Wet summer spells trouble for fall allergies
This year’s exceptionally rainy and humid summer was no picnic for Cape Cod allergy sufferers.
Unfortunately, all that moisture means the fall allergy season also will be worse than usual, said John A. Johnson, Jr., D.O., of the Allergy and Asthma Centers of Cape Cod, which has offices in Falmouth and Hyannis.
“I’ve had people coming in since spring saying this is the worst year I’ve ever had,” he said. “Usually, our patients get a break in the summer.”
That’s because summer is after grass pollen peaks in the late spring and before the late summer-fall weed pollen and mold spore season. But this year’s weather has caused mold to kick in weeks earlier than the usual early fall start, Dr. Johnson said.
The extra moisture also has another key allergen proliferating – dust mites. Seasonal ragweed, sagebrush and goldenrod pollens add to the irritating autumn mix.
A Cumulative Effect
Dr. Johnson likened the effect of all these allergens to candles under a pot of water. Individually, they may not cause a big reaction, but cumulatively, they may cause a person’s immune system to “boil over.”
He identified mold spore as the chief culprit bugging people now.
“Unfortunately, it is mold,” Dr. Johnson said. “Cape Cod is a wet place. We have a lot of oak trees. Those wet, decaying leaves make a great source for mold.”
Mold exists year-round both indoors and out, but spore levels spike with high humidity and warmth. Damp basements and bathrooms can be sources of indoor mold.
“On Cape Cod, it’s important to have a dehumidifier on each floor of the home, not just in the basement,” he said.
Keeping windows closed and air conditioning on in warmer weather can help keep pollen and mold spores out, Dr. Johnson said.
A hard frost ends the outdoor mold spores and weed pollen season, but the tempering effect of surrounding ocean waters keeps fall and winter here milder, prolonging the allergen season, he said.
“We don’t get the deep frost the rest of New England gets, to take a break.”
Pet Dander
The second most common household allergy trigger is pet dander, said Dr. Johnson.
“This is toughest on people who have animals with fur. Cats, dogs, guinea pigs and rabbits in the home can worsen allergy symptoms, especially in the winter when the windows are closed,” he said.
He recommends keeping animals out of the bedroom but acknowledges that may be hard for many people. In addition to that (or in lieu of that), he emphasizes the use of a HEPA air filter.
“Put HEPA air filters where you live; don’t count on having one air filter in the basement; take care of the entire house,” said Dr. Johnson. “Place the HEPA filter in an area shared by you and your pet.”
Bathing animals on a regular basis is also very helpful.
How to treat fall allergies
Dr. Johnson recommends daily use of a nasal steroid spray, such as Flonase, which is available over the counter. Because it can take weeks for it to reach its full effectiveness, he suggests starting to take it in advance of the fall allergy season. Wait until the season ends to stop taking it, he said.
Nasal steroid sprays work better than over-the-counter antihistamines, without the side effect of drowsiness, he said. But because steroid sprays take regular use to kick in, Dr. Johnson backs short-term use of antihistamines at first to quell symptoms of itchy eyes, sinus congestion and a runny nose. Nasal lavage, using bottled sterile or distilled water, to rinse allergens out of the sinuses, can be helpful, he said.
He stressed that people should not use tap water, as it could cause an amoebic brain infection. According to the Centers of Disease Control and Prevention, tap water isn't sterile, and using it for nasal rinses, humidifiers and CPAP machines could cause a respiratory infection, or even a rare brain infection, especially in infants, elderly and people with compromised immune systems.
Asthma and Allergens and Humidity
Asthma makes breathing more difficult by narrowing the lungs’ airways, as muscles in them tighten and the airway walls swell. It also increases mucus production in the airways, further impairing respiration, according to the Asthma and Allergy Foundation of America.
High humidity and allergens can trigger asthma symptoms. Poor air quality occurs during hot weather, which was further degraded this summer by smoke and soot particles from Canadian wildfires.
“Asthma may just show up only as a cough,” Dr. Johnson said, adding that an undiagnosed person with asthmatic cough may say, “I don’t wheeze, I don’t get winded. I don’t have asthma.”
It’s important for people with asthma to keep up with their regular maintenance inhaler, to limit the chance of a serious flare-up or attack. This helps prevent a trip to the emergency room, during which steroid prednisone may be given. Prednisone taken orally in large doses or for an extended time can cause serious side effects throughout the body, including the adrenal glands and intestines, he said. Regular use of the low amount of milder steroids in a maintenance inhaler is not systemic and is much safer, he continued.
A Tried and True Treatment
Testing can determine if the cause of respiratory problems is allergies, Dr. Johnson said. He said testing in his office has produced the surprising result that some people are allergic to two local pollens not generally recognized as allergens: pine pollen and goldenrod.
“Pine pollen is too big to be an issue,” he said, but “it shows up in tests. Goldenrod – leading experts say is not a cause of allergy, but when we test people, it shows up.”
Once a person’s allergens have been identified, allergic reactions to them can be reduced or eliminated through a series of allergy shots given every month and a half for three to five years, Dr. Johnson said. The shots contain small amounts of problem allergens that the body’s immune system eventually learns to tolerate, according to the American Academy of Allergy, Asthma & Immunology.
“Allergy shots have been around since 1911. They train the body not to react,” he said.
