The Government of the Balearic Islands only has one specialist in allergology in the Public Health System for more than one million inhabitants, which makes it the last community in number of allergists in public health. With approximately 40% of the allergic population living on the islands, the only resources that patients have to be treated are two: travel to other provinces or go to private healthcare. This is how the professionals of this medical branch have made it public in Alergomenorca 2023, a meeting that has been taking place since 2016.

This congress has the scientific endorsement of the Spanish Society of Allergology and Clinical Immunology (SEAIC) to continue claiming the situation of the Public Allergology Services in the Balearic Islands, in addition to addressing developments in the matter. In this forum it has been highlighted that the archipelago has a single allergy expert in the public network for the entire population of the Balearic Islands, close to 1.2 million people, when the optimum, according to the World Health Organization, would be one for every 50,000. This means there would have to be 24.

Despite the recommendations of the WHO and the plan to consolidate an Allergology Service by 2025, which implied the hiring to date of five professionals (two specialists, two nurses and a nursing assistant), the Balearic Islands continue with a single specialist. But also this person does not have their own public Allergology service, becoming the only region of Spain that lacks it.

“Actually, she is a specialist integrated into the Son Espases Otorhinolaryngology Service, who is caring for allergic patients. With this scenario, it is likely to be overwhelmed,” explains Dr. Alberto Oehling, president of the Balearic Society of Allergology and Clinical Immunology.

With this situation, allergic patients do not have many options to be cared for.. “They can be diverted to allergists from other provinces. Or directly, go to private healthcare”, laments the doctor. For this reason, he stresses the need for an Allergology Service to be set up, since he insists that “the quality of service right now is minimal.”

In this sense, Professor Ignacio Dávila, president of the Spanish Society of Allergology and Clinical Immunology (SEAIC), recalls that allergic diseases “constitute a permanent pathology that could affect some 400,000 people in the Balearic Islands and that currently affects between 30% and 40% of the population”. It also adds that “the absence of an Allergology Service generates underdiagnosis and undertreatment.”

To make matters worse, the Mediterranean climate of the area encourages pollination to begin early, causing allergic respiratory diseases.. For its part, the characteristic humidity of the archipelago is associated with a greater growth of mites, which increases allergic pathology on the islands.

“The high temperatures, increased due to climate change, cause pollination to be prolonged and an increase in humidity that favors the appearance of a greater number of mites. Climate change and pollution interact with allergens and with allergic people, and may have consequences in the medium and long term: more prevalence, more intensity, more severity and longer duration,” they explain from the SEAIC.

Allergists estimate that the percentage of patients with some type of allergy will increase over the years. In fact, it is expected that by 2025 half of the European population will suffer from some type of allergy.

the invisible asthma

This edition of Alergomenorca, which also vindicates the role of the allergist in the Balearic Islands, focuses on asthma: a disease that caused more than 1,100 deaths in 2018. It is therefore important, adds the SEAIC in a statement about the meeting, “to make this pathology visible, since, in some way, its affectation and its consequences are trivialized.”

This disease affects 10% of the child population and 5% of the adult population.. “The reality is that there is currently a very important lack of diagnosis and control treatments,” they warn from the SEAIC.

In recent years, severe asthma has been studied from a personalized perspective. For this reason, individualized treatments have been established for patients suffering from this pathology.. “It should not be forgotten that it is estimated that more than 50% of patients with severe asthma suffer from allergic asthma. Aeroallergens acting as respiratory sensitizers may give rise to the allergic asthma phenotype.. If this type of asthma is not controlled and treated, airway remodeling can occur, which can lead to bronchial obstruction that is sometimes irreversible and is associated with a progressive loss of lung function,” explains Dr. Santiago Quirce, allergist and member of the SEAIC.

“We classify as patients with severe asthma those who have poor control of the pathology despite following correct treatment with high-dose inhalers. Of the total 2 million adults who suffer from asthma, it is estimated that 5% suffer from severe asthma and that more than half will have poor control,” explains Dr. Eva De Santiago, a pulmonologist at the Hospital del Henares.

In this sense, the doctor recalls that “new therapeutic lines have recently been investigated and for this it is necessary to have Severe Asthma Units: these are multidisciplinary teams made up of allergists, pulmonologists, among other specialties. The objective pursued with the constitution of these units is to reduce the morbidity and mortality of these patients and improve their quality of life”, the expert points out.

Pulmonary fibrosis, silent killer

Another topic that will be discussed during the development of Alergomenorca 2023 is the presentation 'Pulmonary Fibrosis: the silent killer'. Experts agree that this condition, which, despite being closer to the specialty of pneumology than allergy, needs to be better known.

“It is one of the most serious respiratory diseases. Probably after lung cancer it is one of those with the worst prognosis. Without treatment, median survival is 3 to 5 years from disease diagnosis. Two anti-fibrotic drugs are currently available that help slow down the course of the disease”, explains Dr. Álvaro Casanova, a specialist physician in Pneumology and head of an interstitial pathology unit at the Henares University Hospital.

The disease affects lung tissue, hardening it until the patient loses lung function and must be treated with oxygen.. The main symptom of the disease is the feeling of lack of air and it mainly affects people over 60 years of age.

The Alergomenorca 2023 sessions will last until Saturday, May 13, at different venues: Hospital Mateu Orfilia, Isla del Lazareto and Isla del Rey. The first session will focus on the situation of allergology in the Balearic Islands, from the point of view of professionals and patients. It will be on Saturday when asthma takes center stage, treating everything from the basic principles of the condition to its therapeutic and pharmacological approach.

• This is the allergy to profilin that is becoming more common and with more serious reactions