Category Archives: FLU

Respiratory Infections and Asthma

As we enter into the “cold and flu” season, children and adults with a history of asthma may experience an increase in the frequency and severity of their asthma symptoms triggered by these infections.

Most of us have to contend with a few upper respiratory infections (e.g., cold, flu, sinusitis) each year. Viruses are the usual culprits and the rhinovirus is the most common virus causing upper respiratoryinfections in all age groups.  Respiratory syncytial virus (RSV) usually affects the upper and lowerrespiratory tracts in infants and young children.

Upper respiratory tract infections are usually mild self-limited illnesses in otherwise healthy children and adults.  The common symptoms of nasal congestion, runny nose, post-nasal drip, sneezing, sore throat, achiness, and an occasional dry cough may last for about a week.  However, in individuals with a history of asthma, these infections can trigger a flare-up of their asthma by causing wheezing, coughing, chest tightness, and/or shortness of breath.  Once the asthma symptoms are triggered, they can linger for several days to weeks, even after recovery from the infection.

Viral infections also can predispose one to secondary bacterial infections which can lead to complications like sinus infections causing discolored nasal discharge, facial (sinus) pressure and pain, persistent mucus drainage into throat, and coughing.  Fever, chills, night sweats, fatigue, coughing up discolored sputum, and/or soreness in the chest while breathing, may be indicative of pneumonia. A few precautions may help prevent or alleviate respiratory infections and reduce the risk of asthma exacerbations:

  1. Viruses causing respiratory infections are highly contagious.  Avoid contact with others with active infections can minimize the risk of contracting the illness.
  2. Wash hands frequently with soap and water.  This will eliminate most germs causing infections. Hand sanitizers are useful while traveling.
  3. Refrain from touching one’s eyes, nose, and mouth which can minimize the germs from entering into the body.
  4. An annual influenza vaccine (i.e., flu shot) is highly recommended in all children (above 6 months of age) and adults with asthma.  FluMist (the flu nasal spray vaccine) is not indicated in asthmatics and only approved for use in persons 2 through 49 years of age.
  5. Many children and adults also benefit immensely from a pneumonia vaccine to prevent bacterial infections from pneumococcus, a type of bacteria that causes respiratory tract infections.  The two most common vaccines available are Prevnar 13 and Pneumovax.  It is important to check with your primary care physician to check for documentation of what type of pneumonia shot you may have had and when it was administered.  Depending on this information, your physician will recommend which type of pneumonia vaccine may be needed and when it should be given.  The age of the patient, underlying diseases, and history of previous vaccinations all will play a role in determining what, when, and if the vaccine is needed.
  6. Rest, drinking plenty of fluids, and the use of certain over the counter medications may alleviate some of the symptoms.
  7. Prescription antiviral medications [i.e., Tamiflu (oseltamivir), Relenza (zanamivir), Rapivab (peramivir)] can reduce the duration of the flu and they may also decrease the risk of an increase in asthma symptoms.
  8. Monitoring peak flows is helpful in predicting asthma exacerbations.
  9. If the infection ends up triggering asthma symptoms, one should begin using a rescue inhaler or nebulized medications at regular intervals for symptom relief.
  10. Either initiating the preventative controller medications or increasing their doses at the onset of cold or flu symptoms, (as directed by the physician), may be useful in preventing or reducing the severity of asthma flare-ups triggered by viral infections.

The board certified allergists of Black & Kletz Allergy have been treating adult and pediatric patients with asthma for over 5 decades.  We are very familiar with upper respiratory tract infections as well as other triggers that cause asthma exacerbations.  In addition, we also treat all kinds of upper respiratory infections.  Black & Kletz Allergy has 3 offices in the Washington, DC, Northern Virginia, and Maryland metropolitan area.  We have convenient offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  Our offices in Washington, DC and McLean, VA are Metro accessible with free shuttle service between the Spring Hill metro station and our McLean office.  All 3 locations offer on-site parking.  To make an appointment, please call us, or alternatively you can click Request an Appointment and we will respond within 24 hours on the next business day.  The allergy doctors at Black & Kletz Allergy strive to manage your asthma to your utmost satisfaction in a professional caring environment.

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.