Dr Taha Ashraf Qureshi explains allergy causes, testing and treatment in Kashmir. The interview, conducted by Raashid Andrabi for Kashmir Life’s Doctor Lounge, was rendered into text by Wajeeha Hajira.
KASHMIR LIFE (KL): What is allergy?
DR TAHA ASHRAF QURESHI (TAQ): People believe allergy means weak immunity. In reality, it is the opposite. It means good immunity, but in the wrong direction. This causes problems that may involve our throat, nose, eyes, chest, skin or any other body part.
KL: In most people, allergy appears as a cold or sneezing. This creates confusion about whether it is infection or allergy.
TAQ: Most of the time, patients visit us after having already taken loads of antibiotics. These might help sometimes, but most of the time they do not.
If it is an infection, it will not happen again and again. Allergy occurs repeatedly, after 10 or 15 days. It can be related to seasonal changes, dust or any other reason. During an acute attack of allergy, people usually assume it is an infection.
To tell the difference, first check whether you have fever. If not, it can be allergy. If you have fever, it is most probably infection, though the baseline can still be allergy. If you are not sure whether it is allergy or infection, do not take antibiotics.
Fever, body aches and nasal blockage are clear signs of infection, and you can take the necessary medication. But if you have a running nose, sneeze a lot, or have an itchy throat or irritated eyes after exposure to a specific factor, it is allergy. Consult your doctor and do not take any medication on your own.
KL: You have been treating people in Kashmir for a long time. What is the most common allergy, and what causes it?
TAQ: Kashmir follows the world trend. Across the world, the most common allergy causing factor is house dust mites. These are microscopic creatures that live with us, present in millions and billions. They are the most common cause of allergy in Kashmir and the world.
What is different in Kashmir? We have a lot of pollens, and compared to other countries, pollen allergy is much more common here. We also have a variety of pollens.
Insect allergy is another cause, from cockroaches, ants or even mosquitoes. Fungus can also cause allergies. This is not that common, but we see it once in a while. Dust mixes found outside our homes or during cleaning also cause many allergies.
Another element is pet allergy. Most people have pets nowadays, and a fraction of the population is allergic to them. I am not saying everyone has this allergy and should abandon their pets, but one in 10 people can have it. We can test you and find out if you have any of these allergies.
KL: You talked about dust mites. We clean our houses, but many people still have these allergies. Is there a solution?
TAQ: Dust mites are mostly found on our beds. They live in the foam of mattresses and come out at night in search of food. They do not touch us. Our dead skin is their food, and they do not harm us directly. They return once they get their food.
But they pass stool and urine. It dries up, and a protein in it becomes airborne. That is what we inhale, and it causes allergy. Early morning is the peak time, which is why people with this allergy see symptoms then.
Now the solutions. We mostly sit on the floor, since it is our culture, and carpets hold a lot of dust mites. Clothes, curtains and even soft toys can also be a home to these microscopic creatures.
Clean them regularly with soap. Change bed sheets every week. Wash bedding in water above 60 degrees Celsius and dry it inside your house. Vacuum carpets regularly, especially in homes of people with these allergies. Clean the vacuum cleaner’s filters and wear a mask during cleaning. We also have bedding made of material that mites cannot cross, and you can use it.
KL: Can you explain seasonal allergies, their causes and solutions?
TAQ: The most common seasonal allergy here is pollen allergy. We think the peak is April or May, but it is not. April and May are the peak pollen season for grass. August, September and October are the peak pollen season for many weeds. Right now, it is peak season for nettle, cannabis and a few other plants.
We cannot see these pollens the way we see those of April and May, so we assume it is not allergy season. If you have a grass allergy, you will get symptoms during its pollen season. If you have a weed allergy, you will see symptoms during this season.
KL: People suffer from drug allergy, for example during surgeries or with other drugs. It is said that drug allergies can be deadly. Is that real or a myth?
TAQ: I am glad you asked this. Drug allergy is a grey area. People are not very aware, and they are scared. That fear is valid, because this allergy can be deadly. For that matter, other allergies can also be deadly and take life within minutes.
Many drug allergies can react in a certain way and risk lives. Evaluation is important. People do not keep proper records. You must remember which medication affects you. Inform your doctor during any consultation and before surgeries.
KL: Is food allergy real? Specifically, is there anything in wazwan that can cause allergies?
TAQ: One of my teachers used to say everything under the sun causes allergies, including the sun itself. Wazwan is no exception. Not everyone, but someone can be allergic to an ingredient used in preparation. As such, there is nothing specific in wazwan that causes allergies.
It can also contain something that works as an anti-allergy, like turmeric. It is a good anti-allergy, but some people can be allergic to turmeric too. We were talking about drug allergy. I have seen people have deadly reactions to anti-allergy medicines. Allergy is a bizarre response, and a person can be allergic to anything.
Food allergy is an important topic. We Asians are lucky because our food allergies are not that severe. In the West, where the health system is great, people still die from food allergy, such as peanut allergy. People can be allergic to different kinds of food.
KL: People take medicines for allergies, but it returns after a few days or a week. What should they do? Are there tests, and should they already know what they are allergic to?
TAQ: Many allergens can cause allergy, and there are tests to find out what people are allergic to. Are you allergic to pollen, dust, pets, mites, fungus, insects or food?
The best test is the skin prick test (SPT), now called the skin touch test. It can tell within minutes what you are allergic to. You can find out which allergen affects you within 20 minutes. Some blood tests also help, but they are second line tests. If you cannot undergo SPT for any reason, we can perform blood tests.
Before SPT, you have to stop taking anti-allergy medicine. Your skin should be in good condition. The person should not have any phobia and should be mentally prepared.
We have worked hard to make antigen testing relevant here. As I said, pollens are different here. Twenty five types of pollens differ from those elsewhere, while others are similar to other countries. We have worked on the pollens specific to our area. We can test people and find out which variant they are allergic to.
There are two ways to avoid allergens, as I explained with dust mites. We teach people with pollen allergy the same. We have apps, QR codes with information, and PDFs. If this information works, that is great. But sometimes these tips and medications do not work. Then we can use vaccination and remove the root of the problem. It can be given as injections, drops or tablets.
KL: Is there proper technology in Kashmir for treating allergies, and where can people go for help? There is not much awareness.
TAQ: It is available in government hospitals. It has been available in SKIMS since 2007. I work in JLMN, Rainawari, where facilities are available. We even have a separate drug allergy OPD, and we were the first to start one. JVC Bemina also has facilities, as do private centres.
KL: Is it possible to treat allergies, or can we only control them?
TAQ: WHO says there are two ways to modify these problems. One is environmental control. The other is allergen immunotherapy, or vaccination. Other treatments, such as inhalers, nasal sprays and medication, are temporary solutions. You cannot take them for a lifetime.
Allergy is a progressive disease. There are chances that a simple cold can later become asthma. Many people who ignored regular colds are now asthma patients.
So the solutions are environmental changes and vaccination. But the candidate should be suitable. We cannot give these vaccines to anyone. Right candidate, right treatment, right quality of medication and tests.
