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Allergies in Hong Kong: A growing epidemic?

According to the WHO, around 40 percent of the world’s population have allergies. This makes it one of the most common chronic illnesses, and includes food allergy, asthma, atopic eczema, ocular allergy, insect allergy, nasal allergy, and more. The proportion of allergy sufferers in big cities is on the rise, and Hong Kong is by no means spared from this growing epidemic. This article addresses everything you need to know about allergies, and looks at whether allergy treatment is covered by your health insurance.

The allergy situation in Hong Kong

In Hong Kong, more than one in two people suffer from at least one or more forms of allergies. What’s more, the number of children under the age of 14 developing certain types of allergies (e.g. rhinitis and eczema) is increasing.

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While many allergic conditions are indeed manageable, what’s worrying is that many children in the city-state (700 out of 100,000 of the population) have a potentially life-threatening type of allergy, i.e. anaphylaxis.

Equally worrying is the fact that despite the high demand for allergy services in HK, the ratio of allergy specialists per population is quite low compared to international figures (about 1:1.46 million of the population). As such, many patients go to their GPs instead for allergy-related treatments.

Children born in Hong Kong are also at a higher risk of developing allergies. One of the reasons for this is because, according to Dr. Lee Tok-hong from the Allergy Centre at Hong Kong Sanitorium & Hospital, babies delivered through c-sections are five times more likely to develop allergies. With four in 10 babies born via c-section in Hong Kong, the city-state has one of the highest rates of c-section births in the world.

What exactly is an allergy?

Do you sneeze or have an itchy nose when the season changes? Do you get rashes or have diarrhea after eating certain types of food? These might be signs of an allergy. But, what exactly is an allergy? According to the Hong Kong Institute of Allergy, “allergic reactions occur when the immune system reacts inappropriately to otherwise harmless substances”.

Looking at our immune system

Immune systems work by identifying harmful substances (e.g. viruses and parasites) and reacting accordingly to put an end to this danger.

When the immune system encounters harmless substances such as pollen or food, the immune system identifies this substance as harmless and thus creates a tolerance response. Subsequently, antibodies and cells that blocks or suppresses active immune reactions are produced to prevent immune reactions when the body is again exposed to the substance.

However, when immune systems react to these normally harmless substances (allergens) by producing active responses (e.g. producing hives from eating shellfish), it therefore releases a chemical called histamine to counteract it. This response causes a range of symptoms including swelling, nausea, diarrhea, etc.

Common allergens include:

  • Pollen
  • Dust mites
  • Mold
  • Animal dander
  • Insect stings or bites
  • Food-related allergens: milk, eggs, peanuts, soy, nuts, fish, shellfish, gluten, etc.
  • Latex
  • Drugs

Common symptoms to watch out for

Sometimes it can be puzzling to ascertain whether the symptoms you are experiencing is related to an allergy or something else entirely. Especially when the allergen is something that you breathe in (e.g. pollen or dust), the symptoms that you have may be very similar to what you would experience if you were to have a cold.

For example, both allergies and colds may trigger symptoms such as sore throat, coughing, fatigue and runny nose. The most important difference here is that colds don’t tend to last longer than 14 days, whereas allergic symptoms can last days to even months, as long as you’re in contact with the allergen.

If the allergen is something that you’re breathing in, then you will likely experience symptoms related to your eyes (e.g. watery eyes), nose (e.g. stuffy nose), and lungs (e.g. wheezing). On the other hand, if the allergen is something that you’re eating, then it will likely cause symptoms in your mouth (e.g. swelling), stomach (e.g. stomach pain), and intestines (e.g. diarrhea).

More severe reactions

Anaphylaxis is a life-threatening allergic reaction that can cause your body to go into shock – your blood pressure drops and your airways suddenly become narrow, blocking breathing. If anaphylaxis is not treated right away, it can be fatal. Other severe allergic reactions include difficulty swallowing, and heart palpitations.

Common diagnosis methods

If you’re experiencing any allergy symptoms, your doctor will take a detailed look at your medical history and evaluate your symptoms. They will then likely order allergy tests to see what’s causing your allergy. Allergy testing involves either having a skin or blood test.

Skin tests

Skin tests involve pricking the patient’s skin with a drop of suspected allergen. A number of suspected allergens are tested at the same time. If you’re allergic to the allergen, your skin will turn red and swell at where your skin was pricked.

Blood tests

A blood test involves taking a sample of your blood, and then sending it to a lab for testing. The test checks your blood for antibodies (the protein your body produces to fight off harmful substances) against possible allergens. Blood tests are more expensive than skin tests, and will take about a week or two to come back from the lab. That being said, it’s a readily available and accurate way to measure the amount of allergen-specific antibodies in your blood.

Common allergy treatment methods

As the saying goes, prevention is better than cure. If you can, one of the best ways of preventing an allergic reaction is simply avoiding exposure to your allergens. For example, if you’re allergic to dust mites, using “mite-proof” bedding and removing carpets may help significantly in keeping your allergies under control.

Drugs such as antihistamines are also a common method of treatment, and can be taken as pills, nasal sprays, or eye drops to help block the histamine causing your allergic reaction. If you’ve got nose allergies, then steroid nasal sprays can help relieve your symptoms by reducing the inflammation within the nasal passageways.

Another method of allergy treatment is called allergy shots, where a tiny amount of what you’re allergic to is injected into your upper arm. At first, you’ll be getting them around once every 2-4 weeks, and the dose will gradually decrease until you’re getting them once a month for several years to help your body get used to the allergen.

For more severe allergic reactions, you may even require hospitalization. People with severe allergies will often carry emergency medications such as an EpiPen, which is a “rescue drug” that opens the airways and raises blood pressure in the event of an anaphylaxis shock.

Does health insurance cover allergies?

Allergy tests and treatments can be very expensive in Hong Kong, especially in private hospitals where a single consultation with an allergist can cost around HKD 1,600 excluding medications. It’s therefore highly recommended that you obtain a comprehensive health insurance plan so that your costs are covered.

One thing to be aware of concerning allergies and health insurance is that many (but not all) insurers consider allergies, or asthma related to allergies, to be a pre-existing condition (a condition that you have already had before you obtained your insurance). If that is the case, you may not be eligible for coverage. On the other hand, if you did not know you had allergies until after you have secured your policy, then in most cases you’ll be eligible for coverage.

If you’ve got a newborn, it’s also highly recommended that they are added under the parent’s plan, so that allergies can be covered if it develops at a young age.

Covering pre-existing conditions

If you have received treatment or have been diagnosed with allergies prior to securing health insurance, there are plans out there that do cover pre-existing conditions. For example, the insurance provider may place a loading on your plan, meaning your premium will rise by a certain amount so that it covers your pre-existing conditions. Some insurers may also place a waiting period on your plan, which means you’ll need to wait a specified period of time before you’ll be eligible for coverage of your condition.

Many corporate health insurance policies also have what’s called a Medical History Disregarded (MHD) clause, although a growing number of employee health plans are starting to exclude this, as treatment for these conditions tend to be quite expensive. If you’ve got employee health insurance, then it’s a good idea to double check what’s included in your policy.

Got any more questions? Feel free to get in touch with our insurance experts for impartial health insurance advice, and a free quote!

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