ways to decrease my risk of dying of this condition? How effective are they? If you re at risk for certain health conditions because of a family history or lifestyle exposures, like smoking you may choose to have screenings more regularly. If you re considering a screening, talk with your health care provider. WELCOA.ORG 2 of 2

7 ToYourHealth WELCOA S ONLINE GENERAL WELLNESS BULLETIN PAINFUL JOINTS? Early Treatment for Rheumatoid Arthritis Is Key Painful, swollen, and stiff joints can be a sign of arthritis. Rheumatoid arthritis is one of the most common forms. The pain and stiffness can interfere with your life at home and at work. For some people, the disease is mild, but for others it can be disabling. Scientists continue to search for the cause of this disease and for ways to improve treatment. Arthritis is an inflammation of the joints. There are over 100 types of arthritis. While their symptoms can be similar, their underlying causes vary. Osteoarthritis is the most common type of arthritis. It s far more common than rheumatoid arthritis. Osteoarthritis is caused by wear and tear on your joints. In rheumatoid arthritis, your immune system which normally helps protect your body from infection and disease starts attacking your joint tissues. Anyone can get rheumatoid arthritis. The disease most often begins in middle age or later. But it can occur at any age. Even children sometimes get a similar form of arthritis. Some types of arthritis affect one joint at a time, but rheumatoid arthritis can affect your whole body. It s important to get the correct diagnosis because each form of arthritis needs to be treated differently. To diagnose rheumatoid arthritis, doctors use medical history, physical exams, X-rays, and lab tests. There s no single test for the disease. It s not easy to diagnose. SYMPTOMS Your joints may appear red and feel warm. Pain and stiffness may be worse after you wake up or have been resting for a long time. Over time, your immune system damages the tough, flexible tissue (cartilage) that lines joints. This damage can be severe and deform your joints. Research advances have improved patient outcomes in the past 10 to 20 years. Doctors no longer wait to start treating a person with rheumatoid arthritis. Now, they know to begin treatment right away before joint damage worsens. WELCOA.ORG 1 of 2

8 ToYourHealth Early detection is very important to increase the chance that treatment is successful. If we can get you into low disease activity by 6 months and remission [no signs of the disease] by 1 year, we ve got an incredibly good chance of the disease having a very minimal impact on your life, says Dr. Vivian P. Bykerk, an NIH-funded arthritis researcher at the Hospital for Special Surgery in New York. TREATMENTS There are many different classes of drugs available. Many of the drugs, like NSAIDs (nonsteroidal antiinflammatory drugs) and steroids, work by reducing inflammation. Such drugs may be used in combination with others that have been shown to slow joint destruction. We really have to rely on our experience. We consider the combination of signs, symptoms, and blood tests to choose the right treatment, Bykerk explains. Once treatment for rheumatoid arthritis is underway, patients need frequent checkups. Doctors may need to try and adjust different drugs or drug combinations to find the best fit for each person. Treatments are usually required for the long term to maintain control of the disease. For some people, symptoms go on for years, even a lifetime. Sometimes after months of mild disease, symptoms can flare up again. ARTHRITIS TIPS Don t smoke. Smoking increases the risk of getting rheumatoid arthritis. Be active. Walking, swimming, and other forms of physical activity help to reduce pain and stiffness. Rest. Taking breaks from activity helps to reduce active joint inflammation and pain, and to fight fatigue. Take your medicine. Follow your doctor s instructions for taking pain relievers and other medicines. Use heat or cold. You can use either heating pads or cold therapy to reduce pain.»» Find a support group. You may find it helpful to talk to other people about how they cope with the disease. Rheumatoid arthritis can affect virtually every area of your life, from work to relationships. If you have rheumatoid arthritis, there are many things you can do to help maintain your lifestyle and keep a positive outlook. Exercise helps keep your muscles healthy and strong, preserve joint mobility, and maintain flexibility. Rest helps to reduce joint inflammation, pain, and fatigue. Ask your doctor how best to balance exercise and rest for your situation. WELCOA.ORG 2 of 2

9 TEST YOUR KNOWLEDGE ON A VARIETY OF WELLNESS TOPICS 1 Arthritis is a tightening of the joints. o True o False 2 A means that you re told you don t have the disease, but you do. a. failed test b. false negative c. mistake 3 can happen when your immune system your body s defense against germs and foreign substances overreacts to something that s normally harmless a. cancer b. allergic reactions c. diabetes 4 Every screening test comes with its own risks. o True o False 5 Bronchitis and pneumonia both involve in the chest. a. fluid b. inflammation c. microbes 6 Anyone can get rheumatoid arthritis. o True o False 7 There are several treatments for food allergies. o True o False 8 Pneumonia is caused by of the lungs. a. an infection b. cancer c. shrinking WELCOA.ORG