Month: June 2017

Thunderstorms and Asthma

A very interesting article was published in the current issue of the Journal of Allergy and Clinical Immunology in the section “Paradigms and Perspectives.”

In Melbourne, Australia, on Monday, November 21, 2016, hospitals were swamped with emergency patients affected by severe asthma exacerbations.  There were more than 8,500 patients from Monday night to Tuesday and 9 of them died.  Firefighters and police were called in to help physicians and paramedics respond to thousands of calls after the outside conditions caused breathing problems for its many citizens.  It caused many individuals, including those with a history of hay fever (i.e., allergic rhinitis), without a prior history of asthma, to experience breathing difficulties.  Many had severe and/or near-fatal asthma exacerbations.  The epidemic in Melbourne was due to a very unusual weather occurrence.  There were thunderstorms with high wind velocities and torrential rain combined with a high pollen count sending a large amount of grass pollen allergens into the air across the city.

In normal circumstances, pollen grains penetrate into the upper airways of individuals but only reach these larger airways in the lungs due to their large size.   However, it is postulated that during thunderstorms, pollen grains can rupture due to osmotic shock and release their content into the atmosphere.  As a result, the very small granules released into the air are now able to reach the lower smaller airways which then in turn induce asthma symptoms.

During the first 20 to 30 minutes of a thunderstorm, a high concentration of allergenic material released by the pollen is dispersed into the atmosphere.  People who have been previously sensitized to the pollen can experience acute and severe flare-ups of coughing, wheezing, chest tightness, and/or shortness of breath after inhaling these allergens.  This situation described above constitutes a major concern nowadays because of the ‘‘highly likely’’ increase in the frequency of heavy precipitation events, including thunderstorms, projected by climate change scenarios for future decades.

Ironically, rainfall is usually known to remove pollens from the air.  During a thunderstorm, however, dry updrafts force whole pollens into the high humidity at the cloud level, where pollens can rupture and cold downdrafts can carry pollen fragments to the ground level.  The relationship between allergen exposure, airway inflammation, and clinical symptoms is complex.  Factors other than allergens such as cold air and perhaps electrical charges of the atmosphere may also be playing a role in triggering asthma.

It is important to realize that people who previously had only hay fever symptoms are also at a higher risk for asthma during a thunderstorm.  Patients affected by pollen allergies should be aware of the danger of being outdoors during a thunderstorm in the pollen seasons.  Staying indoors with the windows closed significantly reduces the risk of asthma exacerbations.  Using inhaled asthma medications (e.g., bronchodilators, corticosteroids) at the onset of symptoms can minimize the severity of the asthma “attacks.”  Allergy shots (i.e., allergy immunotherapy, allergy injections) can also minimize or prevent asthma exacerbations caused by pollens, as well as dust mites, molds, pets, and cockroaches.

The board certified allergists at Black & Kletz Allergy located in the Washington, DC, Northern Virginia, and Maryland metropolitan area will readily answer any questions you have regarding your asthma and/or allergy symptoms.  We have 3 offices with locations in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  All of our offices offer on-site parking.  In addition, the Washington, DC and McLean, VA offices are accessible by Metro.  There is also a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line.  Please make an appointment by calling any one of our 3 offices, or alternatively, you can click Request an Appointment and we will answer you within 24 hours by the next business day.  Black & Kletz Allergy diagnoses and treats both adults and children and we are proud to serve the Washington, DC metro area residents for which we have done for more than 50 years.

Pet Allergies – What are They and What Can Be Done to Help?

Individuals who are allergic to their pets generally have the same symptoms as people who have allergic rhinitis and allergic conjunctivitis to other allergens such as dust mites, molds, pollens, and, cockroaches.  These symptoms may include some or all of the following:  sneezing, runny nose, nasal congestion, itchy nose, post-nasal drip, itchy ears, clogged ears, itchy throat, itchy eyes, red eyes, watery eyes, puffy eyes, sinus congestion, sinus headaches, snoring, hives, generalized itchiness, swelling episodes, fatigue, wheezing, chest tightness, coughing, and/or shortness of breath.

It is the proteins found in the pet’s dander, urine, and saliva that act as the allergens which cause pet allergic individuals to react when exposed to pets.  In cats, the major allergenic protein is called Fel d 1.  Fel d 1 is primarily produced in cat saliva as well as in the skin itself.  Male cats produce more Fel d 1 than female cats.  Other cat allergens include Fel d 2, Fel d 3, Fel d 4, Feld 5, and Fel d 6.  Fel d 4 seems to be the 2nd most potent cat allergen after the major cat allergen which is Fel d 1.  Can f 1 and Can f 2 are the two major dog protein allergens which are found on a dog’s dander.  They are produced by the dog’s tongue tissue as well as other salivary glands.

In addition to cats and dogs, there are numerous other animals that people have as pets, some of which include birds, rabbits, ferrets, hamsters, guinea pigs, gerbils, mice, rats, spiders, snakes, lizards, turtles, fish, and horses.  In general, fish, reptiles, and amphibians as pets do not cause significant allergies to most individuals.

If you or someone you know has allergy and/or asthma symptoms when exposed to pets or has allergy and/or asthma symptoms and they live with a pet, they should seek a board certified allergist’s care to determine if they are in fact allergic to that pet.  At Black & Kletz Allergy, our board certified allergy doctors have the expertise in determining if someone has a pet allergy.  It begins with a comprehensive history and physical examination to identify any signs or symptoms that appear to be attributable to a pet allergy.  The diagnosis can be confirmed with allergy testing which can be done via blood tests or allergy skin tests, with the latter being a more sensitive testing method.

Once the diagnosis is made, our allergists will make recommendations on how to best avoid the pets as well as reduce exposure to the pet allergens, since in almost every circumstance, the person does not want to part with their pet as it is a beloved member of their family.  Black & Kletz Allergy offers many tips to pet-allergic individuals that help reduce exposure to the pet allergen proteins that cause allergic symptoms.  Allergy medications are usually prescribed in order for the individual to be able to tolerate being around the pet.  These medications may include oral antihistamines, nasal sprays, eye drops, inhalers, and/or leukotriene antagonists.  Allergy immunotherapy (i.e., allergy shots, allergy injections, allergy desensitization) has been found to be extremely effective in the management of pet allergies.  In addition, allergy shots may also contain other allergens such as dust mites, molds, and/or pollen, depending upon the individual’s sensitivities and his or her allergy history.  Allergy shots are effective in the treatment of allergic rhinitis in about 80-85% of the patients that take them.  The average length of treatment on allergy shots usually ranges from 3-5 years.

Black & Kletz Allergy has 3 convenient office locations in the Washington, DC, Northern Virginia, and Maryland metropolitan area.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  All of our offices offer on-site parking and the Washington, DC and McLean, VA offices are Metro accessible.  The McLean, VA office has a free shuttle that runs between our office and the Spring Hill metro station on the silver line.  If you suffer from pet allergies and/or asthma related to animals, as well as any other type of allergy, please call us to schedule an appointment.  Alternatively, you can click Request an Appointment and we will respond to you within 24 hours by the next business day.  Black & Kletz Allergy has been providing excellent allergy and asthma care in the Washington, DC metro area for more than 50 years and we look forward to helping you.