Nasal Allergy & Hay Fever

Children's Allergies

An estimated 40 million to 45 million Americans (15 percent to 20 percent of the U.S. population) have some type of allergy and, in most people, these allergies first appear during infancy or childhood. It is not surprising then, that allergic disorders rank first among children’s chronic diseases.

Any child may become allergic, but children from families with a history of allergy are more likely to be allergic. Children may inherit the tendency to become allergic from their parents, but only some of them will develop active allergic disease. Allergies can show up in different ways in children. Some children get skin rashes (atopic dermatitis) from allergy, some develop asthma, and some get hay fever.

Hay fever, also known as allergic rhinitis, is the most common of all allergy problems. It is characterized by a runny, itchy nose; sneezing; postnasal drip; and nasal congestion. The child with allergies may also have itchy, watery red eyes and chronic ear problems. Despite its common name, “hay fever,” these allergy problems can occur at any time of the year … seasonally or year-round.

The following are just a few points on potential problems for children with allergic rhinitis. Early identification of allergic problems in your child will improve their quality of life, decrease missed school days, and keep you at work.

Nasal Congestion

Allergies are the most common cause of chronic nasal congestion in children. Sometimes a child’s nose is congested (obstructed) to the point that he or she breathes through the mouth, especially while sleeping.

If the congestion is left untreated, this mouth breathing forces air currents through the mouth. The force of the air then changes the way the soft bones of the face grow. The face may actually become abnormally elongated in a pattern called “adenoidal face.” This causes the teeth to come in at an improper angle, as well as creating an overbite. Braces or other dental treatments may be necessary to correct these problems. Early treatment of the allergies causing the nasal congestion may prevent these problems.

Allergy and Ear Infections

Allergies lead to inflammation in the ear and may cause fluid accumulation that can promote ear infections and decreased hearing. If this happens when the child is learning to talk, poor speech development may result. Clinically, allergies can cause earaches, as well as ear itching, popping and fullness (“stopped up ears”). Anyone with these symptoms should be considered for testing and treatment.

Allergies at School

Fall means going back to school. For allergic children, that may mean absences due to problems related to hay fever. The following are some of the problems to look for so that allergy can be properly diagnosed and treated, as well as several suggestions for helping the allergic child.

  • Dust irritation. Reducing dust in the home will be helpful to most allergic family members. At school, children with allergic problems should sit away from the blackboards to avoid irritation from chalk dust.
  • School pets. Furry animals in school may cause problems for allergic children. If your child has more problems while at school, it could be the class pet.
  • Asthma and physical education. Physical education and sports are a big part of the school day for many children. Having asthma does not mean eliminating these activities. Often medication administered by using an inhaler is prescribed before exercise to control their symptoms. Children with asthma and other allergic diseases should be able to participate in any sport the child chooses – provided the doctor’s advice is followed.
  • Dry air. With the onset of cold weather, using a humidifier to accompany forced air heating systems may be helpful in some regions of the country. Adding a small amount of moisture to dry air makes breathing easier for most people. However, care should be taken not to allow the humidity above 40 percent, which promotes the growth of dust mites and mold.
  • Change in behavior. Since children cannot always express their annoying or painful symptoms, they may exhibit behavior problems in school and at home. Be on the alert for possible allergies if your child has bouts of irritability, temper tantrums or decreased ability to concentrate in school. These are all signs of “allergic irritability syndrome” often caused by nose, ear and sinus symptoms in allergic children. Sometimes allergic children manifest overactive behavior, and usually, their schoolwork suffers. This should NOT imply that attention deficit disorder is caused by allergies! When a child’s allergies are properly treated, his or her symptoms, behavior and school performance can improve.

Food Allergic Infants

The best food for a newborn is mother’s milk. However, some especially sensitive babies can have allergic reactions to foods their mothers eat. Babies can be tested for allergies. Eliminating these foods from the mother’s diet may provide relief for the child, but some babies will be allergic regardless of what their mothers do. When this occurs, your physician may recommend a hypoallergenic infant formula.

As infants grow, their nutritional needs continue to change, and your physician will advise when it is time for solid foods. It is best to start with foods that generally do not cause allergic reactions in adults – carrots, pears, potatoes and rice, for example. Foods that should be avoided early on include wheat, eggs, corn products, citrus fruits and nut butters.

Solid foods should be introduced one at a time in small quantities – a teaspoonful, for example. After three to four days, if the child is adjusting well to the new food item, another may be introduced. As the child becomes accustomed to a variety of foods that do not traditionally cause allergic reactions, foods from the second list above may be introduced in small quantities as well, one at a time. This progressive introduction of food items allows parents to better monitor potential allergic reactions to specific kinds of foods.

Cow’s milk is another food that frequently causes allergies in children, but it is a nutritionally important part of a child’s diet. Milk should be eliminated from a child’s diet only if you are sure the child is allergic to it. Parents may suspect allergy if the child exhibits respiratory problems or rash. If you suspect your child may be allergic to dairy products, consult your physician. Your physician may conduct appropriate tests to verify that allergies exist, determine the allergens responsible, and prescribe the proper course of treatment once the diagnosis is confirmed.

Just Remember

  • Allergies are common in children.
  • Many childhood problems are made worse by allergies.
  • While most allergic problems are not life-threatening, treatment of your child’s allergies will make them happier and healthier.

Source: American College of Allergy, Asthma and Immunology

Mold Allergy

What Is Mold?

There are thousands of types of molds and yeasts in the fungus family. Yeasts are single cells that divide to form clusters. Molds are made of many cells that grow as branching threads called hyphae. Although both can probably cause allergic reactions, only a small number of molds are widely recognized offenders.

The seeds or reproductive pieces of fungi are called spores. Spores differ in size, shape and color among types of mold. Each spore that germinates can give rise to new mold growth, which in turn can produce millions of spores.

What Is Mold Allergy?

When inhaled, tiny fungal spores, or sometimes pieces of fungi, may cause allergic rhinitis. Because they are so small, mold spores also can reach the lungs. In a small number of people, symptoms of mold allergy may be brought on or worsened by eating certain foods such as cheeses processed with fungi. Occasionally, mushrooms, dried fruits, and foods containing yeast, soy sauce or vinegar will produce allergy symptoms.

Where Do Molds Grow?

Molds can be found wherever there is moisture, oxygen and a source of the few other chemicals they need. In the fall, they grow on rotting logs and fallen leaves, especially in moist, shady areas. In gardens they can be found in compost piles and on certain grasses and weeds. Some molds attach to grains such as wheat, oats, barley, and corn, which makes farms, grain bins and silos likely places to find mold.

Hot spots of mold growth in the home include damp basements and closets, bathrooms (especially shower stalls), places where fresh food is stored, refrigerator drip trays, house plants, air conditioners, humidifiers, garbage pails, mattresses, upholstered furniture and old foam rubber pillows. Molds also like bakeries, breweries, barns, dairies and greenhouses. Loggers, mill workers, carpenters, furniture repairers and upholsterers often work in moldy environments.

What Molds Are Allergenic?

Like pollens, mold spores are important airborne allergens only if they are abundant, easily carried by air currents, and allergenic in their chemical makeup. Found almost everywhere, mold spores in some areas are so numerous they often outnumber the pollens in the air. Fortunately, however, only a few dozen different types are significant allergens.

In general, Alternaria and Cladosporium (Hormodendrum) are the molds most commonly found both indoors and outdoors in the United States. Aspergillus, Penicillium, Helminthosporium, Epicoccum, Fusarium, Mucor, Rhizopus, and Aureobasidium (Pullularia) are common as well. There is no relationship, however, between a respiratory allergy to the mold Penicillium and an allergy to the drug penicillin, which is made from mold.

Are Mold Counts Helpful?

Similar to pollen counts, mold counts may suggest the types and number of fungi present at a certain time and place. For several reasons, however, these counts probably cannot be used as a constant guide for daily activities. One reason is that the number and types of spores actually present in the mold count may have changed considerably in 24 hours because weather and spore distribution are directly related. Many common allergenic molds are of the dry spore type — they release their spores during dry, windy weather. Other fungi need high humidity, fog or dew to release their spores. Although rain washes many larger spores out of the air, it also causes some smaller spores to be propelled into the air.

In addition to the effect of weather changes during 24-hour periods on mold counts, spore populations also may differ between day and night. Dry spore types are usually released during daytime, and wet spore types are usually released at night.

Are There Other Mold-Related Disorders?

Fungi or organisms related to them may cause other health problems similar to allergic diseases. Some kinds of Aspergillus may cause several different illnesses, including both infections and allergies. These fungi may lodge in the airways or a distant part of the lung and grow until they form a compact sphere known as a “fungus ball.” In people with lung damage or serious underlying illnesses, Aspergillus may grasp the opportunity to invade the lungs or the whole body. In some people, exposure to these fungi also can lead to asthma or to a lung disease resembling severe inflammatory asthma called allergic bronchopulmonary aspergillosis. This latter condition, which occurs only in a small number of people with asthma, causes wheezing, low-grade fever, and coughing up of brown-flecked masses or mucus plugs. Skin testing, blood tests, X-rays, and examination of the sputum for fungi can help establish the diagnosis. Corticosteroid drugs usually treat this reaction effectively. Immunotherapy (allergy shots) is not helpful.

Source: National Institute of Allergy and Infectious Diseases, National Institutes of Health

House Dust Allergy

House dust allergy is common even in clean homes. House dust is a major cause of year-round runny or stuffy nose, itchy, watery eyes and sneezing for allergy sufferers. Dust can also make people with asthma experience wheezing, coughing and shortness of breath.

Why does house dust cause allergic reactions?

House dust is a mixture of many substances. Its content varies from home to home, depending on the type of furniture, building materials, presence of pets, moisture and other factors. A speck of dust may contain fabric fibers, human skin particles, animal dander, microscopic creatures called mites, bacteria, parts of cockroaches, mold spores, food particles and other debris. Of these, animal dander, house dust mites and cockroaches are the most common culprits. A person may be allergic to one or more of these substances, and, if exposed to the dust, will have an allergic reaction.

Is dust allergy a sign of a dirty house?

No. A dirty house can make a house dust allergy problem worse, however. Normal housekeeping procedures may not be enough to get rid of house dust allergy symptoms. This is because many of the substances in dust cannot be removed by normal cleaning procedures. For example, no matter how vigorously you dust or vacuum, you will not reduce the number of dust mites present deep within carpeting, pillows and mattresses. Vigorous cleaning methods can put more dust into the air making symptoms worse.

What are dust mites?

Tiny microscopic creatures called dust mites are an important cause of allergic reactions to house dust. They belong to the family of eight-legged creatures called arachnids. This family also includes spiders, chiggers and ticks. Dust mites are hardy creatures that live well and multiply easily in warm, humid places. They prefer temperatures at or above 70 degrees Fahrenheit with a relative humidity of 75 percent to 80 percent and die when the humidity falls below 40 percent to 50 percent. They are rarely found in dry climates.

As many as 10 percent of the general population and 90 percent of people with allergic asthma are sensitive to dust mites. Recent studies in the United States suggest that at least 45 percent of young people with asthma are allergic to dust mites.

People who are allergic to dust mites react to proteins in the bodies and feces of the mites. These fecal particles are found in the highest concentrations in pillows, mattresses, carpeting and upholstered furniture. They float into the air when anyone vacuums, walks on a carpet or disturbs bedding, but settle out of the air once the disturbance is over. Dust mite-allergic people who inhale these particles frequently experience allergy symptoms. In fact, a dust mite allergic patient who sleeps for eight hours every night spends one third of his life with his nose in direct contact with a pillow loaded with dust mite particles!

There may be many as 19,000 dust mites in one gram of dust, but usually between 100 to 500 mites live in each gram. (A gram is about the weight of a paper clip.) Each mite produces about 10 to 20 waste particles per day and lives for 30 days. Egg-laying females can add 25 to 30 new mites to the population during their lifetime.

Mites eat particles of skin and dander, so they thrive in places where there are people. Dust mites don’t bite, cannot spread diseases and usually do not live on people. They are harmful only to people who become allergic to them. While usual household insecticides have no effect on dust mites, there are ways to reduce exposure to dust mites in the home.

Why is mold present in house dust?

Molds are commonly found in outdoor air. However, any house can develop a mold problem given the right conditions. You might not see it growing on the walls, but it may still be present in your home. Molds require two factors to grow indoors: (1) free moisture that can occur in the form of relative humidity above 50 percent, leakage from pipes or foundations, or any ongoing source of water; and (2) something to grow on. Molds particularly like to grow on wallboard, wood or fabrics, but will grow virtually any place if they are given a chance.

Molds spread by producing spores that can become airborne. These spores end up in house dust where they grow. Dust from mold-contaminated houses can cause allergy symptoms if a mold-sensitive person inhales it.

Does house dust contain cockroaches?

As unappealing as it seems, some houses do have dust that contains parts of cockroaches. This is most common in older, multifamily housing and in the southern United States where complete extermination of cockroaches is very difficult. Allergic individuals, particularly those with asthma, will tend to have increased symptoms when they go into such houses. Cockroaches require food and moisture to survive, so eliminating sources of each can help reduce exposure.

Is house dust allergy seasonal?

In the United States, dust mite populations tend to peak in July and August, and their allergen levels stay high through December. Mite allergen levels are lowest in late spring. Some dust mite-sensitive people report that their symptoms get worse during the winter. That’s because mite fecal particles and pieces of dead mites, both of which trigger dust mite allergy, are still present. Mold levels tend to peak during the summer months depending on where you live since some tropical areas have molds year-round. There is also evidence that cockroaches have a seasonal pattern, peaking in the late summer.

Forced-air heating systems tend to blow dust particles into the air. As they dry out over time, even more of the particles become airborne. This does not account for the seasonal pattern, however, since air blows through the same ducts during the summer when air conditioning is used. People may have fewer symptoms from house-dust exposure during the summer because they spend more time outdoors.

How do I know if I have house dust allergy?

If you think you may have an allergy to house dust, consult an allergist-immunologist. To pinpoint the cause of your symptoms, the allergist may ask questions about your work and home environments, eating habits, family medical history, frequency and severity of symptoms, exposure to pets and a variety of other questions. Your allergist may test you for allergy by doing skin tests, which involves pricking the skin or injecting it with different allergens and observing for a reaction. A positive reaction (a raised welt with redness around it) may indicate that you are allergic to that allergen. Occasionally, your allergist may order a blood test instead of the skin test to confirm the diagnosis of allergy.

What can I do to relieve house dust allergy symptoms?

The three basic treatments for dust mite allergy are:

  • Dust mite avoidance
  • Prescription medications
  • Allergy shots (immunotherapy)

House dust avoidance works best to relieve symptoms.

How do I avoid house dust?

Environmental control of house dust exposure is best done if you know what allergens present in your home’s dust are causing the problem. Dust mites can be difficult to remove completely from your home. However, you can follow certain anti-mite procedures that will reduce mite populations and your exposure to them, thereby reducing your symptoms. Some of these procedures are difficult, and you may not need to do them all. Ask your allergist which ones will be most helpful for your situation.

Pay Special Attention to Bedrooms

On average, people spend one-third of their lives in the bedroom. Studies have shown that, of all the rooms in the home, the bedroom often contains the most dust mites. Concentrate efforts in the bedroom of the dust-sensitive person.

  • Select non-allergic, washable bedding materials. Rather than pillows stuffed with feathers, down, kapok or foam rubber, use pillows stuffed with synthetic materials. Get special casings (plastic or rubberized fabric) that zip around mattresses, box springs and pillows. These limit your exposure to dust mite particles. Avoid bulky comforters and chenille bedspreads. Use washable blankets and spreads, and wash all bedding (including pillows without cases) every week to 10 days, using hot water.
  • If possible, install a room air conditioner and dehumidifier in the bedroom if the home does not have central air-conditioning. Lowering humidity reduces the number of mites, molds and cockroaches. Avoid using vaporizers or humidifiers.
  • Place a filter made of cheesecloth under the faceplate of the bedroom-heating vent to help prevent circulation of dust into the bedroom air and change it frequently.
  • Hang clothes in a closet and keep the closet door closed, or put them into dresser drawers.
  • Get rid of stuffed animals or use washable ones.
  • Never allow pets in the bedroom.

Reduce Surface Dust

  • Clean your home thoroughly on a regular basis (particularly the bedrooms). Vacuum frequently and dust with a damp or oiled cloth. Ideally, someone other than the dust-sensitive person should clean, but if this is impossible, wear a mask. Vacuuming can raise a cloud of dust. Special vacuum cleaner bags for trapping dust are available, and for some patients a central vacuum system may be advisable. You physician may also suggest use of a HEPA (High Efficiency Particulate Arresting) air filtered vacuum. These expensive units are not necessary for all patients.
  • You may need to remove carpeting, especially in the bedroom. Carpeting is a breeding ground for dust mites. If you must have carpeting, select a type with low pile. Scatter rugs that can be washed each week are a better alternative. Wood floors, seamless vinyl or linoleum floor coverings are best because they can be cleaned easily and thoroughly, and mites don’t like to live on uncarpeted floors.
  • You may need to remove from your home any items that tend to collect or hold dust and replace them with easy-to-clean items. Use wooden, leather or plastic-covered sofas and chairs instead of upholstered furniture. Select closed bookcases and curio cabinets instead of open shelves. Books and knickknacks are dust collectors. Use washable curtains or window shades instead of Venetian blinds and heavy draperies. Choose furniture with simple, clean designs instead of ornately carved pieces. Select easily cleaned decorations instead of dried-flower arrangements, wall hangings and straw baskets.

Reduce Dust in the Air

  • Use air-conditioning to keep inside humidity at 50 percent or lower to slow the growth of dust mites and molds during warm weather months. An inexpensive hygrometer will help you monitor humidity.
  • Change or clean air-conditioner and furnace filters often. In some cases, your physician may recommend using a HEPA cleaner on your heating system or a portable HEPA filter unit in your bedroom. The portable units are efficient at cleaning air in their immediate vicinity, but are of limited use in large rooms. They have not been shown to be useful for patients with dust mite allergy, since the dust mite particles are not airborne.

What products are available to get rid of dust mites?

Certain chemicals kill dust mites or inactivate dust mite allergens. They are expensive, and some products can be respiratory irritants for some people. In general, their use is reserved for situations when the above measures have been tried and have failed.

Tannic acid destroys mite allergens but does not kill the mites themselves, so its effect is temporary. It can be sprayed on carpets or upholstered furniture to break down allergen from mites or cat dander. When the allergen is inactivated, it no longer causes allergy symptoms. Tannic acid works fast and is easy to use, but its effects do not last long because mites remain and allergen continues to build up. This requires frequent application of the product. Also, tannic acid may stain some carpets and upholstery so it should be tested in a non-critical area prior to widespread application.

Benzyl benzoate actually kills mites and helps remove them and their waste products from carpet. It comes as a moist powder that needs to be brushed into carpets, allowed to dry for 8 to 12 hours, and vacuumed up. The Environmental Protection Agency (EPA) has approved this product as safe for home use, and it will not usually stain carpets. Unlike tannic acid, benzyl benzoate’s effect may be long lasting. After one or two initial applications, you might be able keep mites and allergy symptoms under control by using it only once or twice a year.

What if avoiding dust mites doesn’t work for me?

If you follow these procedures to reduce your exposure to house dust but allergy symptoms persist, your allergist may recommend other treatment methods such as medications or allergy shots. Consult your allergist to determine the most effective treatment method for you. You can gain control of your dust mite allergy and achieve relief from allergy symptoms.

Source: American College of Allergy, Asthma and Immunology

Pollen Allergy

Each spring, summer and fall, tiny pollen grains are released from trees, weeds and grasses. These grains hitch rides on currents of air. Although the mission of pollen is to fertilize parts of other plants, many never reach their targets. Instead, pollen enters human noses and throats, triggering a type of seasonal allergic rhinitis called pollen allergy. Many people know this as hay fever. Of all the things that can cause an allergy, pollen is one of the most common. Many of the foods, medicines, or animals that cause allergies can be avoided to a great extent. Even insects and household dust are escapable. But short of staying indoors, with the windows closed, when the pollen count is high — and even that may not help — there is no easy way to avoid airborne pollen.

What Is Pollen?

Plants produce tiny — too tiny to see with the naked eye — round or oval pollen grains to reproduce. In some species, the plant uses the pollen from its own flowers to fertilize itself. Other types must be cross-pollinated. Cross-pollination means that for fertilization to take place and seeds to form, pollen must be transferred from the flower of one plant to that of another of the same species. Insects do this job for certain flowering plants, while other plants rely on wind for transport.

The types of pollen that most commonly cause allergic reactions are produced by the plain-looking plants (trees, grasses, and weeds) that do not have showy flowers. These plants make small, light, dry pollen grains that are custom-made for wind transport.

Amazingly, scientists have collected samples of ragweed pollen 400 miles out at sea and 2 miles high in the air. Because airborne pollen can drift for many miles, it does little good to rid an area of an offending plant. In addition, most allergenic pollen comes from plants that produce it in huge quantities. For example, a single ragweed plant can generate a million grains of pollen a day.

The type of allergens in the pollen is the main factor that determines whether the pollen is likely to cause hay fever. For example, pine tree pollen is produced in large amounts by a common tree, which would make it a good candidate for causing allergy. It is, however, a relatively rare cause of allergy because the type of allergens in pine pollen appear to make it less allergenic. Among North American plants, weeds are the most prolific producers of allergenic pollen. Ragweed is the major culprit, but other important sources are sagebrush, redroot pigweed, lamb’s quarters, Russian thistle (tumbleweed) and English plantain.

Grasses and trees, too, are important sources of allergenic pollens. Although more than 1,000 species of grass grow in North America, only a few produce highly allergenic pollen. It is common to hear people say they are allergic to colorful or scented flowers like roses. In fact, only florists, gardeners and others who have prolonged, close contact with flowers are likely to be sensitive to pollen from these plants. Most people have little contact with the large, heavy, waxy pollen grains of such flowering plants because this type of pollen is not carried by wind but by insects such as butterflies and bees.

 

Some grasses that produce pollen Some trees that produce pollen
  • Timothy grass
  • Kentucky bluegrass
  • Johnson grass
  • Bermuda grass
  • Redtop grass
  • Orchard grass
  • Sweet vernal grass
  • Oak
  • Ash
  • Elm
  • Hickory
  • Pecan
  • Box elder
  • Mountain cedar

 

When Do Plants Make Pollen?

One of the most obvious features of pollen allergy is its seasonal nature — people have symptoms only when the pollen grains to which they are allergic are in the air. Each plant has a pollinating period that is more or less the same from year to year. Exactly when a plant starts to pollinate seems to depend on the relative length of night and day — and therefore on geographical location — rather than on the weather. On the other hand, weather conditions during pollination can affect the amount of pollen produced and distributed in a specific year. Thus, in the Northern Hemisphere, the farther north you go, the later the start of the pollinating period and the later the start of the allergy season.

A pollen count, familiar to many people from local weather reports, is a measure of how much pollen is in the air. This count represents the concentration of all the pollen (or of one particular type, like ragweed) in the air in a certain area at a specific time. It is shown in grains of pollen per square meter of air collected over 24 hours. Pollen counts tend to be the highest early in the morning on warm, dry, breezy days and lowest during chilly, wet periods. Although the pollen count is an approximate measure that changes, it is useful as a general guide for when it may be wise to stay indoors and avoid contact with the pollen.

Source: National Institute of Allergy and Infectious Diseases, National Institutes of Health

Pet Allergy

More than 70 percent of U.S. households have a dog or cat. Pets provide companionship, security and a sense of comfort. Children often learn responsibility and lessons about life and death from pets.

However, people with allergies should be cautious in deciding what type of pet they can safely bring into their home. Pet exposure may cause sneezing and wheezing. An estimated 10 percent of the population may be allergic to animals. A higher rate of 20 percent to 30 percent of individuals with asthma have pet allergies.

Pets can cause problems to allergic patients in several ways. Their dander, or skin flakes, as well as their saliva and urine, can cause an allergic reaction. The animal hair is not considered to be a very significant allergen. However, the hair or fur can collect pollen, dust, mold and other allergens.

What Are the Most Common Pets?

The most common household pets are dogs, cats, birds, hamsters, rabbits, mice, gerbils, rats and guinea pigs. Larger animals such as horses, goats, cows, chickens, ducks and geese, even though kept outdoors, can also cause problems as pets.

The number of pets in the United States is estimated at more than 100 million. This large number also increases the likelihood of accidental exposure to animals by the allergic patient when visiting homes, farms, etc.

Both feathers and the droppings from birds, another common pet, can increase the allergen exposure. The allergic patient should not use feather pillows or down comforters. If a feather pillow is used, it should be encased in plastic. An encasing with a zipper is recommended, so none of the feathers can escape.

Bird droppings can be a source of bacteria, dust, fungi and mold. This also applies to the droppings of other caged pets, such as gerbils, hamsters and mice.

What Do Allergists Recommend?

The best types of pets for an allergic patient are pets that don’t have hair or fur, shed dander, or produce excrement that creates allergic problems. Tropical fish are ideal, but very large aquariums could add to the humidity in a room, which could result in an increase of molds and house dust mites.

A frequent misconception is that short-haired animals cause fewer problems. It is the dander (skin scales) that causes the most significant allergic reactions – not the length or amount of hair on the pet. As stated previously, allergens are also found in the pet’s saliva and urine. In addition, dogs have been reported to cause acute symptoms of allergic conjunctivitis, or inflammation of the eye, and hay fever after running through fields and then coming back into contact with their owners.

Those pets that are known to cause significant allergic reactions should be removed from the home of the allergic patient to avoid possible progression of symptoms. A “trial” removal of a pet for a few days or even weeks may be of little value since an average of 20 weeks is required for allergen levels to reach levels found in homes without pets.

Can Pet Allergies Be Managed?

If the family is unwilling to remove the pet, it should at least be kept out of the patient’s bedroom and, if possible, outdoors. Allergic individuals should not pet, hug or kiss their pets because of the allergens on the animal’s fur or saliva.

Indoor pets should be restricted to as few rooms in the home as possible. Isolating the pet to one room, however, will not limit the allergens to that room. Air currents from forced-air heating and air-conditioning will spread the allergens throughout the house. Homes with forced-air heating and/or air conditioning may be fitted with a central air cleaner. This may remove significant amounts of pet allergens from the home. The air cleaner should be used at least four hours per day.

The use of heating and air-conditioning filters and HEPA (High Efficiency Particulate Arresting) filters as well as vacuuming carpets, cleaning walls and washing the pet with water are all ways of reducing exposure to the pet allergen. Vacuum cleaners with HEPA filters are now available. However, in a patient with severe symptoms resulting from animal dander exposure, a HEPA filter is not an effective solution.

Litter boxes should be placed in an area unconnected to the air supply for the rest of the home, and should be avoided by the allergic patient.

Some allergic patients may have severe reactions, such as wheezing and shortness of breath, after exposure to certain pets. Also, a chronic, slowly progressive feeling of shortness of breath, loss of energy and feeling of fatigue can result from long-term exposure to birds and their droppings. This type of disease is known as hypersensitivity pneumonitis and can result in severe disability. In the event of these severe cases, removal of the offending animal is mandatory.

How Are Pet Allergies Diagnosed?

The avid pet owner may claim that exposure to his or her pet does not cause their allergy symptoms. This, however, should be viewed skeptically, since pet ownership is an emotionally charged subject. Also, many allergic pet owners are rarely away from their pets, so an accurate reporting of pet-related symptoms may not be possible.

Skin tests or special allergy blood tests are helpful for diagnosing allergy to animals, but are not always accurate. To gain confirmation about a pet’s significance as an allergen, the pet should be removed from the home for several weeks and a thorough cleaning done to remove the hair and dander. It should be understood that it can take weeks of meticulous cleaning to remove all the animal hair and dander before a change in the allergic patient is noted.

Are Allergy Shots Effective for Pet Allergies?

Allergy shots (immunotherapy) may be indicated for cat or dog allergies, particularly when the animal cannot be avoided – as might be the case when the patient is a small animal veterinarian. They are typically given for at least three years. They decrease symptoms of asthma and allergy. Usually after about six months of weekly injections allergy symptoms improve and less medication is required

Allergy shots are most effective and safe when administered under the supervision of an allergist-immunologist. The response is highly individual and depends on environmental avoidance as well as the initial sensitivity of the individual

What Can I Do When Visiting People With Pets if I Am Allergic?

The approach to visiting households with pets for an allergic individual is to take appropriate precautions including administration of medications prior to visitation. Your allergist-immunologist can provide information on medications for your animal allergy, such as antihistamines, nasal sprays, decongestants or appropriate asthma medications.

For patients who have severe symptoms on animal dander exposure, the pet should removed from the house at least day before the visit, and the host household should be cleansed of animal allergen to the extent practical.

Source: American College of Allergy, Asthma and Immunology