ALLERGIES ON THE RISE: UNDERSTAND AND COPE!

ALLERGIES 101: by Dr. Myron J. Zitt, MD FAAAAI

Interview & Transcription by: Melyssa Reizian

On Long Island, and in fact throughout the United States, an increase in allergic conditions of all types is currently being experienced.  While the basis for this is hypothetical, global warming, overuse of antibiotics, an overly clean environment, inadequate exercise and the delayed introduction of allergenic foods in infancy have been put forth as theoretical explanations.   Respiratory and skin allergies are most prevalent in our practice, as is food allergy, which is increasing at alarming rates.

RESPIRATORY SYMPTOMS

From early spring until the first frost, our patients are often troubled by exposure to OUTDOOR ALLERGENS, including tree, grass and weed pollens, and molds. “Allergic rhinoconjuctivitis” (affectionately known as “rose fever” in the spring and  “hay fever” in the late summer and fall), is most common and is characterized by itchy, tearing bloodshot eyes, runny, itchy, stuffy nose and sneezing. Studies indicate that in this country, up to 40% of children and 30 % of adults suffer from allergic rhinoconjuncitivitis.  These numbers are high and continually increasing. 

In the late fall and winter, as the pollen diminishes, folks may experience respiratory symptoms from INDOOR ALLERGENS like dust mites and animal dander.   Because we are on an island, where humidity tends to be high, mold growth is prevalent and mold allergy is quite common.  As a result of damage from hurricane Sandy, mold exposure has increased significantly.  In the inner city, cockroach and rodent allergens have also been found to be significant causes of respiratory symptoms.

Our patients are often troubled by symptoms of asthma, which is characterized by cough, wheeze, chest tightness and/or shortness of breath.  Asthma prevalence is also increasing.   It is estimated to affect about 10 % of the population, but occurs with greater frequency, in children.  Of great concern is that asthma has been reported in up to 25% of inner city children.   As many as 85% of children with asthma have an allergic basis for symptoms, while in folks diagnosed with asthma later in life, allergy plays a significant role in only about 40 to 50%. 

Asthma can be triggered by heavy allergen exposure, and in our area, tends to increase most commonly in the fall, after kids return to school. Of interest is that the so-called  “wheezin’ season” peaks on Long Island over Halloween weekend, when emergency room visits for asthma flare-ups are greatest.  Exposure to late fall pollens, to mold growth from rotting leaves that have fallen from the trees, and to indoor allergens like dust and animal dander, heightened by decreased air circulation when windows are closed, all contribute to this uptick in symptoms.  Of additional importance at this time of year are rapid shifts in weather conditions and viral upper respiratory infections, which are easily transmitted during close contact with others at school and work.    

Viral infections in asthma patients heighten the sensitivity of the airways to allergens and non-specific irritants, which may lead to coughing and wheezing that can persist for many weeks after the infection has cleared.  Persisting cough may be the earliest and perhaps the only symptom exhibited by patients with asthma.  In those in whom a definitive diagnosis has not been made, appropriate studies should be done to determine if cough is due to asthma.  It is important to recognize that most asthma flare-ups do not require antibiotic therapy and are best treated with an aggressive anti-inflammatory asthma regimen.   To prevent further increase in the reported rising incidence of bacterial resistance to antibiotics, the inappropriate use of these agents should be avoided whenever possible.   In addition, the use of “cough medicines” to treat chronic cough, in the absence of a diagnosis, to explain the cause of symptoms, should be discouraged. 

ALLERGY THERAPY

Patients with respiratory allergies should make every effort to avoid their allergenic triggers whenever possible.  This is particularly important in the home, where humidity should be maintained at optimal levels (30 to 40%) and exposure to mite, mold and animal dander minimized.   Immunotherapy, commonly known as allergy shots, has been extremely helpful in improving the tolerance of patients with respiratory allergies to both indoor and outdoor allergens.  Nonetheless, one must not diminish the importance of proper diet, sleep and exercise, as well as adhering to a medical regimen provided by a trained and qualified health care provider to achieve optimal allergy control.

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DR. MYRON ZITT has been serving the Long Island community for over 35 years, initially as the Chief of Allergy and Immunology of the Queens – Long Island Medical Group and currently with the Mid Island Allergy Group with offices in Plainview and Babylon.  He also serves as Director of the Adult Allergy Clinic at Nassau University Medical Center and holds an appointment as Associate Professor of Clinical Medicine at the State University of New York at Stony Brook.  He received his medical degree from the State University of New York Downstate Medical Center in Brooklyn, New York. He completed a residency in Medicine at Long Island College Hospital and a fellowship in Allergy-Immunology and Chest Disease at Duke University Medical Center in Durham, North Carolina. He is Board Certified in Internal Medicine and Allergy and Immunology.


Dr. Zitt is an active Fellow of the American College of Allergy Asthma and Immunology where he is Past President and has served on its Executive Committee, Board of Regents, and ACAAI Foundation. He is also a Fellow of the American Academy of Allergy Asthma and Immunology, where he has served on numerous committees.  Locally, he is a Past President of the Long Island Allergy Society.

Dr. Zitt has also served on the Board of Directors for the Asthma and Allergy Foundation of America where he acted as Vice President of Research, on the Board of Directors of the World Allergy Organization where he chaired the Emerging Societies Committee.  and on the Board of Directors of the Joint Council of Allergy Asthma and Immunology.

For more information, visit: http://www.midislandallergy.com