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ARTICLE 1

The trouble with dust mites – Singapore’s most common allergy

25-Aug-2011 (Thu) Health & U special supplement, The Straits Times

Invisible to the naked eye, these tiny organisms are responsible for Singapore’s most common allergy, reports Geraldine Ling

Dust mites are the top cause of allergic rhinitis, Singapore’s most common allergy, which produces symptoms like runny nose, sneezing and nasal congestion.

Other triggers of allergic rhinitis include cats, dogs and cockroaches.

About 10 per cent of the general population here have the condition, with 90 per cent of these cases caused by dust mites, says Dr Mark Thong, a consultant at the department of otolaryngology – head and neck surgery – at the National University Hospital.

It is the mite’s droppings that are responsible for the allergic reactions, says Dr Thong.

Allergic rhinitis, like all allergies, typically result from a hyper response from the body when it comes into contact with an offending protein (allergen), says Dr Leong Jern-Lin, a consultant ENT surgeon and director of Ascent Ear Nose Throat Specialist Group.

In such cases, the body produces large amounts of an antibody called Immunoglobulin E (IgE). The high IgE levels then trigger the allergic response of swelling, mucous secretions and itchiness, he says.

A person who suffers from symptoms at least four days a week is said to have moderate to severe allergic rhinitis, adds Dr Leong. In severe allergic rhinitis, sleep is often disrupted.

Genetics are a key factor in allergy development.

Dr Thong explains that a child has a 13 per cent chance of developing allergies if both parents do not suffer from allergies.

However, that statistic increases to 30 and 50 per cent respectively if one or both parents suffer from allergies. Other factors that play a role in allergic reactions include over-exposure to environmental allergens and a person’s immunological balance.

“Allergies are generally a result of the complex interaction among these three major factors,” says Dr Thong.  
Allergic rhinitis is usually diagnosed through a physical examination and a thorough check of the patient’s medical history.

To get rid of dust mites, wash clothes and bed linen in hot water of least 55 to 60 deg C every one to two weeks. Anti-dust mite casing should be washed once every two to three months.

Special care should also be taken in ensuring that the surfaces in your home are dust-free.

Household objects or furniture that can trap dust should be removed. These include stuffed toys, carpets, upholstered furniture and curtains. Dust mites typically feed on skin flakes that have been shed and commonly found in household dust.

Use furnishings made from leather, wood or plastic as these can be wiped clean easily, says Dr Thong.

Books, decorative items and clothing should also be kept in enclosed cupboards that have easy-to-clean surfaces to prevent dust from gathering. Beddings and mattresses must ideally be covered with anti-dust mite casings.

Wash stuffed toys with hot water to remove dust mites. If the toys are not machine-washable, freeze the toys overnight, followed by vacuuming them the following day. This will kill dust mites.

Dust mites, Dr Thong explains, are very small and their droppings are even smaller. At about 28 microns in diameter, the droppings are 10 times smaller than a strand of human hair.

But not all vacuum cleaners work equally, he cautions.

Often, regular vacuum cleaners have big holes in their filters that allow dust mites and their droppings to pass through.

These allergens are then blown back out into the air through the cleaner’s exhaust ports.

To trap dust mites and their droppings, use vacuums with a medical-grade true HEPA (high efficiency particulate air) filtration system. True HEPA filtration can trap particles that are as small as 0.3 microns with up to 99.97 per cent efficiency. “Do not be misled by terms like HEPA-type or HEPA-like as they are probably not medical-grade true HEPA-filters. The only way to be sure is to buy from a reputable company whose cleaners are affixed with medical-grade HEPA or true HEPA filters,” he says.

“Do not be misled by terms like HEPA-type or HEPA-like as they are probably not medical-grade true HEPA-filters. The only way to be sure is to buy from a reputable company whose cleaners are affixed with medical-grade HEPA or true HEPA filters.”
- Dr Mark Thong

ARTICLE 2

In the first comprehensive adult allergy cohort study in Singapore, researchers have found that dust mites are the primary cause of respiratory allergies in the island nation. Scientists and clinicians made these findings, which were published in the journal Allergy on 24 January 2014, from NUS and the Agency for Science, Technology and Research’s (A*STAR) Singapore Immunology Network (SIgN). The results carry potential implications in the management of asthma and allergic rhinitis in tropical urban environments.

The new study, which was conducted on some 8,000 participants, revealed that close to 15% of Singapore’s adult population is affected by asthma and nearly 40% is troubled by allergic rhinitis. According to the World Health Organization, it is estimated that approximately 300 million people suffer from asthma worldwide and even more are affected by allergic rhinitis. Both conditions are now increasingly common in Southeast Asian populations.

“Given the increasing prevalence of airway allergic diseases in Singapore and Southeast Asian countries, this study is truly a breakthrough in understanding why there are such high numbers of allergic rhinitis patients in Singapore. Knowing the cause is the first step in developing more effective interventions to improve the quality of life for asthma and allergic rhinitis sufferers,” said Research Associate Professor Wang De Yun, from the Department Otolaryngology at the NUS Yong Loo Lin School of Medicine. He co-led the study with Adjunct Associate Professor Olaf Rötzschke from NUS’ Department of Microbiology, who is also a Principal Investigator at SIgN.

ARTICLE 3

Researchers implicate house dust mites as the main cause of respiratory allergies in Singapore

Dust mites the culprit behind allergies in Singapore: Study

BY JUNE YANG
PUBLISHED: FEBRUARY 7, 11:58 AM

In the first comprehensive adult allergy cohort study in Singapore, scientists and clinicians from A*STAR’s Singapore Immunology Network (SIgN) and the National University of Singapore (NUS) have discovered that the primary cause of respiratory allergies in Singapore is the exposure to the house dust mite. The results carry potential implications in the management of asthma and allergic rhinitis in tropical urban environments. The findings of the study were published as open access in the latest issue of the journal Allergy.

According to the World Health Organisation, it is estimated that approximately 300 million people suffer from asthma worldwide[2] and even more are affected by allergic rhinitis[3]. Both conditions are now increasingly common in Southeast Asian populations. The new study revealed that close to 15% of Singapore’s adult population are being affected by asthma and nearly 40% are troubled by allergic rhinitis.
The research team, comprising scientists from SIgN and NUS, conducted a large scale cohort study with approximately 8,000 participants. Reactivity to a panel of 12 common allergens was evaluated by a skin prick test or by measuring the level of allergy-associated Immunoglobulin E (IgE). IgE is a class of antibodies that is raised upon reaction to an allergen. The findings showed that approximately 80% of those surveyed were reactive to house dust mites, and only minor reactivity to any other allergen. This high rate of reactions from house dust mites is strongly correlated with increased rates of allergic rhinitis and asthma in Singapore.

The study further found that participants who originate from non-tropical countries had low sensitization rates for house dust mites when they first arrived in Singapore, but these rates increased as they spend more time here. This increase was accompanied by an increase in airway allergies. Migrants from countries that have similar tropical climate, such as Malaysia, showed comparable rates as Singaporeans, pointing again to house dust mites as primary environmental cause.

These findings address the widening problem of allergy and asthma in tropical countries. The results suggest that changes in lifestyle resulting in more time spent indoors increase our exposure to high loads of house dust mite allergens, which translates into a dominant cause of respiratory allergic diseases in Southeast Asia. With the identification of this trigger and its dominance in Singapore, scientists can develop more effective allergen-specific desensitization strategies as well as environmental interventions aiming at the reduction of the house dust mite-load.

Prof Olaf Rotzschke, the lead investigator of the study at SIgN, said, “Rather than relying on statistics from other countries, we have managed to pin point the cause of airway allergies in Singapore. We believe that results from this study will help to understand the differences of allergies in the tropics and other parts of the world. Knowledge of the allergic trigger together with a nearly complete sensitization of the local population provides the perfect basis for the future exploration of the molecular and genetic factors that ultimately determine if the response to an allergen progresses into an allergic syndrome.”

Research Associate Professor Wang De Yun, from the department of Otolaryngology at the NUS Yong Loo Lin School of Medicine, said, “Given the increasing prevalence of airway allergic diseases in Singapore and Southeast Asian countries, this study is truly a breakthrough in understanding why there are such high number of allergic rhinitis patients in Singapore. Knowing the cause is the first step in developing more effective interventions to improve the quality of life for asthma and allergic rhinitis sufferers.”

Prof Laurent Renia, Acting Executive Director of SIgN, said, “This study is a perfect example of clinicians and scientists collaborating to investigate and tackle a very important public health problem, each bringing to the table very different, yet important domain knowledge.”

ARTICLE 4

SINGAPORE — Scientists have pinpointed house dust mites as the culprit behind the large number of runny noses in Singapore.

A study conducted by scientists and doctors from A*STAR’s Singapore Immunology Network (SIgN) and the National University of Singapore (NUS) found that a large majority adults in Singapore are allergic to the dust mites.

Almost 15 per cent of Singapore’s adult population is affected by asthma and nearly 40 per cent are susceptible to allergic rhinitis, an inflammation of the upper respiratory tract that causes sneezing, watery eyes and runny noses.

The study, published in the latest issue of the scientific journal Allergy, tested the allergic responses of 8,000 people to 12 common respiratory allergens and found that approximately 80 per cent of them showed allergic reactions to house dust mites, and only minor reactivity to the other allergens.

Furthermore, the study further found that participants who originate from non-tropical countries had low sensitivity to house dust mites when they first arrived in Singapore, but these rates increased as they spent more time here. This increase was accompanied by an increase in airway allergies.

Migrants from countries that have similar tropical climate, such as Malaysia showed comparable allergy rates as Singaporeans.

The scientists hope that these results will lead to the development of not just anti-allergy treatments that are more effective for tropical countries, but also environmental interventions to reduce the levels of house dust mites people are exposed to.

“Rather than relying on statistics from other countries, we have managed to pin-point the cause of airway allergies in Singapore,” said Prof Olaf Rotzschke, the lead investigator of the study at SIgN. “We believe that results from this study will help to understand the differences of allergies in the tropics and other parts of the world.”

Research Associate Professor Wang De Yun, from the department of Otolaryngology at the NUS Yong Loo Lin School of Medicine, said, “Given the increasing prevalence of airway allergic diseases in Singapore and Southeast Asian countries, this study is truly a breakthrough in understanding why there are such high number of allergic rhinitis patients in Singapore. Knowing the cause is the first step in developing more effective interventions to improve the quality of life for asthma and allergic rhinitis sufferers.”

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