Nothing to Sneeze About

by  Devang Doshi, M.D.
Director, Division of Pediatric Pulmonology and Pediatric Allergy and Immunology; Adult Allergy and Immunology Staff Physician

It’s that time of year again when the fall colors dominate the landscape in Michigan. Unfortunately, with the “back to school” season well underway and Autumn in full bloom, ragweed, mold spores and other fall weed pollen are peaking outdoors.

For those individuals that suffer from seasonal allergies, the fall can be one of the most difficult seasons due to the high incidence of ragweed allergy.  It has been estimated that up to 20 percent of Americans are allergic to ragweed pollen. The duration of the ragweed pollen season has also increased approximately 3-4 weeks over the last 10-15 years, presumably due to climate changes. The combined ragweed and mold season usually starts in early to mid August and ends after the first hard frost—which we can never predict in Michigan.

There are several things we can do to limit our exposure to ragweed pollen and mold spores:

  • Try to keep doors and windows closed, especially on the windy days in the fall. Pollen can travel for hundreds of miles on a windy day.
  • Cooler days, especially after rainfall will increase the mold spore levels outdoors.
  • Mold also is present in piles of leaves (especially when wet) as well as decaying vegetation. It is important to rake leaves up promptly and dispose of them in an appropriate area to prevent mold from building up in your yard.
  • If you suffer from fall allergies and have asthma, try to limit your time outdoors, especially in areas with high mold levels (hay rides, corn mazes, apple orchards, etc.).

Common allergy symptoms include: watery, itchy eyes, nasal congestion or persistent clear nasal drainage, throat irritation and sneezing. For individuals that suffer from asthma, they may experience an increase in cough, chest tightness and wheezing. Treatment options include minimizing exposure as much as possible, over-the-counter (OTC) and prescription medications.

Traditional over-the-counter medications include: oral antihistamines, decongestants, eye drops, nasal saline sprays and irrigation kits. Prescription medications include: medicated eye drops, nasal sprays, nasal inhalers, prescription antihistamines and decongestants. For those with asthma, keeping a rescue inhaler (short-acting) on hand is very important for outdoor activities, yard work, sports/sporting events, recreation, etc. When all else fails, some patients may benefit from allergy immunotherapy (allergy shots) to help control symptoms due to medication failure and/or intolerable side effects of conventional medications.

It is important to avoid mixing multiple types of medications that may contain similar types of medicine such as antihistamines. When in doubt, seek the advice of your primary care physician. Your primary care physician may also choose to refer you to an allergy/immunology specialist if your symptoms cannot be adequately controlled with conventional medications.

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