This story originally ran in February 2003

End of Cold War helps
knowledge of kids' asthma

Dr. Strunk examines one of his young patients, Brittany Ross.

 

In 1990, East and West Germany were unified. That historic event played a part in helping doctors understand more about kids' allergies such as asthma.

It's hard to believe the end of the Cold War between Russia and the U.S. would help doctors change their ideas about kids' allergies. But, it did.

Here's how it worked, according to Dr. Robert Strunk at St. Louis Children's Hospital. He works in the hospital's allergy and pulmonary department. He also is a professor of pediatrics at Washington University's School of Medicine.

He said, "When East and West Germany were united, doctors felt that provided a good chance to study differences in incidence of asthma and other allergies."

He said the doctors expected to find more asthma in East Germany. There the air was dirtier and people were poor with worse housing. In more prosperous West Germany, the air was cleaner, the housing better and people were more prosperous.

"We found out exactly the opposite," he said.

Doctors now believe early exposure to germs can actually help a kid's maturing immune system. This allows the kid's own body to better protect itself against future allergies.

That original German study results were tested again on kids from Russia and Finland. Another study involved poor Arab and richer Jewish kids in Israel.

Earlier this year, the New England Journal of Medicine reported another study involving farm kids in Germany, Austria and Switzerland.

Dr. Strunk said farm kids in Europe live much closer to animals than American farm kids do. "In America. the barns where the animals live usually are far from the farm houses," he said.

But, on European farms, the animals may even live on the first floor of a farm house and the family on the second floor. When animals are close, it's likely kids will come in contact with animal waste.

"There's a lot of bacteria in animal poop. And the walls of dead bacteria contain endotoxins that aggravate allergies. These endotoxins become a part of farm dust," he said.

Other studies have involved kids in homes that had "lots of dogs and cats as pets." Their health is compared to kids from homes with no pets. Dr. Strunk said all studies came out the same. Where the living conditions were dirtier, kids have less allergies.

"For allergies, cleaner is worse," he said.

Doctors have known that dust and dirt can aggravate existing allergies. So, they thought kids would be more susceptible to allergies if exposed to dirt, dust and pet hair in their homes and communities.

But, Dr. Strunk said, "Common sense doesn't always work out."

He said allergy doctors now believe exposure to bacteria and germs when kids are small actually can keep allergies from developing. That's because early exposure can help the baby develop immunity to disease and certain allergies.

But, this new knowledge makes it harder for children doctors to know what advice to give to parents with young kids.

Dr. Strunk has joined with fellow allergist, Dr. Leonard Bacharier. to write an article about kids and pets. It will be published later this year in the Pediatrics journal.

The article suggests "it makes a difference if a child is born into a home with lots of pets or into one with no pets," Strunk said. All studies show a lower rate of asthma in kids where there are pets.

"There is no compelling reason to get rid of pets if they are already in the home," he said.

However, he adds some kids in homes with pets will develop asthma. It's just that the rate of asthma cases is less in homes with pets than those without pets.

He admits that leaves parents with a dilemma concerning their kids and pets.

But, with the new knowledge, parents will know that it isn't automatic that the cleaner the home the less chance of allergies. In fact, it might be that a dirtier home is actually better for their kids.

St. Louis Children's Hospital is one of the nation's leading hospitals for kids' medical treatment as well as research into children's illnesses.