The statistics are alarming... up to 30 percent of adults and 40 percent children in the United States alone now suffer from allergic rhinitis.

The more common name associated with nasal congestion, itchy and runny eyes and runny noses is hay fever, something many here in Bermuda can identify with. Until recently they would have had to go abroad for allergy testing but now that is not necessary with help available right here on the Island for that and other allergies, which will be explored in a month-long series beginning today.

Allergic rhinitis is an inflammation of the mucous membranes that occurs when allergens touch the lining of the nose. It is characterised by sneezing, congestion, itching and dripping of the nose and itchy, watery eyes.

Common allergens associated with allergic rhinitis are dust mites, pollens from weeds, grasses and trees, animal dander and molds.

Allergic rhinitis may be seasonal for people who suffer at certain times of the year, and perennial which is more related to indoors, specifically molds, dust mites and animals. Symptoms are worse during warmer months when they are likely triggered by pollens and/or molds and indicate a case of seasonal allergic rhinitis.

Seasonal allergic rhinitis affects nearly 70 million people worldwide. "The way rhinitis works is you breath something in the air that you are allergic to -- usually only very small particles are inhaled -- and they come into contact with the lining of the nose, the lining of the sinuses, the eyes and the throat,'' explained Jutta Hayward, the Nurse Manager at the Allergy Clinic of Bermuda.

"The lining of the sinuses swells and secretes fluid and if the lining swells sufficiently to block the drainage the fluid builds up and becomes stagnate and you can have a sinus problem.

"There is a thing called the Eustachian Tube between the ears and the back of the throat and it is also lined with the same kind of mucous membrane lining and if that swells it blocks and your ears can swell or pop like they do on an airplane.'' According to Mrs. Harvey there is one telltale sign of this type of allergy and that is a crease across the nose which comes from a person with an allergy pushing their nose upwards with the palm of their hand as a reaction to a runny nose. She calls it the "allergic salute'' while another sign of rhinitis is dark circles under the eye which she calls "allergic shiners''.

"Some people, even some doctors, consider allergic rhinitis as merely a nuisance but it can affect other parts of the body so it should be taken seriously,'' she cautions.

"One important thing to know is that rhinitis can make asthma worse.'' Aggravating factors of allergic rhinitis include cigarette smoke, the fumes from trucks or buses and chemical sprays which can all make allergies worse.

The causes of allergic rhinitis is this: Chemical substances, such as histamine, are normally stored in mast cells found in tissues of the body, including the nose, eyes and skin. Allergic people form antibodies called IgE against pollens and other allergens.

The antibodies attach to mast cells and combine with the allergen to cause the release of histamine and other chemicals from the mast cells. These chemical substances cause the allergic responses of itching, sneezing, congestion and dripping nose.

Allergic rhinitis often appears before the age of 20 but may be diagnosed as early as the first year of life, particularly if there is a history of maternal allergy or if the mother is a heavy cigarette smoker.

"The allergy is an exaggerated response of the immune system which is over vigilant and attacks substances that is not inherently harmful,'' explained Mrs. Harvey.

"An allergic person has an exaggerated ability to produce an antibody called IgE and the IgE is very specific for what they are allergic to. If they are allergic to cats they breath in cat dander, the body produces cat antigen and together they causes the release which stimulates the mast cells to release histamines and in turn the histamines causes all the symptoms, swelling, runny mucous and itching.'' The Allergy Clinic of Bermuda will share information and advice about the various allergies during their Allergy Awareness Open House tomorrow (9 a.m.

to noon) at their Point Finger Road premises.

Present will be representatives from various local companies such as Caesars Pharmacy, Medtech International, Rock On (nutritional supplements), Down to Earth Store and Safe Performance and Environmental Rehabilitation. There will also be a demonstration on Asthma products and indoor air filters.

There will also be activities for children, including a fun castle and balloons as well as free refreshments.

The Allergy Clinic of Bermuda, which receive patients referred by their general practitioners, has the ability to determine the type of allergy a person may suffer from by charting the patient's history and conducting skin testing to determine which specific allergens are triggering reactions.

"The best result is skin testing because that is the most sensitive area,'' said Mrs. Harvey.

"The skin actually has mast cells in it so when we inject cat dander under the skin the skin swells and we are causing a mini allergic reaction.

Treatments for allergies overlap a lot so avoidance is the main thing.'' There are various medications available, including antihistamines which, while helping with itching and running noses, can have side effects such as making people drowsy.

"There is a new type that is now non-sedating,'' said Mrs. Harvey.

"Other medications are decongestants which can help to relive the pressure on the nose and sinus areas, but they have side effects too, where people with blood pressure problems or certain other medical conditions should not take them.'' There are other nasal sprays and eye drops which are useful for a short period of time. If used daily they will cause `rebound congestion' and make the allergy worse, says Mrs. Harvey.

"They are certainly useful for a short period of time but not ever the kind of medication to take long term,'' she warns.

"There are other sprays and medications that a doctor can prescribe that can be perhaps more beneficial and have preventative effects as well. That would be steroid nasal sprays which need to be taken every day to have the desired effect.'' Allergy shots, also known as allergen immunotherapy, have been shown, through documentation of well-controlled studies, to be highly effective for patients with stinging insect hypersensitivity, allergic rhinitis/conjunctivitis and allergic asthma.

Fighting allergies This type of treatment has often been viewed as a last resort for people with allergies and often not considered at all to treat asthma. But studies suggest that shots not only control the symptoms of allergies and asthma but help keep people from developing new allergies or more severe asthma.

"After two days of reviewing the date on allergic asthma and immunotherapy, we are convinced that allergy shots can prevent new disease,'' said Ira Finegold, MD, chairperson of the immunotherapy conference and director of RA Cooke Institute of Allergy at St. Luke's-Roosevelt Hospital Centre in New York city.

"We are recommending that patients who have asthma discuss immunotherapy with an allergist as soon as possible after a diagnosis is made.'' Asthma, which affects 17 million Americans, is a chronic inflammation of the lung airways characterised by wheezing, coughing, chest tightness and shortness of breath.

It is estimated that 80 percent of all asthma in children and half of all asthma in adults is triggered by allergies. These are the patients who could be helped by immunotherapy, the report said. It was also predicted 20 percent of children who suffer from allergic rhinitis will develop asthma within eight to 10 years, according to information presented at an international conference sponsored by the American College of Allergy, Asthma and Immunology (ACAAI) that reviewed current and new research on immunotherapy.

"We have some excellent medications for allergies and asthma today, but still the number of cases of both diseases continues to climb. The severity seems to be increasing and 5,000 people die of asthma each year,'' said Dr. Finegold.

Next week: Food allergy.