Back to School on Oral Immunotherapy: Prevention is Key!
 
 

Back to School on Oral Immunotherapy:  Prevention is Key!

by Dr. Inderpal Randhawa, M.D.

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After treating nearly 600 patients with oral immunotherapy for nearly a decade, I am often asked what worries me the most.  From a parent’s standpoint, I would imagine the anticipated response will be a severe anaphylactic reaction during a visit updose/challenge or a severe reaction at home.  However, I believe in security during OIT.  Hence, the hospital based therapy and food challenges.  Similarly, the dosing protocols which limit the risk of a significant reaction to under 1 percent.  So what worries me the most with OIT?  The month of September.

September is back to school month.  After a predictable summer, the children on OIT now return to a bastion of bacteria, viruses, pollutants and more.  This is fodder for the immune system to react to.  It is most common, in my experience, to see a surge of mild reactions during home based therapy in September.  My advice is the same every year.  Prevent what you can and notify your physician prior to any OIT dosing if you see any signs of infection or increased inflammation.

The most common illnesses in September include:

  • Viruses (simple to complex colds)
  • Wheezing/Bronchitis
  • Sinusitis
  • Pharyngitis (strep throat)
  • Otitis media (ear infections)
  • Skin infections (pustules)
  • Gastroenteritis (diarrhea/vomiting)
  • Conjunctivitis (eye/eyelid infection)

What can you do to prevent a difficult September for your child?

  1. Lots of handwashing
  2. Use a safe nasal washing system after school daily
  3. Talk to the school teacher about sanitizers, wipes, and handwashing for all children
  4. Enforce the sick child policy (so sick children are sent home)
  5. Obtain a lung function test prior to school starting to ensure maximum lung function
  6. Monitor and limit activity on high pollution days
  7. Ensure your child’s technique for inhalers and nasal sprays is correct
  8. Avoid unnecessary visits to high risk areas (busy grocery stores, daycares, etc.)
  9. Apply the wash and change routine to all children and adults in the home. Many studies show the most common carrier of viral and bacterial pathogens are adults and older children.  The first thing to do when you get home?  Change clothes and wash down (hands, arms, neck, and face) with soap and water.
  10. Ensure a healthy classroom (refer to the American Lung Association healthy classroom checklist).

As always, if your child is ill during OIT, notify your doctor immediately PRIOR to dosing. 

Hopefully this September will be a smooth transition for all OIT patients.  Stay healthy!

 

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