Allergist notes country food allergies among Inuit
"How can you live in Nunavut and be allergic to caribou and Arctic char?"
Dr. Antony Ham Pong says he first noticed an increase in the number of Nunavut patients coming to see him a few years ago.
The Ottawa-based allergy specialist was seeing more and more Inuit — many of them young children — with symptoms like eczema, hives, asthma and other nasal problems related to allergies.
So Ham Pong decided to bring his expertise to the North. He and his nurse Colleen Lessard became licensed to practice in Nunavut, and spent the week of March 12 running an allergy clinic at Iqaluit’s Qikiqtani General Hospital.
The clinics were “packed,” Ham Pong said, noting that he and Lessard saw about 20 patients a day during the five days they spent in Iqaluit.
And that has the specialist wondering if there’s a real increase in allergies among Inuit or whether Inuit have had these allergies all along, but they’re only now being noticed and treated.
In what is a fairly common scenario, Ham Pong saw a seven-month-old baby from Iqaluit who had hives and facial sweating after eating raw caribou.
The baby was having a classic allergic reaction to the food, he said.
At nine-months-old, he saw the same baby after the infant had a more severe reaction to raw Arctic char. The child could tolerate small amounts of cooked meat, but also reacted to seal and walrus meat.
Fish and seafood are considered among the most highly allergenic of foods, but seeing Inuit unable to tolerate their own country foods surprised Ham Pong.
“I’m seeing new allergies that I’ve never seen before,” Ham Pong said. “How can you live in Nunavut and be allergic to caribou and Arctic char? Before Inuit had access to western diets, how did these babies survive?”
The majority of Ham Pong’s patients are children, and most come to see him with bad eczema, which can be caused by an allergic reaction to food or the environment.
Of the children with eczema who Ham Pong has treated, about 25 per cent are found to have food allergies. And roughly 75 per cent will eventually suffer from asthma, another potential symptom of food allergies.
Although the Arctic is free of many of the environmental allergens that exist in southern Canada, such as pollen, dust mites or even indoor pets, many Inuit adults suffer from environmental allergies when they visit him in Ottawa, Ham Pong said.
There may be environmental allergens in Nunavut that he’s not aware of, which could result from heating sources or living in overcrowded homes.
But are allergies among Inuit really an emerging phenomenon?
Ham Pong suggests Inuit may have a genetic predisposition to allergies that didn’t surface until now, although he admits there hasn’t been enough research done in the North to support any conclusion.
But Ham Pong, who has kept statistics on his practice for more than 20 years, plans to document his work with Nunavummiut over time to see if it paints a clearer picture.
The allergies that he has seen are enough to bring him back to the North: Ham Pong has already scheduled a second clinic in Iqaluit for September.
That’s when he’ll encourage parents to bring children to him who have shown signs of eczema, hives or breathing problems.
Ham Pong will test patients for foods that are considered most highly allergenic, like milk, eggs, peanuts and fish.
“The only real management for food allergies is to first recognize which foods are a problem,” he said. “You can’t treat it, but you can avoid it.”
If the allergy is severe enough, Ham Pong will train patients or their parents to inject a medication to stop a bad reaction. Tools like the Epipen, with injects a dose live-saving adrenalin to diffuse a severe allergic reaction, can help families avoid having to medevac out of smaller communities without the means to treat severe reactions, he said.
And a word of advice to new parents: Ham Pong says to introduce those highly allergenic foods to babies and toddlers cautiously, taking note of any reaction.