Resource person: Dr. Noor Zehan Abdul Rahim, Consultant Paediatrician and Paediatric Respiratory Specialist, Sunway Medical Centre, Malaysia

In Malaysia, where urban living and vibrant cityscapes define daily life, an unsettling trend is emerging – an increase in childhood allergies. What was once considered a minor nuisance has become a significant health concern, with triggers ranging from dust mites to severe food reactions. According to estimates, one in five Malaysian children may develop allergies [1], a situation that urges parents to pay more attention on, understand, manage, and prevent these conditions.

“Allergies are more than just sneezes or skin rashes, they can deeply affect a child’s quality of life,” shares Dr. Noor Zehan Abdul Rahim. “Urban living exposes children to higher allergens like dust mites, smoke, and pollution. While parents can’t control everything, they can take steps to make their homes safer havens.”

Most common allergens affecting Malaysian children

1. Dust mites are the most common triggers for respiratory allergies in Malaysia. They thrive in humid conditions and hide in bedding, carpets, and soft furnishings.
2. Pet dander is another major culprit. “Even hypoallergenic pets can still provoke reactions in sensitive children,” explains Dr. Noor Zehan.
3. Food allergens, though less common than in Western countries, can include reactions to peanuts, shellfish, and milk.
4. Pollen and mould also pose challenges, particularly in damp urban areas.

Recognising symptoms

Allergy symptoms can vary and typically appear between 2 to 3 years of age, although food allergies may develop as early as 6 months, while respiratory allergies, such as hay fever, often emerge around 5 or 6 years old.

Respiratory triggers can cause sneezing, coughing, wheezing, or nasal congestion. Allergic rhinitis, the most common childhood allergy [2], is characterised by sneezing, a runny nose, and nasal blockage. Skin reactions like rashes or eczema may signal environmental or dietary causes, while vomiting or diarrhoea can indicate food allergies.

“Parents should watch for recurring symptoms,” advises Dr. Noor Zehan. “If a child frequently reacts after eating certain foods or being in specific environments, it’s worth investigating further.” She recommends keeping a symptom diary to help identify patterns and triggers.

Related: Flu on the rise: How Asia is managing a widespread seasonal threat

Ignoring allergies can have lasting effects

The risks of untreated allergies go far beyond temporary discomfort. Persistent allergic rhinitis can lead to chronic sinusitis or asthma, which disrupt a child’s sleep, focus, and everyday activities.

Alarmingly, asthma rates in Malaysian children have surged, from 6.4% to 9.4% among 6 – 7-year-olds and from 9% to 13% among 13 – 14-year-olds [3].

“Asthma triggered by untreated allergies can be life-altering if not properly managed,” warns Dr. Noor Zehan. “It’s heartbreaking to see children struggle with something that can often be prevented or controlled.”

What parents can do

While allergies can feel overwhelming, Dr Noor Zehan outlines simple but effective steps parents can take to reduce allergen exposure and manage symptoms that can make a big difference, including:

1. Clean and declutter: Use dust-mite-proof covers and vacuum regularly with HEPA filters.
2. Eliminate smoke exposure: Even particles on clothes can aggravate allergies.
3. Manage pet allergens: Keep pets out of bedrooms, and in severe cases, consider rehoming.
4. Introduce allergenic foods carefully: Under medical guidance, introduce foods like peanuts or eggs between 4 and 6 months, but avoid whole peanuts to prevent choking.
5. Choose air purifiers wisely: Avoid fragrances or chemicals that irritate sensitive airways.

Truths and fallacies on allergy

Misconceptions about allergies persist, including the belief that children will naturally outgrow them. “While some do, many allergies persist into adulthood, impacting the quality of life if not managed properly,” explains Dr Noor Zehan.

Another myth is that avoiding triggers like cold drinks can prevent respiratory issues. “With proper management, children with asthma or allergic rhinitis can enjoy normal activities without unnecessary restrictions,” she reassures.

Parents may also worry about inhaler dependency, but Dr. Noor Zehan dispels this fear. “Inhalers are not addictive. They are life-changing tools that help children breathe freely and thrive. As conditions improve, reliance on medication can be gradually reduced,” she explains.

Exposure to different environments for immunity building

The pandemic has also influenced allergy trends. Lockdowns temporarily reduced children’s exposure to infections, easing respiratory symptoms, but limited opportunities for immunity-building. “Reduced exposure meant children missed out on essential immunity-building, leaving them more vulnerable post-COVID,” explains Dr. Noor Zehan.

She also encourages parents to strike a balance. “Gradually reintroduce your child to diverse environments while maintaining good hygiene. This helps rebuild their defences and allows you to identify potential allergens.”

Managing childhood allergies requires teamwork between parents and healthcare providers. Regular check-ups with a paediatrician are essential for early detection and treatment. “The early years are crucial for long-term health,” emphasises Dr. Noor Zehan. “Stay informed, take action, and don’t hesitate to seek medical advice. Every step you take now will help your child live a healthier, happier life.”

References:

1 Subramaniam, S. (2014, November 29). Allergies and what we need to know about them. Scientific Malaysian Magazine. Retrieved from Scientific Malaysian Allergies and What We Need to Know About Them | Scientific Malaysian Magazine

2 Subramaniam, S. (2014, November 29). Allergies and what we need to know about them. Scientific Malaysian Magazine. Retrieved from Scientific Malaysian Allergies and What We Need to Know About Them | Scientific Malaysian Magazine

3 Dinglasan, J. L., Tang, L. Y., Chong, M. C., & Al Raimi, A. M. (2022). Asthma prevalence and the relationship between level of knowledge and quality of life among asthmatic schoolchildren in Malaysia. Saudi Medical Journal, 43(1), 113-116. https://doi.org/10.15537/smj.2022.43.1.20210211

A child’s cardiorespiratory endurance – a measure of how well the body handles long periods of exercise – is a more important aspect of physical education (PE) than losing weight. A study by researchers at the University of Georgia, US, and the University of Jyväskylä, Finland, highlights how children who are more active during PE, despite their weight, are more likely to stay active after school as well.

“It’s not really your weight that matters. Children can be a little bit overweight but still be relatively fit,” said Associate professor Sami Yli-Piipari, UGA’s Mary Frances Early College of Education.”Research has shown that even in young children, people who are fitter in terms of cardiorespiratory endurance participate in more intense physical activities, even out of PE.”

The study followed 450 children in Finland who took 90 minutes of mandatory PE every week. After a week of tracking their physical activity using an accelerometer, simple tests were conducted to determine mastery of physical skills. The researchers also explored whether the children enjoyed PE or participated out of obligation.

(In Finland, children have more PE on average than their American counterparts; PE classes also teach them how to incorporate exercise into everyday life.)

The researchers found that boys tended to be more active than girls, but surprisingly, muscle strength and motor skills, motivation, nor enjoyment of PE classes, played a role in their physical activity levels.

Children who didn’t participate in after-school sports were also typically less active during their downtime. It was clear that PE was the only time the children exercised hard enough to work up a sweat, which makes it even more important to use class time effectively to get them moving and motivated to keep it up.

Yli-Piipari said variety is key to helping children be more active: introduce children to multiple ways they can get their heart pumping and explain why it’s important to stay active. Model lifestyle and behaviours of a physically active adult may also help children understand the positive physical and mental health effects of exercise.

Read: Exercise hormone injections boost mice fitness and overall health

The risk of acquiring SSPE was previously believed to be about 1-in-1,700, based on an earlier German study of children younger than five years old infected with measles.

The new study looked at children who got measles during a large California outbreak around 1990, and found the rate of SPPE to be 1-in-1,387 for kids under the age of five and rose to about 1-in-600 for babies infected before their first birthday.

Findings were presented at an infectious disease meeting in New Orleans known as ID Week.The presentation included an account of a mother whose five-month-old got measles after a trip to Disneyland during an outbreak last year.

Dr. James Cherry, a research professor in pediatric infectious diseases at UCLA, who was part of the study team, described the findings as a “very frightening surprise”.

Dr. Cherry recommended creating herd immunity through vaccination to protect those who are most vulnerable to measles and those at greatest risk of SSPE. Herd immunity would protect infants too young to get the measles vaccine and people with compromised immune systems ineligible for vaccination.

Merck & Co and Glaxo Smith Kline are among the main manufacturers of measles vaccines.

Researchers hope the data will raise alarms with parents who refuse vaccines for their children, despite science confirming their safety and benefits.

They also cautioned parents about traveling with unprotected children to countries where measles is endemic, saying that children should have had two doses of measles vaccine before traveling to Europe or the Philippines.

The average age of SSPE diagnosis was 12, but the range was from three to 35, researchers said. Even without the SSPE complication, measles is still a fatal disease. It also causes encephalitis, an acute infection and inflammation of the brain.