Month: November 2014

Asthma in the Winter

With the onset of cold weather, some children and adults with a history of asthma are experiencing flare-up of their symptoms.  Breathing in cold, dry air can irritate and inflame the lungs, causing acute exacerbations of one’s asthma.  The other common triggers of asthma symptoms are viral infections, which are usually more common in winter months.

The viral infections usually begin as “cold-like” symptoms with sneezing, followed by copious amounts of clear mucus in one’s nasal secretions and usually are associated with nasal congestion.  Some of us also can have a skin rash, low-grade fever, sore throat, and/or frequent cough.  Many children and adults recover spontaneously from these infections after a few days. However, they can result in aggravation of asthma, causing the typical symptoms of wheezing, chest tightness, coughing and/or difficulty in breathing.

A few precautions during the coming season may ward off flare-ups of asthma, the suffering, and the loss of productive time:

  1. Avoid exposure to the cold air to the extent possible.  Wearing a face mask while walking outdoors during the height of winter can be helpful.
  2. The air can be very dry indoors and can irritate the respiratory passages.  A room humidifier will help in hydration of the air we breathe.
  3. General hygiene, frequent hand-washing, avoidance of sharing utensils, etc. may prevent certain infections.
  4. Staying home when sick and covering the sneezes and coughs can keep the infections from spreading.
  5. Plenty of fluids, rest, and eating well will help in a faster recovery.
  6. Antibiotics usually have no role in viral illness, except in rare secondary bacterial infections.
  7. Receiving the influenza vaccination (flu shot) as soon as possible in the season.
  8. Pneumococcal vaccine, as per indications.

Children and adults with a history of frequent flare-ups of asthma during the late fall or early winter should begin taking the daily controller medications on a regular basis starting early in the season.  At times, one also may need to increase the doses of preventive maintenance medications.

The board certified allergists and staff at Black and Kletz Allergy practice are always available to answer questions and address the concerns of people in the greater Washington, DC, Northern Virginia, and Maryland metropolitan area who may be dealing with above conditions.  Feel free to contact us by phone or via our “Request an Appointment” page on our main website to make an appointment.

SINUS INFECTION vs. “COLD” vs. WINTER ALLERGIES vs. FLU

As Winter approaches, people with dust, mold, and pet allergies tend to suffer more than those with pollen allergies.  Pollen levels in the mid-Atlantic region (Washington, DC, Virginia, Maryland, etc.) become immeasurable once the first frost occurs.  The first frost usually occurs by November in our region of the country.  Therefore, when people experience the typical allergy symptoms during the late Fall and Winter months, dust mites and/or molds are generally the culprits.  Keep in mind that there are other causes of these symptoms, namely the common cold, flu (influenza), or other upper respiratory tract infection (i.e., sinus infection, bronchitis).  How does one know the difference between winter allergies, a “cold,” the “flu” or other type of upper respiratory tract infection?

WHAT ARE THE SYMPTOMS?

Winter Allergies – the same symptoms as seasonal allergies and can include all or some of the following:  runny nose, nasal congestion, post-nasal drip, sore throat, cough, sneezing, itchy nose, itchy eyes, watery eyes, red eyes, itchy throat, fatigue, sinus headaches, wheezing, and shortness of breath.

Common Cold – can include all or some of the above symptoms, but in addition may contain achiness, fever, and chills, although discolored nasal discharge and a fever do not occur in most cases of the common cold.

“Flu” (also referred to as influenza) – can include all or some of the symptoms of the common cold, but unlike a “cold,” there is usually severe achiness and/or headache, and a fever is almost always present.

Note:  For the flu season of 2014-2015, one must be cognizant of the recent Ebola epidemic in Western Africa.  If a person develops “flu-like” symptoms and has traveled to Western Africa and/or if they have been in contact with someone infected with the Ebola virus in the last 21 days, he or she must assume that they could have Ebola and should contact the CDC (Centers for Disease Control) and local county and state health agencies for guidance about seeking medical care at an appropriate hospital.  If one cannot get in touch with the CDC or local health agency, they should go immediately to closest emergency room.

Sinus Infection (also referred to as sinusitis) – can include all or some of the symptoms of the common cold, but unlike a “cold,” there usually is discolored nasal discharge, sinus pain and/or pain that radiates to the teeth.

WHAT ARE THE CAUSES?

Winter Allergies – Dust mites; Molds: Pets; Cockroaches

Common Cold – Viruses [Rhinoviruses, Coronaviruses, Parainfluenza viruses, and Respiratory syncytial virus (RSV) are the most common ones]; Note that there are many more viruses that cause the common cold. “Flu” – Viruses (Influenza virus types A, B, and/or C)

Sinus Infection – Viruses, Bacteria, and/or Fungi (Most are caused by viruses)

HOW ARE THESE CONDITIONS DIAGNOSED? Besides a thorough history of your symptoms and a physical examination, the following also help our physicians distinguish between the 4 common conditions below:

Winter Allergies – An experienced allergist can perform blood and/or skin tests to evaluate if you have a true allergy to one of the many allergens that can cause winter allergy symptoms.  When symptoms last longer than 1-2 weeks or there is a history of recurring symptoms every Winter or perennial (year-round) symptoms, allergies should be a top concern.

Common Cold – Typically the symptoms last less than 1 week in duration and resolve on their own.

“Flu” – A fever is the hallmark of this condition.  The flu can be very serious particularly in the elderly.  There are rapid influenza diagnostic tests that can identify the flu in about 30 minutes.  These require that the physician to wipe the inside of the back of one’s throat or nose with a swab and then send it for testing.  They are not 100% accurate however.

Sinus Infection – The symptoms may begin as a result of an individual being exposed to an allergen, virus, and/or bacteria.  A thorough history together with a complete examination of the ears, nose, mouth, and throat can usually identify a sinus infection in the majority of patients.  Further diagnostic studies such as a CT scan of the sinuses may be necessary in some individuals.  When there is recurrent sinus infections, the diagnosis of chronic sinusitis and/or an immunologic disorder should be investigated by an experienced allergist.

WHAT ARE THE TREATMENTS?

Winter Allergies – There are many allergy medications that can be used which include tablets, syrups, nasal sprays, and/or allergy shots (allergy immunotherapy or allergy injections).

Common Cold – Usually self-limited and generally does not require treatment except to help relieve symptoms with medications and nasal sprays.

“Flu” – Usually self-limited and generally does not require treatment except to help relieve symptoms with medications and nasal sprays.  Occasionally a severe case or a case in the elderly may need hospital care of complications from the flu which can include dehydration, pneumonia, and other more severe complications. Antiviral flu medications can be taken to reduce the duration and severity of the flu. These medications work best if they are taken within the first 48 hours of the beginning of symptoms, however they can still be effective if taken later.

Sinus Infection – May need to be treated with antibiotics if it persists or is recurrent.  Other medications may also be used if needed to help alleviate the symptoms with tablets, syrups, and/or nasal sprays.

WHAT CAN BE DONE TO PREVENT THESE CONDITIONS?

Winter Allergies – Avoidance of dust mites, molds, and pet exposure.  Allergy medications and/or allergy shots (allergy immunotherapy or allergy injections).

Common Cold – Washing of hands; good hygiene; avoidance of crowded areas.

“Flu” – Flu vaccination (unless one has a reason not to take it such as egg allergy, previous reaction to the flu vaccine or the preservative used in the flu vaccine, etc.).  In addition, one should avoid exposure to people with the flu.  They should also practice good hygiene, avoid crowded areas during the flu season, wash their hands, etc.

Sinus Infection – Control allergies; washing of hands, good hygiene; avoidance of crowded areas.

As one can see from the information above, it may not be so easy for the average person to distinguish the difference between Winter allergies, the common cold, the flu, and a sinus infection.  Many of the symptoms are the same, similar, and/or overlap.  The board certified allergists at Black & Kletz Allergy have the expertise to help diagnose the correct ailment and more importantly, treat your problem.  We have 3 office locations in the Washington, DC metro and Virginia areas and we will be happy to schedule a visit for you at your earliest convenience.