My son has recently been diagnosed as having asthma, which appears to be caused by an allergy to the house dust mite. He is on a Pulmicort inhaler. I am concerned that we are only treating the symptoms. Is there no way of desensitising him to the house dust mite? Childhood asthma seems to be becoming more common and is very expensive to treat.

Answer

I know just how expensive asthma treatment is as I am asthmatic myself! To deal with the last part of your question first, yes, asthma is being diagnosed more frequently in children. This is happening all over the world and was a controversial subject when I was working in Canada and in Britain. Experts are divided as to the reasons for this, but most seem to think that increasing atmospheric pollution is one of the reasons. Our houses are also probably good places for house dust mites, with wall to wall carpeting, central heating and so on.

If you were in North America then you would probably be sent to an allergy specialist who would recommend a course of injections to desensitise your son to house dust mite. However, elswhere in the world these are recognised as being more dangerous than the allergy which they are trying to treat.

The way these injections work is to introduce small amounts of the allergen in the hopes of getting the body to produce enough antibodies to combat the allergy once and for all. However, they have frequently stimulated what is known as anaphylactic shock where the body has an overwhelming response to the allergen, which can be fatal. In fact there have been some deaths following desenitisation. They also tend not to work and you land up needing treatment for the allergy anyway.

Pulmicort contains a steroid called budesonide. This is regarded as one of the safest types of inhaled steroid as it has very little effect on the rest of the body, so you need not be worried about all the side effects of steroids you will have heard about. At one stage there was some concern about inhaled steroids affecting children's growth. Studies have shown that this is not the case. In fact the effects of untreated asthma are far more detrimental. If it is any consolation I inhale 800 micrograms of budesonide daily, and have done for many years, with no adverse effects.