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NEWS & NOTES
Written By: Sakina N. Bharani, M.D.
*Sneezing *itchy, runny nose *itchy watery eyes *stuffy nose *post-nasal drainage *wheezing *coughing
After a long, cold winter we look forward to the warm weather when everything around us is in bloom. However, for many “hay fever sufferers” it could be a time of discomfort and misery.
It is estimated that more than 14 million Americans suffer from what is popularly called hay fever or allergic rhinitis. Hay fever can affect any age group. Hay fever can extend from early spring to late fall depending on the pollen involved.
Hay fever is a misnomer. It has nothing to do with hay or fever. It is in fact an allergic reaction to inhaled tree, grass, and weed pollens. Similarly rose fever is not caused by roses. In the Midwest, early symptoms are from tree pollens (mid April to early May). The late spring and summer symptoms are from grass pollens (mid May to the end of June) and in the latter part when the hay fever is at its worst, it is due to ragweed pollen and other weed pollens (late August to the end of September).
Certain species of grasses are more allergenic than others. These include Timothy, Orchard, Redtop, Kentucky Blue/June and Bermuda.
Ragweed is the major cause of hay fever in Illinois. During August and September approximately a quarter million tons of ragweed pollen are distributed into the air. As the ragweed pollen is light in weight, a brisk wind can release an abundance of pollen in the air. There are many weeds other than ragweed which may cause pollen allergy, such as Burweed, Cocklebur, Kochia and Lamb’s quarter. Goldenrod and dandelions are often blamed for the trouble, but these plants have heavy pollens which are not windborne and can only cause symptoms when one comes in very close contact with them. This is also true of such flowers as Zinnias, Cosmos and Goldenglow.
The severity of hay
fever depends on the amount of pollen in the air and the degree of sensitivity
of the person. Another factor causing a variation in the symptoms is weather
conditions. On a cloudy, rainy day as the pollen is being cleared from the air,
the patient has fewer symptoms.
In genetically susceptible people repeated exposure to pollen leads to the production of allergy causing antibody or IgE, also known as Immunoglobulin E. It may take many months or years to form enough antibody to produce the symptoms. When a person is re-exposed to the same pollen, the IgE antibody reacts with the pollen and releases certain chemicals such as histamine, which in turn causes the symptoms.
SYMPTOMS OF HAY FEVER
The major symptoms of “hay fever” are sneezing, runny nose, itching and congestion of the nose. Sneezing is often in the form of paroxysms, up to 10 to 20 sneezes at a time, and more apt to occur in the morning. Usually, the nasal discharge is watery and thin and can be quite profuse. Nasal congestion alone may be the primary symptom in some patients due to swollen turbinates (swelling of the nasal mucus membrane). Eye symptoms can be very bothersome and consist of itching, watering, redness, soreness or a “tired” feeling with light sensitivity. Some patients may develop a cough and sensation of tightness in the chest; causing difficulty in breathing. These symptoms are a warning signal of the possible development of asthma. Patients who have bronchial asthma and sensitivity to ragweed pollen may experience a flare-up of the symptoms at this time.
WHAT CAN YOU DO?
Avoid pollen if you can. Since it is widespread, your chances of complete escape are limited. Wide open windows will increase the pollen in the home. Closed windows with air conditioning and air filters will help relieve hay fever symptoms by keeping out pollen-containing air. If possible, avoid mowing lawns and areas of freshly cut grass. Driving, particularly in the country with the windows rolled down, will expose you to more pollen. Showering after yard work will wash off pollen and will decrease allergy symptoms. Line drying of the laundry should be avoided because damp clothing catches the pollen.
Other suggestions for symptomatic relief are medications such as antihistamines and decongestants. There are many of them in the market. Some work better than the others. Some may not be tolerated by certain people. Mild cases of hay fever may get complete relief with antihistamines without any other help. However, moderate and severe cases may need the help of an allergist.
The antihistamines/decongestants frequently produce unwanted side effects such as drowsiness and/or irritability. Newer antihistamines are without such side effects may become available in the near future.
Over the counter nasal sprays may make the condition worse if used extensively and continuously. Cromolyn sodium is available and may relieve the symptoms if used early in the season. Many years of research and patient experience have led to the use of better nasal sprays containing cortisone preparations. These can be used safely under a physician’s care and provide a dramatic improvement in symptoms.
In patients with severe allergy symptoms, the most specific management of hay fever is desensitization or immunotherapy. The process of immunotherapy takes many months and must continue for several years. Extracts of the particular pollen to which the patient is allergic (as determined by skin test) are injected beginning with very small doses and then gradually increased. During the process of desensitization the body responds by developing tolerance or immunity to a particular pollen.
PLEASE NOTE: The information in this “News and Notes” represents general guidance in the field of Allergy.
Nothing herein stated shall be construed as a specific or implied treatment for an ailment.
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