原文：

A modern epidemic
The first indication that something was not quiet,right with Matteo came when he was 1 month old:oozing skin rash on his face.Over the next few months it got so bad that his skin lesions weren’t healing properly .”Instead of oohing and aahing over my baby,people were disgusted”,says his mom,Cristina.At 5 months,doctors ran some tests and found that Mateo was among the 6 to 8 percent of children under the age of 3 with an allergy to food-in this case,breast milk.His mother put him on soy milk,but after a few months the skin rashes returned,and Meatteo began vomiting.His doctors put him on a predigested chemical milk made from amino acids.Now 2 and a half,Matteo is allergic to tomatoes,many vegetables and can’t even touch milk.Doctors haven’t made any promises,but when Matteo turns 5 they plan to administrer a controlled test of his allergic response to milk and other substances.They are hoping he simply outgrows his allergies.
Implausible as it seems,Matteo’s condition is at the cutting edge of modern pediatric medicine,right up there with hay fever.If a popular magazine had run a children’s health issue a hundred years ago,the first article might have been about diphtheria or cholera-external threats that the West has largely conquered by antibiotics and sanitation.Instead we are examining allergies,a self-generated danger,the result of an immune system out of sync with its surroundings.It’s a threat that may in part be an unintended consequence of our triumph over the infectious scourges of the past.And the urgency is growing .All allergies seem to be on the rise,in fact,but “it’s not just that more kids have allergies”,says Dr.Marc,director of allergy and immunology at hospital.The severity of those allergies has also increased.
An allergy is an overreaction by the immune system to a foreign substance.According to the Food Allergy ,almost any food can trigger an allergy,although eight categories account for 90 percent of all reactions:milk,eggs, peanuts(technically,a legume),tree nuts,fin fish,shellfish,soy and wheat .For reasons not fully understood ,in some people these otherwise harmless substances provoke the same reactions by which the body attempts to rid itself of dangerous pathogens.These may include sneezing,vomiting and the all-purpose localized immune-system arousal known as inflammation .The lungs may affected;allergies are a leading trigger for asthma attacks.In extreme cases,the reaction involves virtually all organ systems and proceed to anaphylaxis ,a dramatic drop in blood pressure accompanied by extreme respiratory distress that may be fatal without prompt treatment.
What can underlie such a self-destructive reaction?An infant who grows violently ill in the presence of as little as one hundredth of a peanut almost surely has some sort of genetic predisposition.Indeed,if one parent has an allergy ,chances are one in three that the child will be allergic,according to the Asthma and Allergy Foundation of America,If both parents have allergies,the odds rise to 70 percent.But the children aren’t necessarily allergic to the same things as the parents-strongly suggesting that some other factors must be at work as well.And genetics cannot explain the rapid rise in allergies over the past few years or for that matter,centuries.
So something must have changed in the environment.One obvious place to look is air pollution.Studies by Dr Saxon,chief of a clinical immunology at UCLA,and his colleague David,have found a strong correlation between pollutants-diesel exhaust and cigarette smoke-and the development of allergies.Researchers don’t believe pollution is the whole story,though;allergies have continued to climb even as smoking and air-pollution rates have fallen.But industrialization has also brought about declines in infectious diseases and close exposure to farm animals.The “hygiene hypothesis” holds that these trends have contributed to the rise in allergies.The human immune system,which evolved in a natural environment teeming with hostile bacteria and parasites,finds itself uncomfortably idle in the antiseptic confines of the modern suburb,and failing to mature properly takes out its frustration on harmless peanuts and shrimp.Numerous studies have lent support to this general notion.But although many researchers accept the hygiene hypothesis in outline,the emerging picture is of a complicated relationship,where does and timing of exposure play important but still uncertain roles,say Dr Scott .
So the hygiene hypothesis has yet to generate any concrete prescriptions.The eventual hope is for a way to artificially stimulate the immune system to reduce allergy risk without having all these diseases .Meanwhile,though,researchers are developing new drug therapies that go beyond epinephrine (for emergency treatment of anaphylaxis) and the growing array over-the-counter antihistamines(Histamine is a key substance in the cascade of biochemical events that constitute an allergic reaction).Newer drugs ,like Singulair in the chain.
Pediatricians have also begun taking allergies more seriously.One key bit of advice to mothers is to breast-feed infants exclusively for six months.Delaying children’s exposure to novel foods in this way is the hallmark for food-allergy prevention,says the American Academy of Pediatrics.once an allergy has been diagnosed,the only thing to do is draw a cordon sanitaire around the child .Susan is allergic to milk products,eggs,fish,nuts and mustard,goes so far as to check out school art supplies;a fourth-grade teacher once mentioned adding eggs to tempera paint for a better texture.Thanks to her vigilance ,her home-cooked and prefrozen meals and New York’s ubiquitous fruit and vegetable markets,David is a healthy,normal boy,an avid skier and alive
翻譯：

現代流行病
馬特奧1個月大的時候，第一個跡象表明他有點不安靜：臉上滲出了皮疹。在接下來的幾個月里，情況變得非常糟糕，以至于他的皮損無法正常愈合。他的媽媽克里斯蒂娜說：“人們不是為我的寶寶流口水，而是感到惡心?！?#xff0c;醫生們做了一些檢查，發現在3歲以下的兒童中，有6%到8%的人對食物過敏，這就是母乳。他的母親給他喝豆漿，但幾個月后皮疹復發，Meatteo開始嘔吐。醫生給他喝了一種由氨基酸制成的簡化化學牛奶?，F在是2.5，馬特奧對西紅柿、許多蔬菜過敏，甚至不能接觸牛奶。醫生們還沒有做出任何承諾，但當馬特奧滿5歲時，他們計劃對他對牛奶和其他物質的過敏反應進行一項對照試驗。他們希望他能完全擺脫過敏。
令人難以置信的是，馬特奧的病情正處于現代兒科醫學的前沿，正處于花粉熱時期。如果說一百年前有一本流行的雜志刊登了一期兒童健康雜志，第一篇文章可能是關于白喉或霍亂的外部威脅，西方主要是通過抗生素和衛生設施來戰勝這些威脅，而我們正在研究過敏，一種自我產生的危險，免疫系統與周圍環境不同步的結果。這是一種威脅，部分原因可能是我們戰勝了過去的傳染病帶來的意外后果。而且這種威脅的緊迫性正在增加。事實上，所有的過敏似乎都在增加，但“不僅僅是更多的孩子有過敏癥”，過敏和醫院的免疫學。過敏的嚴重程度也增加了。
過敏癥是免疫系統對外來物質的過度反應。根據食物過敏癥，幾乎任何食物都會引發過敏癥，盡管8種食物占所有反應的90%：牛奶、雞蛋、花生（從技術上講，是豆科植物）、堅果、魚翅、貝類、大豆和小麥。由于不完全了解的原因，在一些人中其他無害的物質也會引起同樣的反應，身體試圖擺脫危險的病原體。這些反應可能包括打噴嚏、嘔吐和被稱為炎癥的通用局部免疫系統喚醒。肺部可能受到影響；過敏是哮喘發作的主要誘因。在極端情況下，該反應幾乎涉及所有的器官系統，并進行過敏反應，血壓急劇下降伴隨著極度呼吸窘迫，如果不及時治療，可能是致命的。
這種自我毀滅性的反應有什么根據？如果一個嬰兒在只有百分之一花生的情況下嚴重生病，幾乎可以肯定他有某種遺傳傾向。事實上，根據美國哮喘和過敏癥基金會的數據，如果父母雙方都有過敏癥，那么孩子過敏的幾率是三分之一但是，孩子們不一定對父母的同樣東西過敏，強烈地暗示其他一些因素也一定在起作用。遺傳學也不能解釋過去幾年或幾個世紀里過敏的快速增長。
所以環境一定發生了變化。一個顯而易見的地方就是空氣污染。加州大學洛杉磯分校臨床免疫學主任薩克森博士和他的同事大衛的研究，已經發現污染物柴油廢氣和香煙煙霧與過敏癥的發展有很強的相關性。盡管研究人員不認為污染是全部；盡管吸煙和空氣污染率已經下降，但過敏癥仍在繼續攀升。但是工業化也導致了傳染病和近距離接觸農場動物?！靶l生假說”認為這些趨勢導致了過敏的增加。人類免疫系統是在充滿有害細菌和寄生蟲的自然環境中進化而來的，但在現代郊區的消毒環境中卻令人不安地無所事事，如果沒有適當的成熟，它就會對無害的花生和蝦產生挫敗感。許多研究都支持這一普遍觀點。但是，盡管許多研究者大體上接受了衛生假說，但新出現的情況是一種復雜的關系，在這種關系中，暴露的時間和程度起著重要但仍然不確定的作用，比如斯科特醫生。
因此，衛生假說尚未產生任何具體的處方。最終的希望是找到一種方法，在沒有所有這些疾病的情況下，人為地刺激免疫系統，以降低過敏風險，研究人員正在開發新的藥物治療方法，包括腎上腺素（用于過敏反應的緊急治療）和越來越多的非處方抗組胺藥物（Histamine是構成過敏反應的生化事件級聯中的關鍵物質）
兒科醫生也開始更認真地對待過敏癥。給母親們的一個關鍵建議是用母乳喂養嬰兒6個月。美國兒科院說，用這種方法推遲兒童接觸新食物是預防食物過敏癥的標志。一旦診斷出過敏癥，唯一要做的就是在孩子周圍畫一條警戒線。蘇珊對奶制品、雞蛋、魚、堅果和芥末過敏，甚至檢查學校的藝術用品；一位四年級的老師曾經提到在蛋彩畫中加入雞蛋以獲得更好的質感。多虧了她的警惕，她的家常菜和預凍食品以及紐約隨處可見的水果和蔬菜市場，大衛是一個健康，正常的男孩，一個滑雪愛好者和活著的

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