Travelling with Allergies

Part of the fun of holidays is exploring new places and trying new activities. But about 1 in 1000 people have anaphylaxis-type reactions – the most serious kind of allergic reaction. So if you’re one of the tens of thousands affected in the UK, you may be wary about unfamiliar surroundings.

But having allergies certainly doesn’t mean you have to stay home, wrapped in a protective bubble. In fact, with a little forward planning and a few precautions, you can relax, unwind and enjoy your time away.

The sort of precautions you’ll need to take will depend on the type of allergy you have. People in the UK are more likely to have an allergy than almost anywhere else in the world – in fact, almost half of people (44%) have some sort of allergy, and almost half of them have more than one allergy. Some of these are minor inconveniences, and a simple nose spray or eye drops keep symptoms under control. But if you have anaphylaxis, the tiniest exposure to something you’re allergic to could bring on a life-threatening reaction.

Whatever type of allergy you have, check whether you need to declare your condition on your travel insurance – failure to do so could mean any treatment isn’t covered. And do take out travel insurance, even if you’re travelling within Europe.

Hay Fever

Hay fever is really common – it affects between 1 in 5 and 1 in 2 people. The medical name for hay fever is seasonal allergic rhinitis:

• Rhinitis means inflammation of the nose, although hay fever can affect your eyes and throat as well, and can also make asthma symptoms worse.
• Allergic because it’s a response to allergy to pollen (grass pollen is the most common, although you can be allergic to tree or weed pollen too).
  
  
• Seasonal because you get symptoms when pollen counts are highest. In the UK, grass pollen levels peak in May-July, tree pollen from March-May, and weed pollen throughout spring and summer, dropping in early autumn.

If you’re travelling abroad, you may find pollen levels are higher at other times of the year, depending on the climate. So it’s worth taking your hay fever medication with you, just in case. Wrap-around sunglasses can reduce eye exposure to pollen and a dab of Vaseline under your nose can help protect your nostrils. When you return to your accommodation, shower and wash your hair to get rid of pollen.

It’s also a good idea to check pollen levels where you’re going. Pollen levels tend to peak in the morning and late afternoon/early evening on warm days. However, if it’s cloudy the pollen can hang around. Likewise, in warmer countries, pollen levels may stay higher at night. Avoid areas with a lot of grass or trees when levels are high.

Asthma

Asthma affects about 5.4 million people in the UK – 1 in 12 adults and 1 in 11 children. It’s often due to allergy – asthma, like hay fever and eczema, tends to run in families, and if you or other family members have one condition, you’re more likely to develop another.

Asthma affects the smaller airways of your lungs, causing them to narrow and reduce airflow. This can lead to shortness of breath, wheezing, and coughing. You may find that your symptoms are worse at night or in the early mornings – if you’re waking at night because of your asthma symptoms, it’s important to speak to your doctor.

The mainstay of treatment is inhalers – usually a combination of:

• A ‘reliever’, which opens up the airways by relaxing the walls of the small airways; and
• A ‘preventer’, which reduces inflammation in the airways; or
• A combination inhaler that acts as both reliever and preventer.

It’s essential that you take your preventer inhaler regularly, even if you don’t have asthma symptoms. The effect of the preventer on inflammation builds up over time, so you need to take it regularly for the best effect.

The severity of asthma symptoms varies between people, and at different times for the same person. You may have triggers that make your asthma worse – pollen, colds, pets, pollution or even hormone changes.

So even if your asthma is largely well controlled and you rarely have symptoms, changes in temperature, pollution or other triggers could mean you’re prone to an asthma attack when you’re on holiday. Make an appointment with your nurse or doctor a few weeks before you go to make sure you’re on the right treatment for you and know what to do if your asthma gets worse while you’re away.

For more tips on how to avoid problems with asthma when you’re on holiday, you can read my top tips.

Food Allergies

The most common food allergies in the UK are:

• Dairy/cow’s milk
• Eggs
• Fish (cod, haddock, pollock, salmon and tuna are the commonest culprits)
• Food Additives – sulphites (including sulphur dioxide) and benzoates (inculding benzoic acid)
• Peanuts
• Sesame
• Shellfish (such as crab, lobster, prawns and shrimp)
• Soy
• Tree nuts (including walnut, almond, cashew, brazil, hazelnut and pistachio)
• Wheat

Depending on which part of your immune system is involved in your reaction, you could have a severe, almost immediate reaction (anaphylaxis – see below) or a milder reaction, with dry, red or itchy skin; tummy pain and diarrhoea; and feeling or being sick.

Food intolerance is different from food allergy – it doesn’t involve your immune system and is never life-threatening. However, many people find certain foods make them feel bloated or cause tummy pain and/or diarrhoea.

If you have ever had an anaphylactic reaction to a food, you need to take advice from your specialist on what steps to take – for instance, as well as the food that triggers your reaction, you may need to avoid other foods which you have a high chance of being allergic to. You’ll also need to take some steps in advance to make sure you can identify and avoid any exposure to your triggers.

If you have a food intolerance or a milder allergy, it’s worth keeping a food diary to try and identify your triggers. It’s still possible to enjoy new foods in the country you’re travelling to, but do look at ingredients in supermarkets and take a translation app so you can check with restaurant staff to ensure any dishes you choose are free from ingredients you’re allergic to.

Anaphylaxis

Food isn’t the only – or even the most common – cause of anaphylaxis. The most widely reported triggers are insect stings (especially from wasps and bees); peanut and tree nut allergies; other foods; and some medicines (including antibiotics and painkillers). About half a million Brits have had an anaphylactic reaction to insect stings and almost a quarter of a million to nuts.

Symptoms of anaphylaxis come on very quickly, usually within minutes of exposure to something you’re allergic to. They include swelling of the lips, throat, and tongue, which can make it hard to breathe; wheezing, shortness of breath, and hoarseness; a rapidly spreading, very itchy pink rash like nettle rash; palpitations; feeling or being sick; and lightheadedness or feeling faint. If untreated, anaphylaxis can lead to confusion, collapse, and even death.

If you’ve ever been diagnosed with anaphylaxis, you’ll have to avoid even the slightest exposure to whatever you’re allergic to, usually for life. You’ll also need to carry an adrenaline injector with you at all times – and ideally make sure that whoever you’re with knows how to use it, in case you’re not able to during an attack. You’ll also need an allergy action plan, which you should use as soon as you have any suspicion you’ve been exposed to a trigger.

For full details on steps to take to maximise the chance of a trouble-free holiday if you have anaphylaxis, read my top tips on travelling with allergies.