What rhymes with rhinitis

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The proper term for what ails 4.6 million Australians is ‘seasonal allergic rhinitis,’ more commonly known as hay fever. The latter name has stuck, even though scientists have known that grass pollen was the key culprit since the late 1800s.

I surely don’t have to tell you this is one of the worst springs on record for seasonal allergies. But I will.

If you live in Melbourne and suffer from asthma and seasonal allergies, this has been and still may be a life-threatening year.

American and UK media outlets pounced on Melbourne’s “thunderstorm asthma’’ story – six dead and five more on life support, brayed NBC, portraying it as a ‘freak’ event, though Melbourne has previously had four storm-induced asthma outbreaks. The city’s emergency services were swamped, with 8,500 receiving hospital treatment.

NBC (and other media outlets) explained that the storm caused saturated ryegrass pollen grains to ‘explode and disperse’ over the city. About a third of patients reported never having had asthma before. Inter alia, about half of asthmatics have allergic rhinitis or vice versa.

The Telegraph in the UK tracked down the Melbourne scientist who discovered and named the phenomenon in 1992 (when two people died after two consecutive storms). Cenk Suphioglu, from Deakin University, said authorities should be ready to issue public alerts during such events as Melbourne is a well-known allergy hotspot. Previous epidemics occurred in 1987, 1989 and 2010.

So I thought it was (again) time to start taking seasonal hay fever seriously. Like so many of Australia’s rhinitis sufferers, I reach for the antihistamines too late – the pollen has already got to me, hence tissue boxes placed strategically around the house. If we could all be bothered, the early warning systems are in place to take prophylactic action.

Melbourne University botanist Associate Professor Ed Newbigin said in August that hay fever sufferers were set for a worse-than-usual season.  He told ABC Rural a wet winter had contributed to spring growth in grasslands across western Victoria.

These grasslands released “huge amounts of pollen” when flowering and this is then carried to the city by northerly and north-westerly winds.

website, a free service provided by the University of Melbourne and the Asthma Foundation Victoria. This useful website now also includes pollen count forecasts for Brisbane, Canberra and Sydney. Pollen is measured as grains of pollen per cubic metre of air.

Dr Newbigin told FOMM yesterday pollen counts range so widely there’s nothing he can call a ‘norm’. Pollen count ranges are 0-19 (low), 20-49 (moderate), 50+ (high) and 100+ extreme.

A pollen count of 19 to 25 grains can make a sensitive person feel rather unwell. So Melbourne’s extreme count of 154 on Sunday November 6 explains a lot about the pressure on hospital emergency departments.

It starts with itchy eyes and sneezing

Allergic rhinitis symptoms are caused by the body’s immune system mistaking inhaled pollen for a virus, hence chronic inflammation of the eyes and nasal passages.

Symptoms include sneezing, runny, itchy, stuffy nose, itchy, watery and red eyes, itchy ears, throat and palate, headache and a “woolly headed feeling.” Allergic rhinitis predisposes people to sinus infections and poor quality sleep, leading to day-time fatigue.

Writer Suzanne Moore, a new convert to the World of Snot described her world of misery well in The Guardian.

“Wearing my sunglasses indoors, struggling to tear into some new drugs, my daughter looks alarmed.”Mum, what are you doing? You look like a crackhead.”

“I know I look stupid; I feel even more stupid. Hay fever does that.

“Apart from turning your body into a snot factory, you feel perpetually fogged up; not really there at all. It’s a miserable thing.”

So do you find it just a tad worrying that medical science still does not have a cure for seasonal allergic rhinitis? We sufferers form an orderly queue at our local chemist shop, ready to try anything new.

The best known relief remedies are, in no particular order, antihistamines, nasal sprays, steroid sprays, and, for the determined, few, a series of injections designed to desensitise the sufferer.

The newly afflicted Suzanne Moore says 20% of people in the UK are affected by allergic rhinitis. Allergy UK says Brits spend close to a billion pounds on treatments.

The one in five Australians affected spend a total of $120 million a year in over-the-counter remedies, so one could be forgiven for thinking there is no real incentive to find a cure.

The preferred treatment for someone who suffers acute attacks of allergic rhinitis is to start the patient on a preventative (corticosteroid) nasal spray before the onset of the hay fever season (in Australia September-December).

Some will go further to lead a normal life. As a lad, West Tigers prop Tim Grant took on serious treatment. The Sydney Morning Herald revealed that after he was diagnosed as a 12-year-old with a grass allergy, the NRL star endured three years of injections to build up his immunity so he could train and play.

Rhinitis rare in the 19th century

In the 19th century hay fever was regarded as something that afflicted the aristocracy, possibly because the landed gentry could afford to consult the best physicians. Without exception, they prescribed rest and recreation by the seaside or at an alpine lodge in Europe. John Bostock, a British physician, spent most of his life studying an ailment which befell him in June every year from the age of eight. An article in the Journal of the Royal Society of Medicine says a speech by Bostock in March 1819 about summer catarrh is the first description of hay fever as we know it. The condition was so rare in pre-industrial revolution Britain it took Bostock nine years to find 20 other people to put under the microscope. Bostock experimented on himself with remedies and tonics including bleeding, vomiting, opium, mercury, cold bathing and digitalis, all to no avail.

It may come as no surprise to find that Canberra is the hay fever capital of the country, given the woolly-headed thinking emanating from Parliament House. Scientists attribute this status to the diversity of plants in the Australian Capital Territory which produce allergen-laden pollen.

One in 5 people living in the ACT reported suffering from long-term allergic rhinitis, followed closely by Western Australia, Victoria and South Australia. The lowest rates occur in Queensland and New South Wales (half that of the ACT). Dr Newbigin has previously said that as the planet warms and the population grows, it will be important for allergic rhinitis sufferers, health experts and city landscape planners to be aware of what environmental change may mean for population health in allergy hotspots like Canberra.

A map (below) usefully identifies where in Australia you are more likely to be afflicted. That’s not to suggest you should move to a low-allergy location. Some 95% of sufferers are allergic to grass, so their symptoms are destined to return, wherever they live.

But as John Updike once said, I moved to New England partly because it has a real literary past. The ghosts of Hawthorne and Melville still sit on those green hills. The worship of Mammon is also somewhat lessened there by the spirit of irony. I don’t get hay fever in New England either.”