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Seasonal Bulletin


Q. What can I do to reduce the effects of seasonal allergies?

A. There are a number of steps you can take to help stop symptoms:

Keep windows closed and use air conditioning in your home or car to reduce your exposure to airborne allergens.

Schedule outdoor activities early or late in the day and limit your exposure to peak pollen hours.

Make an appointment with us to help identify your specific allergies and give you an action plan tailored to your needs. Peak time for ragweed sufferers to avoid, for example, is early midday, whereas grass pollens are at their peak in the afternoon and early evening.

Shower right after you come in from outside to wash pollen right out of your hair and clothes and help keep it out of your bed-linens, which also should be laundered frequently to keep indoor and outdoor allergens way when you sleep.

Last, don't fret a rainy day. It washes the pollen away!

Q. How do you tell the difference between a cold and allergies?

A. The biggest clue in deciding whether symptoms like sneezing or a runny nose are a cold or allergies is how long they last. A cold normally lasts about a week, but allergies can last for several weeks or longer—depending on what you are allergic to and how often you are exposed to it.

Other differences include some of the symptoms. While both can cause a runny or stuffy nose, sneezing and wheezing, you are more likely to have itchy, watery eyes with allergies and get a fever or body aches with a cold. Another clue is your runny nose. If it's clear, it's usually related to an allergy and not an infection.

Q. What's the difference between allergies and asthma?

A. Allergies are an immune system response, or oversensitivity, to an environmental "trigger" (known as an allergen), such as pollen, dust, mold, pet dander or certain foods, to name a few. Signs of an allergic reaction include frequent or regularly recurring itchy eyes, nose, mouth or ears, sneezing, a runny nose, dry skin or hives, a productive cough, wheezing or tightness in your chest. Allergies can trigger an asthma attack; however, asthma is present in some people without allergies.

Asthma involves inflammation of the lungs that constricts the muscles around your airways, resulting in chest wheezing, coughing and shortness of breath. The bronchial tubes tighten and air flow is reduced as the lungs expand. While allergens provoke most asthma attacks, other triggers include smoke, cold or humid air, strong odors, and strenuous exercise.

Allergies and asthma are treatable and the first step is proper diagnosis to pinpoint the source of your symptoms. An allergist is a specialist in diagnosing and treating allergies and asthma.

Q: Could I be allergic to work?

A: If you develop symptoms that resemble those of hay fever and that appear or become more serious at work, you may be suffering from occupational rhinitis.

Occupational rhinitis, or work-related rhinitis, is a condition in which symptoms are triggered or further aggravated by allergens or irritants in the workplace. These symptoms can include sneezing, a runny nose and watering eyes. Common triggers include cleaning products, chemical fumes, certain types of dust, and corrosive gases.

If your allergy symptoms appear at work, or seem to get worse there, ask us to help you identify potential triggers and develop a treatment plan.

Q: Who has allergies and why?

A: Does someone in your family have allergies? If so, you might have allergies too. That’s because allergies are often hereditary. While allergies are more common in children, they can appear at any age. Sometimes allergies disappear, only to return years later.

Exposure to allergens when the body’s defenses are weak — like after an illness or during pregnancy — can play a role in developing allergies. It’s time to take control of your allergies and start enjoying life again. 

Q: Do food allergens remain on objects? Can an allergic reaction occur from touching food allergens that remain on things like board games or computer keys?

A: Yes, food allergens can potentially remain on objects if they are not carefully cleaned. Simply touching an object that contains something you are allergic to would either do nothing, or at worst possibly cause a rash on your skin at the site of contact. Without swallowing any of the allergen, it’s highly unlikely you would have any further reaction. If you did, it would be exceptionally rare to develop a severe allergic reaction. In most cases, simply washing the area will stop the rash, and it’s like that no medication would be needed. It is a common myth that you can have a severe reaction from simply touching something without eating the food. Many studies have shown that if you wash your hands well with soap and water, as well as thoroughly clean the surface with detergent, you can effectively remove the allergen. Gel-based alcohol hand sanitizers will NOT remove allergens from your skin.

Q: Can food allergies develop as an adult?

A: Although most food allergies develop when you are a child, they can, rarely, develop as an adult. The most common food allergies for adults are shellfish – both crustaceans and mollusks – as well as tree nuts, peanuts and fish. Most adults with food allergies have had their allergy since they were children. An allergic reaction to a food can sometimes be missed in an adult because symptoms such as vomiting or diarrhea can be mistaken for the flu or food poisoning. Adults don’t always pay close attention to symptoms, which can be dangerous since crucial hints can be missed and place the adult at risk if they continue to eat the food.

Oral allergy syndrome is something that can develop in adulthood. Also known as pollen-food syndrome, it is caused by cross-reacting allergens found in both pollen and raw fruits, vegetables, and some tree nuts. This is not a food allergy, though the symptoms occur from food, which can be confusing.  This is a pollen allergy.  The symptoms of oral allergy syndrome are an itchy mouth or tongue, or swelling of the lips or tongue. Symptoms are generally short-lived because the cross-reacting allergens are quickly digested, and do not involve any other part of the body. These symptoms can help distinguish oral allergy from a true food allergy.

Q: Can you outgrow food allergies?

A: Yes.  This is an important point to emphasize. Children generally, but not always, outgrow allergies to milk, egg, soy and wheat. New research indicates that up to 25 percent of children may outgrow their peanut allergy, with slightly fewer expected to outgrow a tree nut allergy. There is no need to assume your child’s food allergy will be lifelong, though for many, this may be the case. If a food allergy develops as an adult, chances are much lower you will outgrow it. Food allergies in adults tend to be lifelong, though there has not been a lot of research in this area.

Q: What are the chances of having a severe reaction to airborne allergens?

A: Virtually none.  No study has ever conclusively proven that allergens become airborne and cause symptoms to develop.  Outside of a few case reports involving symptoms from fish allergy appearing when someone cooked fish, those with food allergies only have severe reactions after eating the allergic food. Many people with peanut allergy also worry about the dust from peanuts, particularly on airplanes. Most reactions probably happen after touching peanut dust that may be on tray tables or other surfaces.  A recent study showed that wiping the surfaces to remove any dust resulted in fewer people reporting reactions during a flight.

Q. Has climate change caused a change in pollen levels?

A. Tree pollination appears to be starting earlier and lasting longer, as well as grass and weed pollination. Ragweed especially appears to be increasing its northern reach into Canada, as there has been an increase in frost free days there! Pollen production and release indeed depend on the climate within which grasses, weeds and trees grow. Factors include temperature, humidity, soil moisture, soil radiation and carbon dioxide (CO2) levels. It does appear that across the continental United States (North America), that not only has the amount of pollen released increased with the various weather (meteorological) factors, but even the period of the year and the duration of pollen release appears to be changing as well (for the worse).

When is the best time to introduce Peanut-containing foods?

The wait is over for parents who’ve been wanting to know how and when to introduce peanut-containing foods to their infants to prevent peanut allergy. New, updated guidelines from the National Institute of Allergy and Infectious Diseases (NIAID), published today, define high, moderate and low-risk infants for developing peanut allergy, and how to proceed with introduction based on risk.

“This update to the peanut guidelines offers a lot of promise,” says allergist Stephen Tilles, MD, president of the American College of Allergy, Asthma and Immunology (ACAAI). “Peanut allergy has literally become an epidemic in recent years, and now we have a clear roadmap to prevent many new cases moving forward. The Learning Early About Peanut allergy (LEAP) study, the study that paved the way for the updated guidelines, has had a dramatic impact on day-to-day patient care. In fact, during my career as an allergist I cannot think of a single publication with more of an impact.”

According to the new guidelines, an infant at high risk of developing peanut allergy is one with severe eczema and/or egg allergy. The guidelines recommend introduction of peanut-containing foods as early as 4-6 months for high-risk infants who have already started solid foods, after determining that it is safe to do so. 

“If your child is determined to be high risk, the new guidelines recommend evaluation by an allergy specialist, which may involve peanut allergy testing, followed by trying peanut for the first time in the specialist’s office,” says allergist Matthew Greenhawt, MD, MBA, MSc, ACAAI Food Allergy Committee chair, and a co-author of the guidelines. “If a child is tested and found to have peanut sensitization, meaning they have a positive allergy test to peanut, from that positive test alone we still don’t know if they’re truly allergic. Peanut allergy is only diagnosed if there is both a positive test and a history of developing symptoms after eating peanut-containing foods.” 

A positive test alone is a poor indicator of allergy, and studies have shown infants who have a peanut sensitivity aren’t necessarily allergic. “In fact in the LEAP study, infants sensitized to peanuts showed the most benefit from early introduction of peanut-containing foods,” says Dr. Greenhawt. The updated guidelines recommend that Infants with a positive peanut skin test have peanut fed to them the first time in the specialist’s office. Some infants may have a large reaction to the skin test (8 mm or larger) which could indicate they are already peanut allergic.  “An allergist may decide not to have the child try peanut at all if they have a very large reaction to the skin test. Instead, they might advise that the child avoid peanuts completely due to the strong chance of a pre-existing peanut allergy. Other allergists may still proceed with a peanut challenge after explaining the risks and benefits to the parents.”

Moderate risk children – those with mild to moderate eczema who have already started solid foods – do not need an evaluation. These infants can have peanut-containing foods introduced at home by their parents starting around six months of age. Parents can always consult with their primary health care provider if they have questions on how to proceed. Low risk children with no eczema or egg allergy can be introduced to peanut-containing foods according to the family’s preference, also around 6 months.

The new guidelines offer several peanut-containing food suggestions as well as methods to introduce age-appropriate peanut-containing foods to infants who have already eaten solid foods. It is extremely important parents understand the choking hazard posed by whole peanuts and to not give whole peanuts to infants. Peanut-containing foods should not be the first solid food your infant tries, and an introduction should be made only when your child is healthy. Do not do the first feeding if he or she has a cold, vomiting, diarrhea or other illness.

“The guidelines are an important step toward changing how people view food allergy prevention, particularly for peanut allergy,” says Dr. Tilles. “They offer a way for parents to introduce peanut-containing foods to reduce the risk of developing peanut allergy.”

The guidelines are simultaneously being published in Annals of Allergy, Asthma and Immunology, the ACAAI’s scientific publication, and several other scientific journals.

To learn more, watch “Peanuts and your baby: How to introduce the two.” For more information about allergies, please contact our office at 317-706-2839.

Food Allergies versus Intolerance

Some of the symptoms of food intolerance and food allergy are similar, but the differences between the two are very important. Eating a food you are intolerant to can leave you feeling miserable. However, if you have a true food allergy, your body’s reaction to this food could be life-threatening. 

Digestive system versus immune system 

A food intolerance response takes place in the digestive system. It occurs when you are unable to properly breakdown the food. This could be due to enzyme deficiencies, sensitivity to food additives or reactions to naturally occurring chemicals in foods. Often, people can eat small amounts of the food without causing problems. 

A food allergic reaction involves the immune system. Your immune system controls how your body defends itself. For instance, if you have an allergy to cow’s milk, your immune system identifies cow’s milk as an invader or allergen. Your immune system overreacts by producing antibodies called Immunoglobulin E (IgE). These antibodies travel to cells that release chemicals, causing an allergic reaction. Each type of IgE has a specific “radar” for each type of allergen. Unlike an intolerance to food, a food allergy can cause a serious or even life-threatening reaction by eating a microscopic amount, touching or inhaling the food. Symptoms of allergic reactions to foods are generally seen on the skin (hives, itchiness, swelling of the skin). Gastrointestinal symptoms may include vomiting and diarrhea. Respiratory symptoms may accompany skin and gastrointestinal symptoms, but don’t usually occur alone. Anaphylaxis (pronounced an-a-fi-LAK-sis) is a serious allergic reaction that happens very quickly. Symptoms of anaphylaxis may include difficulty breathing, dizziness or loss of consciousness. Without immediate treatment—an injection of epinephrine (adrenalin) and expert care—anaphylaxis can be fatal.