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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.

The “Cold” of Winter Has Effect on Allergy and Asthma Patients

The onset of winter in the Washington DC metro area has brought two cold-related health problems to the forefront.

The first one concerns many people with respiratory disorders like asthma and COPD (Chronic Obstructive Pulmonary Disease).  Cold dry air is a known irritant to the respiratory passages and can trigger an increase in the frequency and severity of respiratory symptoms like coughing, wheezing, and shortness of breath. In addition, respiratory infections, especially caused by viruses, are more prevalent during the winter months.  Influenza (the “flu”) is just one of the many viral infections which are notorious in aggravating asthma and pulmonary-related conditions.

Avoiding exposure to the cold air, in addition to minimizing the chance of developing a viral upper respiratory tract infection by frequent hand washing and covering one’s sneezes and coughs, can help prevent flare-ups in people with breathing difficulties such as asthma and COPD.  People with persistent asthma (defined by any asthma symptom which occurs more often than twice a week during the daytime and/or more often than twice a month during the nighttime) need to use their controller medications on a daily basis as prescribed, in order to reduce the chances of exacerbating their asthma.  Controller medications may include inhaled corticosteroids, long-acting beta agonists, leukotriene antagonists, and/or theophylline.  In more severe asthmatics that meet certain criteria, a humanized antibody called Xolair (omalizumab), may also be prescribed in order to help prevent asthma exacerbations.

The second issue concerns people with a history of a specific type of “hives” called “cold-induced urticaria.”  Though there are usually multiple triggers for hives (urticaria), exposure to colder temperatures can result in giant hives over exposed skin in susceptible individuals.  The condition can be very serious in selected patients and is usually diagnosed in our office by an “ice cube test,” where an ice cube is placed on the forearm of the patient for 10 to 15 minutes and then removed.  When the skin re-warms in a few minutes, an elevated red wheal or hive in the shape of the ice cube confirms this disorder.  In rare instances, this condition is also associated with some systemic diseases and blood tests for cold agglutinins and cryoglobulins may be appropriate.  Treatment begins with avoiding the cold when possible.  In addition, various medications can be used to help prevent the hives and/or anaphylaxis that can occur in people with this condition.

The board certified allergists at Black and Kletz Allergy are experts in cold-related respiratory and skin disorders.  Please call any one of our 3 office locations in Washington, DC, McLean, VA (Tysons Corner, VA) or Manassas, VA if you need further information or are in need of an evaluation and advice regarding any of the cold-related disorders above or other cold-related disorder not mentioned above.

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.

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.

Ragweed Allergies – What Are They and Do You Have Them?

As summer draws to a close and schools reopen across our region, most of us look forward to cooler days and fall colors. But if you are one of several million Americans who suffer from “Hay Fever” (“seasonal allergic rhinitis,” as it is more accurately named) to ragweed, the rising levels of pollen from ragweed are sure to increase your misery due to your allergic reaction to these pollen grains.

Though many weeds like Pigweed, Mugwort/Sagebrush, Cocklebur, and Russian thistle pollinate in the fall, Ragweed (species Ambrosia) is the most common and predominant allergen in our geographical area. Each plant can produce up to one billion pollen grains per season, and these can remain airborne for several days and travel hundreds of miles from the site of origin. In the Washington, DC metropolitan area, the ragweed pollen usually starts appearing in the air in mid-August. The pollen counts gradually increase and peak in early September and subside after the first frost which is usually in late October. Many scientists believe that rising temperatures and an increase in atmospheric carbon dioxide (CO2) levels may prolong the ragweed season.

When a person who has been previously sensitized to a particular pollen is exposed to that pollen in the air, the proteins trigger specialized cells in the immune system to release excessive levels of histamine and other chemical mediators which are responsible for various allergic symptoms, some of which are listed below:

  • Excessive sneezing
  • Itchy, red, puffy, watery eyes
  • Persistent runny nose
  • Nasal stuffiness, blockage, or congestion
  • Itchy throat and post-nasal drip leading to a dry cough
  • In asthmatic individuals, the pollen can also induce flare-ups of wheezing, chest tightness, cough and/or breathing difficulty.

In ragweed sensitive people, eating fresh fruits and vegetables like melons (cantaloupe, honeydew, watermelon, etc.), cucumber, zucchini, kiwi, and bananas may cause itching and tingling of mouth, tongue, and throat. This condition is called “pollen-food allergy syndrome” or “oral allergy syndrome” and is due to cross-reacting proteins in the pollen and fresh fruits.

A few avoidance measures can reduce the exposure to pollen and the suffering:

  • Minimize outdoor activities in the early morning hours when the pollen counts tend to be the highest.
  • Keep the windows at home and in automobiles closed and use air-conditioning.
  • Shower to remove pollen from the skin and hair after coming indoors and wash clothing.
  • Nasal irrigation can wash the pollen and irritants from nasal passages.

If the symptoms are bothersome, several medications like antihistamines (available in pills, liquid, nose sprays and eye drops), decongestants (pills and liquid), and corticosteroids (nasal sprays, pills, liquid), either alone or in combination may offer considerable relief. To be optimally effective, the medicines are best started a few days before the onset of the active season. For many people with moderate to severe sensitivity, allergy immunotherapy (also referred to as “allergy shots,” will cause a desensitization to that pollen, which in this case is ragweed pollen) will offer the most effective long-term relief from the symptoms and can reduce or eliminate the need for medications.

The physicians and Washington, DC allergy doctors at Black and Kletz Allergy practice in DC and northern Virginia have several decades of experience and expertise in managing ragweed sensitive patients and are committed to provide the most up to date and evidence based treatment options in a patient-friendly environment.