Separated by a Common Language

'Allergies' always felt like a prototypical Americanism to me. It was a phrase I only ever encountered in 90s children's books, by Paula Danziger and her ilk. The notion of getting 'shots' every season for all the things you're allergic to was one of those alien American concepts that didn't seem quite real, like going off to Camp for two months every summer, or classrooms full of children mechanically chanting thei loyalty to a flag every morning.

[Sidenote: the Captcha is exceptionally American- I've been asked to identify candy and pickup trucks.]

I agree that the high frequency of allergies in American most probably reflects the high frequency of (diagnosed) allergies in America.

You don't get allergy shots every year, though: they apply to specific allergens only, are typically a single series, and are only done if the allergen is very dangerous to the patient and difficult to avoid. Reactions to insect bites are allergic, but nobody gets treated for them unless they are at risk of death, as some people are from bee stings.

We aren't loyal to the flag, we are loyal to the republic for which it stands, as the pledge says. Think of it as the American loyal toast.

This may be a recency illusion, but my feeling is that in the US the word 'allergy' has become common for all sorts of reactions that aren't allergies at all. People will say they're allergic to lactose or to other kinds of food, for example, when what they really mean is they have an intolerance of some sort.

I even noticed this when I went to a pre-op interview for surgery some years. The nurse asked me if I had allergies to any drugs, and I do, so I mentioned them. But then at the end of the interview I said that there were a couple of other drugs I couldn't tolerate. She asked why I didn't mention before. Because they're not allergies, I said. Puzzlement ensued.

Of course, there's a strictly metaphorical use of 'allergy' but I'm talking about contexts where the scientific sense is (presumably) meant.

Then again, for most Britons the loyal toast is as alien as the US pledge, something only seen in old films and books.

Then again, when I was at school in the sixties, we started each day singing a Christian hymn and often had a reading from the bible. And that was a normal state school, not a religious school.

Before giving patients contrast dye for a CT scan in UK we have a checklist. One line is, "Do you have asthma, eczema, hay fever or any other allergies?". When I asked why hay fever was singled out I was told that not every hay fever sufferer realises it's an allergy so we cover ourselves that way.

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Hay fever = seasonal allergic rhinitis. I happen to be allergic not only to most wind blown pollen (tree pollen in spring, grass pollen in summer, and weed pollen (particularly nettle pollen) in autumn), but fungal spores are also bad for me.

"Allergies" will include (but are not limited to) hay fever. Will extend to other allergic reactions.

I have always associated 'hay fever' with autumnal dander, that is, seeds being spread around in the Fall. Accordingly, I always wondered why there wasn't a corresponding term 'pollen fever' for my infernal vernal rhinitis. Apparently, 'hay fever' refers to both, though dander and pollen seem dissimilar enough to me to warrant different terminology. My physician just calls them seasonal allergies.

50-year old Ohioan and I've always said "hay fever" although now that I think of it, it does seem that people say "allergies" more often now.

I've always said, and suffered from, hay fever, but my American friends always talk about their allergies.

While I am well aware that hay fever is caused by an allergic reaction to some kind of pollen or other, "allergy", to me, is much more serious - the life-threatening reaction some people have if they eat peanuts, for instance, or when people are violently sick after eating oysters or shrimps.

I grew up (AmE Midwest) saying "hay fever," usually referring to ragweek. But over the years, as I kept reading the obligatory "it's not caused by hay" disclaimer in print discussions, my editorial-accuracy reflex pushed me toward "allergies." Possibly those repeated corrections influenced others, too?

*ragWEED. Speaking of editorial accuracy ...

Google Books Ngram suggests "hay fever" is down from its peak in both countries, whether or not it's being replaced by "allergies."
https://books.google.com/ngrams/graph?content=hay+fever%2Callergies&year_start=1800&year_end=2000&corpus=15&smoothing=3&share=&direct_url=t1%3B%2Chay%20fever%3B%2Cc0%3B.t1%3B%2Callergies%3B%2Cc0

As others have also said, "hay fever" often refers to more than just pollen (dust mites, for example), so I [Australian] would not expect anyone to avoid using it just because "I'm never really sure what I'm sneezing out". Also as others have said, to me "allergies" comes across not as being vague about the cause, but about the symptoms.

If Americans are more inclined to restrict the meaning of "hay fever" to pollen allergies only, or to use "allergies" for hay fever –like symptoms specifically (and some other term/form for other types of reactions), then those are indeed differences worth noting.

I have perennial allergic rhinitis but still use "hay fever" to describe it as it represents a constellation of symptoms that the majority of people recognise. I think the rise in the use of the term "allergies" in the UK is seperate from it's replacement or otherwise of hay fever. Simply, the prevalence of allergy in general has increased significantly over the last few decades, as has public awareness of them. I would wager a significant amount of the use of Allergies refers to allergy to animal dander, foodstuffs (eggs, apples nuts, cows milk and peanuts), beestings and the like. It is common for people to talk of "gluten allergy" referring to coeliac disease. This not an actual "Type 1 Hypersensitivity" Allergy (IgE mediated) but is more an intolerance (it is a type 4 hypersensitivity (T lymphocyte mediated) reaction). The difference being that coeliac disease will not cause an anaphylactic reaction whereas the type 1 hypersensitivity "allergies" theoretically can.

To add to the confusion, the definition of allergy has changed over time, as it once did refer to all 4 types of hypersensitivity reaction. Modern usage restricts it to describing type 1 reactions like hay fever. The broader usage survives in names like "Extrinsic Allergic Alveolitis" which is actually a type 3 hypersensitivity (Immune complex) reaction. One of the extrinsic allergic alveolitis diseases is called Farmer's Lung. This is a disease caused by an immune reaction to mold spores found in hay. One of the acute signs of this disease is a fever. However, despite being a fever caused by hay, it has absolutely nothing to do with Hay Fever.

Paul Dormer

for most Britons the loyal toast is as alien as the US pledge, something only seen in old films and books.

Not because the notion is outdated, but rather because the formal dinners at which it is a feature are now so rare in so many lives.

I'm an almost-20-year-old in Ohio, and I've only ever heard "hay fever" in cartoons and storybooks as a kid (many of which were from other countries - the example of "hay fever" I can call clearest to memory is from a Canadian cartoon that played on PBS when I was little). I know what it means, but I'd never use it and I haven't really ever heard others much use it.

Allergic or atopic rhinitis avoids the issue of it not being hay... But allergies to my mind is actually more useless than hay fever. We know hay fever isn't necessarily to hays and grasses but type I hypersensitivity reactions (which are allergies) include reactions to thing like bee stings, many forms of asthma and so on, anything that is an IgE mediated response.

Things like contact dermatitis (being "allergic" to creams, ointments, non-gold jewellery etc) is strictly not an allergy because it's T-cell mediated.

Sorry, I'll go crawl back under a rock now.

Since there's been some discussion about whether "allergy" might reasonably refer to anything other than the sort of un-useful immunological reaction that can result in anaphylaxis, I did what a writer will normally do, go to dictionaries. 8-)

Merriam-Webster online:

http://www.merriam-webster.com/dictionary/allergy

Dictionary.com

http://www.dictionary.com/browse/allergy

And, for completeness, the Mayo Clinic:

http://www.mayoclinic.org/diseases-conditions/allergies/basics/definition/con-20034030


None of those definitions (predominantly AmE) would seem to indicate that there's any restriction to specific types of immunological responses implied by "allergy".

I wonder whether the term has acquired a more specific meaning regionally, by profession, or by some combination of those.

Doug, I suspect Merriam-Webster, Dictionary.com and the Mayo Clinic's PUS interface are all reporting a really non-technical usage. In fact from the Merriam-Webster definition there are just enough of the right words that the technical definition is almost there.

Given the time that allergy appeared, I would further guess that allergy appeared in AmE in response to the hypersensitivity reactions being categorised, so a Type I hypersensitivity reaction is properly called an allergic reaction. I wouldn't normally refer you wikipedia, but I'm guessing immunology textbooks are thin on the ground out there (although Janeway et al is a good one), and if you hit up https://en.wikipedia.org/wiki/Allergy#Pathophysiology the first words are "In the early stages of allergy, a type I hypersensitivity reaction...: then towards the end of the first paragraph you get "…production of a large amount of a particular type of antibody known as IgE. Secreted IgE circulates in the blood…"

Allergy really is a type I hypersensitivity response mediated by IgE. I'd encourage you to read the references if you don't want to believe Wikipedia.

I'm fairly sure it's a word like cancer, vector etc. where there is a precise definition but it's leaked into common usage and that precision has been blurred rather than the other way around.

In an updated 2009 Third Edition entry, the OED traces the word allergie to 1907, when it was a translation of German Allergie apparently coined the year earlier in 1906.

In 1907 the Journal of the American Medical Association spelled it 'allergie' {Note quotes]

In 1908 the Lancet spelled it 'allergeia' {Still in quotes]

In 1911 a contributor to the Archive of International Medicine called von Piquet wrote

We might rightly use the word ‘allergy’..as a clinical conception. [Modern spelling but still in quotes]

1913 an English translation of a reference (presumably in German) referred to von Piquet, but not to his spelling

According to Wolff-Eisner, this is the cause of the increased capacity of the organism for reaction to the toxin of the foreign albumin after repeated injections, the ‘allergia’ of von Pirquet. [Still in quotes]

In 1926 Scientific Monthly — an American publication — prophesied

It is true that some people have an idiosyncrasy towards certain foods. We will soon speak of idiosyncrasy as food allergy.

Note the grammar of all these quotations. There was at first no such then as an allergy. Quotes from 1916 and 1929 write of allergies — i.e. instances of the condition 'allergy'. Only as late as 1946 are we given the quotation

Cases of so-called ‘nylon dermatitis,’ or ‘an allergy to nylon,’ are attributed to contact with finishing materials. {Note the quotes]

At least in the OED quotations of the 1940's and 50's allergies seems to have denoted types of instances of the condition allergy. More recently an allergy came to mean an individual case of a type of an instance of the condition allergy — especially in the transferred non-medical sense of 'aversion'.

By contrast the term hay fever can be traced to 1829. In a letter of1835 Sidney Smith wrote

I am suffering from my old complaint hay~fever (as it is called).

A book of Practical medicine of 1840 explained

The Summer Catarrh, hay-fever, or hay-asthma as it is termed from its supposed connexion with the effluvium of new hay.

The remaining quotation is from 1851

The King enjoyed an exemption from his annual attack of hay-fever.

From all this I conclude that

• hay fever began and has remained asa term for a personal experience of a seasonal complain

• allergy began as an abstraction denoting a physiological process, extending to substance-specific processes such as food allergy and specific instances such as a food allergy.

This, I believe, is the default understanding of the word to British English speakers of my generation. The further extension of allergy to cover complaints as suffered by individuals is something that is intelligible but not the norm to my generation and at least some younger speakers.

For current complaints, I would normally speak of an attack of a THINGY allergy or an allergic reaction to THINGY.

Eloise: "Doug, I suspect Merriam-Webster, Dictionary.com and the Mayo Clinic's PUS interface are all reporting a really non-technical usage. In fact from the Merriam-Webster definition there are just enough of the right words that the technical definition is almost there."

Oh, I have little doubt that there is a technical definition that matches what you have said. But the instant* article refers, at least as I read it, to common usage. From what little I can glean, the common usage is earlier (in the US, anyway, and I might be wrong about that, of course). Expecting common usage to follow a change in technical usage might be a bit unrealistic. Frankly, expecting common usage to match an earlier technical usage is a bit of a stretch.


* Probably an archaic usage, but I find it ... felicitous. 8-)

I think it's important to keep in mind that I was just talking about the plural 'allergies', not the singular. Using it in the plural in everyday speech takes it a step into the vague, non-technical realm. If I say 'my allergies are bothering me', I'm talking about hay-fever-like symptoms, not my food or drug allergies. I wouldn't say in that case "My allergy is bothering me" or "I have an allergy that's bothering me".

Of course, some or many of the 'allergies' in the data set may be technical usage, but my friend's observation that "Americans say 'allergies' and Brits say 'hay fever'" was to say "Americans say 'allergies' for what the Brits call 'hay fever'". (As it happens, she wasn't quite right about that, but she was right that people use plural 'allergies' to mean 'I'm sneezing because of something in the air'.)

To me and, I think to other BrE speakers — older speakers at any rate — that use of my allergies is quite alien to the point of misunderstanding. An allergy isn't a current batch of symptoms and nor are allergies.

In my speech you can have one or more allergies and never suffer a single symptom — by virtue of living carefully and never going near a peanut or whatever it is. I couldn't say of you for Mrs Redboots in the dead of winter that you have hay fever when there are no symptoms. You have hay fever now. You'll still have that pollen allergy (or whatever it is precisely) when the season is over, but you'll no longer have hay fever.

My dad has always talked about his sneezing/sniffling/etc. due to ragweed (among other things) as hay fever so I grew up hearing that, but I think I consider it old-fashioned. I'd be pretty surprised to hear someone significantly younger than my parents use the phrase, I think. I'd expect them to say "allergies", which, I agree with Lynne, when used in the plural like that almost exclusively refers to sneezing/sniffling/etc. due to environmental (particularly seasonal) allergies, and not something like a food allergy.

(Massachusetts born/raised/live, 35 years old)

I agree with David Crosby. Hay fever is something you get and suffer from. An allergy isn't necessarily something you get. It's a condition, a predilection, that means that you get a nasty reaction from certain foods or other substances. You have the allergy just as much if you've been good, have not been exposed to whatever causes the risk, and aren't experiencing any reaction as you do if you are throwing up, have come out in spots or are having lots of nasty spasms.

You get hay fever because you are allergic to pollen. But when you aren't suffering the symptoms, you no more have hay fever than you have 'flu when you had it a month ago and have recovered.

That's my understanding of BrEng usage.

To me it's a temporal difference. I _have_ allergies, in the sense of an ongoing condition that I know won't go away. But I _experience_ hay fever in-the-now, when there's pollen in the air.

Anecdotally, I heard people speak only of "hay fever" during the first half of my life that I lived in the UK, and only of "allergies" during the latter half in the US (California). I don't believe I've ever heard an American say "hay fever" until today.

About the only time it comes up for me is when a doctor's office asks if I'm allergic to anything and I reply that I have hay fever. I usually then change it to "seasonal allergies" but always say "hay fever" first. This may be a matter of region (western South Dakota which is the northern Great Plains where they begin to meet the Rocky Mountain west), but I think it really is more likely an age thing (now in my very late 50's, childhood mostly in the 1960's).

"Ragweed" (or "ragweek"?). Surely the usual name is ragwort.

Little Black Sambo: When I was finally tested for allergies, in my late teens--after suffering all year round from one thing or another throughout my Southern California childhood--"ragweed" was indeed one of the many culprits identified in the printout. I have no idea whether it's an Americanism; I've never heard "ragwort." https://en.wikipedia.org/wiki/Ragweed

BTW, I lived in a big city, miles from any hay bales, so although I'd occasionally heard or read "hay fever," it always struck me as limited and ludicrous. We tended to say "I'm allergic" rather than "I have allergies"; I was allergic to all sorts of pollen (year round in SoCal), molds, tobacco, and -- worst of all -- cat dander. They all smooshed together to provoke nonstop sneezing and dripping. Happily, I outgrew all of it.

According to the OED, ragweed has been another name for ragwort in Britain for centuries (earliest quotation 1610), but the name is now chiefly confined to Sc. and Irish English.

I think 'Sc.' covers both Scots and Scottish English. Burn apparently wrote

Wither'd Hags..on ragweed nags, They skim the muirs.

The Belfast Telegrah in 2003 warned

Occupiers of land are reminded that ragwort (also called Ragweed or Bogweed) is poisonous and may cause illness.

The plants called ragweed in America are of a different family. The OED notes that ragweed is a major cause of hay fever in America and in Australia. I take this to imply that ragwort has no such effect.

Ragwort has pretty yellow flowers. It is pollinated by bees etc - so doesn't cause hay fever.

I'm in the SE US. When I was a kid--65 years ago--I took allergy shots for hay fever.

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Hayfever is commonly written as a single word in British English: https://books.google.com/ngrams/graph?content=hayfever%2Chay+fever&year_start=1800&year_end=2000&corpus=18&smoothing=3&share=&direct_url=t1%3B%2Chayfever%3B%2Cc0%3B.t1%3B%2Chay%20fever%3B%2Cc0 . The two variants "hay fever" and "hayfever" when added together seem to be more common in British than American English.

I'd be interested to see regional usage in the US. I grew up in rural TN, and heard both but think I heard hayfever more. I'd be willing to bet that in places where hay is actually grown you see more hayfever usage.

I remember reading about a British doctor's surprise when, at a US-UK medical conference in the 1990s, all the US doctors wanted to discuss and present papers on was allergies; at that time "allergies" other than hay fever (and I feel that was uncommon relative to today) were practically unknown in the UK but the coming thing in the US. Since then, we Brits have been doing our best to catch up - from recent research probably by limiting our young children's exposure to "germs" and peanuts. As familiar as I am with the term, Lynne's casual use of "allergies" to refer to a single allergy is very surprising - a little like me complaining about my "illnesses" when I have laryngitis.

I share David L's experience of the extension of the use of allergy to cover intolerance, to the extent that the latter word is rarely heard nowadays. Well, allergy sounds so much better anyway.