Month: October 2014

Pet Allergy: What You Should Know

The two most common pet allergies in the United States are cats (20% of the population) and dogs (10% of the population).  Dogs, however, are the most common pet, followed by cats.  There has been an upward trend in the U.S. in the number of household pets with almost 70% of households having at least one pet.  Of course, besides dogs and cats, other common pets include birds, rodents (i.e., hamsters, guinea pigs, gerbils, chinchillas, mice, etc.) reptiles (i.e., lizards, snakes, turtles, etc.), rabbits, ferrets, horses, hermit crabs, spiders, and fish.  Horses, unlike the other pets mentioned above, do not live in people’s homes, but can be quite allergenic.

One can be allergic to any animal, but clearly the most common indoor pet allergies are cats and dogs.  For the purpose of this blog, we will talk exclusively about cats and dogs.  If you would like to see more information about allergies to other types of pets, please visit our website, www.bkallergy.com , click “SERVICES,” and then click the 4th bullet which is a link entitled “Pet Allergies.”

When an individual is “allergic” to a pet, they are in fact “allergic” to particular proteins that are produced by that animal.  For example, the proteins that cause most of the misery suffered by people who are allergic to cats are designated “Fel d 1” and “Fel d 4.”  Likewise, in individuals that are allergic to dogs, the major protein involved is called “Can f 1.”  Most proteins that cause allergies in any household pet tend to be concentrated in the pet’s dander, urine, saliva, and/or feces.

The dander (from the skin of an animal) tends to be a big problem with most pets.  In cats, the dander tends to “stick” to things such as clothing, walls, carpeting, bedding, etc. and therefore can and is “transported” from the home to other places that people go to, such as their workplace.  If Fel d 1 protein is measured on a cat owner’s clothing or their upholstered chair at work, it is likely to be found.  In addition, since the proteins stick to the walls of the cat owner’s home, it takes months for the proteins responsible for causing an allergic reaction to diminish to non-detectible levels, despite a thorough cleaning of the home.  Since the protein is also found in urine, cat litter boxes are a rich source of the proteins.  In dogs, luckily the protein Can f 1 is not as “sticky” as the cat proteins, but still can stick to clothing, bedding, etc.

As a general rule, it is advisable not to have a pet if one is allergic to it.  However, despite common sense, most people still opt to either acquire a pet or to keep an existing pet that they have had even if they cause bothersome allergy symptoms.  Even though this is not advised, it is understandable since a pet can cause great joy in one’s life and becomes a member of the family!

One major misconception is that there are “hypoallergenic” cats and dogs.  While some people feel that

they do better around short-haired cats or around dogs that do not shed like poodles, most scientific studies do not support this phenomena.

One can take some measures to reduce their exposure to the allergens that cause pet allergies.  Brushing your cat or dog frequently and bathing your cat or dog often will help reduce the levels of cat and proteins.  It is also advisable to prevent the cat or dog from entering your bedroom.

The symptoms of pet allergies are similar to any other type of environmental allergy.  The symptoms can include any or all of the following:  sneezing, runny nose, stuffy nose, itchy/watery/red puffy/eyes,

post-nasal drip, itchy skin, hives, wheezing, chest tightness, coughing, and/or shortness of breath.

The board certified allergists at Black and Kletz Allergy can help you diagnose whether you have a pet allergy by simple tests which involve a thorough history and physical examination as well as skin tests and/or blood tests.  In addition to avoidance measures, there a number of medications that can be tried to try to alleviate your symptoms of pet allergies.  These medications can be in the forms of tablets, nasal sprays, eye drops, creams, inhalers, and/or injections.  Since pet allergies are a perennial (year-round) problem, many patients find allergy shots (allergy immunotherapy) extremely effective in preventing and/or diminishing their pet allergy symptoms.  Allergy shots can be administered to children, pregnant women, and adults and have been used for over a century.

If you would like to have a consultation with us regarding your pet allergies (or other type of allergies), please call us or use our website to “Request An Appointment” and we will get back to you by the next work day.  Black and Kletz Allergy has been serving the Washington, DC metropolitan area including Maryland and Northern Virginia for more than 50 years.

Mold Allergies

As the temperatures are dropping and the leaves are starting to “fall”, the ragweed and other weed pollen counts are also gradually decreasing, but the mold spores will be a significant trigger of asthma and allergy symptoms in the coming few months for sensitized individuals.

Mold is a fungus which can cause bothersome symptoms in a few different ways:

  1. Allergic Reaction:  Though all of us are exposed to molds, only some of us develop “sensitivity” to them determined by our genetic composition.  When a genetically predisposed individual inhales spores from molds, his/her immune system considers them as foreign invaders and manufactures antibodies in an attempt to fight them.  These antibodies memorize the particular spores and “attack” them when they are exposed to them again.  This reaction causes certain chemicals like histamine to be released into the tissues which cause the typical symptoms of sneezing, stuffy/runny nose, itchy/watery eyes, etc. (Note: If your vision is seriously impaired, it may be a sign on something more severe, and you may wish to consult with a LASIK surgeon in Washington DC.)
  2. Irritant Reaction:  Molds can release substances called volatile organic compounds (VOC’s) which can irritate skin and mucus membranes inside the mouth, nose and eyes resulting in burning sensation, watery eyes, runny nose, scratchy throat and cough.
  3. Toxic Reaction:  Mycotoxins, produced by certain types of molds, in addition to causing irritant symptoms can also lead to flu-like symptoms, fatigue, headache, dizziness, and shortness of breath.
  4. Infection:  Though skin lesions are the most common infectious manifestation, different types of molds also can cause respiratory, gastrointestinal, and neurological disorders.

Molds are found in both indoor and outdoor environments and thrive in high humidity.  Moist and decaying leaves on the ground, which tend to peak in the Fall, form a substrate for the mold growth.  Damp basements, leaky faucets, wet shower curtains, and wet bathroom tiles also encourage proliferation of molds.  Though many mold overgrowths are visible, their spores are microscopic and are air-borne.  The most common types of molds that cause human suffering are alternariahormodendrumcladosporium and penicillium.

Most people sensitive to mold spores only exhibit “hay fever”- like symptoms involving the eyes, nose, mouth, and throat.  Less commonly, molds also play a role in more serious conditions like:

  1. Allergic Asthma:  In sensitized individuals with a history of asthma, mold spores can induce sudden and severe flare-ups of asthma symptoms which may require emergency treatments and/or cause an increase in the number or dose of controller medications.
  2. Allergic Bronchopulmonary Aspergillosis (ABPA):  It is a hypersensitive reaction to a particular type of mold called aspergillus in the lungs of patients with persistent asthma or cystic fibrosis.
  3. Allergic Fungal Sinusitis:  A chronic inflammatory response of the membranes and tissues inside the sinus cavities can be caused by certain types of molds in susceptible people.

Diagnosis:  Mold allergies can be detected either by skin testing or by measuring the amount of specific IgE antibodies in a blood sample by a clinical laboratory.  Skin testing is a more sensitive test and is the preferred method used by allergists.  A detailed history of the symptoms and their possible triggers in the environment followed by a focused physical examination will help the allergist in determining the type of testing needed to confirm the diagnosis.

Treatment:  The first principle in the management of any allergic disorder is to identify the possible triggering and aggravating factors in the environment and to avoid exposure to them to the extent possible.  To reduce exposure to the mold spores, the following measures can be quite useful:

  1. As dampness encourages mold growth, indoor humidity levels should be kept below 50 percent. Avoiding water leaks and running a dehumidifier in damp and musty areas of the house can also inhibit mold proliferation.
  2. Installing HEPA filters in HVAC systems and changing them periodically will reduce indoor spore counts by trapping them before fresh air is circulated.
  3. Adequate ventilation of the bathrooms either by running the exhaust fan or opening the windows will reduce mold growth.  Keep in mind that by opening the windows, outdoor molds may enter one’s home which can be counterintuitive.
  4. Proper care of indoor plants such as removing the dead leaves and avoiding standing water can be helpful.
  5. Wearing a face mask to cover the nose and the mouth before raking leaves and cutting grass will reduce exposure to molds substantially.
  6. Mold spore counts are usually higher at nights when the atmosphere is cool and damp.  Closing the windows will keep the outdoor molds from entering inside one’s home.

Medications like ocular, nasal, and oral antihistamines as well as nasal and inhaled anti-inflammatory drugs can relieve the misery of symptoms to a certain extent.  When environmental control measures and medications do not help enough or when the side effects of the drugs are bothersome, a desensitization process (i.e, allergy shots or allergy immunotherapy), which induces tolerance to the offending allergens, can be a long term solution which is highly efficacious.

The board certified physicians and staff at Black & Kletz Allergy have the training, expertise, and decades of experience in the diagnosis and treatment of adults and children with mold and other allergies in a professional, caring, and patient-friendly environment in the Washington, DC, Maryland, and Northern Virginia area.