Month: January 2015

Cockroach Allergies

It is an awful thought, but many people are allergic to cockroaches.  No one likes to think that they are within miles of a cockroach, however, cockroach allergy is one of the most common indoor pests.  They can cause many problems for those allergic to them including allergic rhinitis symptoms (sneezing, runny nose, nasal congestion, etc.), asthma symptoms (wheezing, shortness of breath, chest tightness, and/or cough), and skin symptoms (itching and/or rash).  There is a very strong correlation between chronic asthma and cockroach allergy.  Since cockroaches live in homes and businesses throughout the year, patients suffering from cockroach allergy have year-round symptoms.  Other allergens such as dust mites, mold, and pets can also cause perennial symptoms and must also be assessed when diagnosing an allergy or asthma patient for year-round symptoms.  In addition to causing allergies and asthma, cockroaches can also carry and transmit various diseases.

Cockroaches live just about everywhere and have adapted to living in all types of climates.  There are over 3,500 species and they have been around for more than 300 million years.  In general, cockroaches are nocturnal and are usually not seen during the daylight hours. Since cockroaches prefer moist and warmer environments, they tend to gather more in kitchens, bathrooms, basements, cracks in the walls, and closets.  In the U.S., the two most common species are the German (Blattella germanica) and American (Periplaneta Americana) cockroaches.  They tend to be much more common in the inner cities.  Thus, cockroach allergies are fairly prevalent in people living in inner cities. Anywhere between 30 – 60% of asthmatics living in an urban area are said to be allergic to cockroaches.  Overall, about 33% of the U.S. population are sensitive to cockroaches, if they are allergic to at least one other allergen such as dust mite, mold, pollen, pets, etc.

In inner-city children with asthma, the percentage of cockroach sensitivity increases to between 55 – 80%.  Most urban locations, including Washington, DC, have their fair share of cockroaches living amongst us.  It is estimated that over 75% of urban homes and/or apartments have cockroaches present.  Even more shocking is that the number of cockroaches living in each home or apartment ranges from about 1,000 to over 300,000 insects. For every cockroach you see, there are approximately 800 present that you don’t see.

The cause of cockroach allergy Is due cockroach allergens.  These allergens are found in the saliva, feces, and exoskeleton of the insect.  The most common cockroach allergens are Bla g 1, Bla g 2, and Per a 1.  Other cockroach allergens include Bla g 4, Bla g 5, Bla g 6, Bla g 7, Bla g 8, Bla g 9, Per a 2, Per a 3, Per a 4, Per a 5, Per a 6, Per a 7, Per a 8, Per a 9, and Per a 10.

One can be diagnosed with cockroach allergy by seeing an allergist who would then take a careful history from the patient.  After an examination, the allergist would test the patient for cockroach allergy by either skin or blood testing.

The treatment of cockroach allergy first involves prevention of further contact with cockroaches.  This is easier said than done.  It is very difficult to get rid of every cockroach in a home, but there are some things that should be tried which include:  keep garbage and food in closed containers; make sure that there are no leaky pipes or faucets; do not leave dirty dishes in the sink or on kitchen countertops; do not bring food into the bedrooms; make sure to close up any holes in the walls or baseboards to decrease entry and exit paths for cockroaches; contact an exterminator for help with cockroach infestation.  In addition to prevention, there are a multitude of medications that can be used to help relieve the allergy, asthma, and/or skin symptoms that one can experience from their cockroach sensitivity.  They come in various formulations including pills, syrups, nasal sprays, inhalers, and creams.  Allergy shots (allergy immunotherapy) are a very effective means to treat cockroach allergy and are used in both children and adults.

The board certified allergists at Black & Kletz Allergy have managed thousands of patients with cockroach allergy for more than half a century in the Washington, DC, Northern Virginia, and Maryland metropolitan area.  We have 3 convenient locations with offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  Our Washington, DC and McLean VA locations are easily accessible by car or the Metro.  We have parking at all 3 of our locations.  Please call us or click Request an Appointment on our website to schedule an appointment, if you have any of the symptoms mentioned above.  We look forward to diagnosing and treating you in order for you have a better quality of life.

Mammalian Meat Allergy

Mammalian Meat Allergy is a delayed allergic reaction triggered by eating the meat of some mammals.   The condition was discovered by researchers at the University of Virginia only a few years ago.  Their findings of this new allergy were published in 2009.  The allergy initially was confined to the southeastern part of the U.S. with a majority of the cases in Virginia.  Subsequently, the condition has become more widespread.
Mammalian Meat Allergy is initiated by a bite from a Lone Star Tick (Amblyomma americanum), named because of its distinctive small white mark on its back.  Many people deny a tick bite and instead say there were bitten by chiggers (a type of mite), even though chiggers do not cause the allergy.  For this reason, it is prudent that an allergist ask the patient if they have ever been bitten by a tick or a chigger.   In susceptible individuals, the bite sets off a chain reaction which results in the formation of an IgE antibody (the “allergy” antibody) that attaches to a carbohydrate (sugar) present in the meat of only mammals called galactose-alpha-1,3-galactose (also known as “alpha-gal”).  This is present in mammalian meat such as beef (cow), pork (pig), lamb (sheep), venison (deer), rabbit, goat, bison, whale, etc.  It is also important to point out that for people who travel to exotic locations, one must be aware that there are other mammals that are eaten which contain alpha-gal.  Some of these mammals include horse, dog, cat, squirrel, guinea pig, kangaroo, and whale, to name a few.  Since fish, shellfish, and poultry (i.e., chicken, turkey, duck, quail) are not mammals; they do not have alpha-gal.

In this condition, unlike a typical food allergy, the symptoms usually do not start for several hours (typically 3-6 hours) after the consumption of the offending meat from a mammal.  In more common food allergies like peanut, tree nut, fish, and shellfish allergies, symptoms usually begin in less than one hour after exposure to the food.  When a person who harbors this antibody eats the meat from mammals, it causes release of histamine and other chemicals which are responsible for allergic reactions.  The symptoms can include itching, rashes, hives, swellings of lips, tongue and other soft tissues, abdominal pain, nausea, vomiting, and diarrhea.  In severe instances, it can also lead to life threatening anaphylactic reactions resulting in difficulty in breathing, drop in blood pressure, dizziness, and loss of consciousness.  In summary, the person will develop delayed anaphylaxisangioedema (swelling), and/or urticaria (hives).

If you have experienced any of the above symptoms, please call Black & Kletz Allergy and request to see one of our board certified allergists at any one of our 3 locations in Northern Virginia and Washington, DC.  We can confirm or rule out the condition by taking a complete history, performing an examination, and obtaining a blood sample.  Avoiding meat from mammals and in severe cases limiting the intake of dairy products can prevent serious and dangerous adverse reactions.