Rising Ragweed Pollen: Why Fall Allergies in the U.S. Are Getting Worse
Every fall, ragweed pollen has long been a familiar culprit behind sneezing, congestion, and itchy eyes. But lately, it’s not just the symptoms that are changing—it’s the season itself. Rising ragweed pollen levels are making allergy season longer, more intense, and harder to escape.
What the Data Show
- Since about 1995, the ragweed pollen season has lengthened in 10 out of 11 studied locations in the central U.S. and Canada. In northern areas, the increase has been especially large: Winnipeg has seen the season grow by approximately 25 days, Fargo by 21 days, and Minneapolis by 18 days.
- Research also finds that warmer temperatures and higher carbon dioxide levels lead ragweed (and other seasonal allergens) to produce more pollen and to start earlier and end later.
- A recent investigation in Michigan linked high ragweed pollen exposure to increased respiratory mortality in older adults; the effect could persist for up to two weeks after exposure.
How This Affects Americans in the Fall
- Longer exposure: Ragweed pollen, which traditionally peaks in mid-September and lasts through October in many regions, is now beginning earlier and lingering later into fall.
- More severe symptoms: With more pollen in the air over a longer time, people with seasonal allergic rhinitis (“hay fever”) and asthma are experiencing worse flare-ups.
- Broader impacts on health and well-being: Beyond just discomfort, there are effects on sleep, school and work productivity, increased healthcare visits, and elevated risks for those with chronic respiratory conditions.
What’s Driving the Increase?
- Climate change: Warmer average temperatures delay the first frost in fall, extend the growing season for ragweed, and allow for earlier flowering in spring.
- Higher CO₂ concentrations: Plants respond by producing more pollen, and sometimes pollen that is more allergenic.
- Urban heat islands and environmental changes: Cities tend to stay warmer, which can magnify these effects. Land disturbance, changes in land use, and soil exposure contribute to ragweed spread.
What Can Be Done
- Awareness and monitoring: Check daily pollen counts; be alert for early season symptoms.
- Preventive measures: Starting allergy medications before symptoms flare can help. Using air filtration, keeping windows closed on high-pollen days, and rinsing off pollen after outdoor exposure all help.
- Seek professional help: For people with severe allergy or asthma symptoms, getting evaluated by a medical provider may be important—immunotherapy might reduce the severity long-term.
- Find a provider near you: If you think you might benefit from allergy testing or long-term treatment, you can use this tool:
Takeaway
Fall allergies aren’t what they used to be. With ragweed pollen seasons getting longer and stronger, more Americans are suffering for more of the year. But by understanding what’s changed, staying informed, taking preventive steps, and connecting with medical providers when needed, it’s possible to reduce the burden and breathe a little easier.
A Deep Dive into Summertime Allergies
As the warmth of summer graces us with its presence, many of us are eager to embrace outdoor activities and soak up the sun. However, along with the barbecues, beach days, and sunny strolls, comes an uninvited guest: allergies. For many people, summer is synonymous with sniffling, sneezing, itchy eyes, and other symptoms that signal the onset of seasonal allergies. Let’s delve into what exactly causes summertime allergies, how they impact us, and what we can do to manage them better.
The Cause: Summer Allergens
Seasonal allergies, also known as hay fever or allergic rhinitis, are triggered by allergens—substances that the immune system mistakenly identifies as harmful. When the body encounters these allergens, it responds by producing a type of antibody called Immunoglobulin E (IgE), leading to an allergic reaction.
During the summer months, the primary culprits are pollens from grasses, weeds, and trees. While spring is most commonly associated with tree pollen allergies, summertime often sees a rise in grass pollens (such as Timothy grass, Kentucky bluegrass, and ryegrass) and weed pollens (like ragweed, sagebrush, and pigweed). Mold spores, which thrive in warm, humid environments, also become more prevalent during summer, contributing to allergic symptoms.
The Impact: Symptoms of Summertime Allergies
The allergic reaction sparked by these allergens can result in a variety of allergy symptoms, many of which can be quite discomforting. These symptoms typically include:
- Sneezing
- Runny or congested nose
- Itchy, watery, or red eyes
- Coughing
- Itchy throat or ears
- Fatigue
These symptoms can severely affect an individual’s quality of life, leading to disturbed sleep, irritability, and an inability to fully enjoy outdoor activities during the summer season.
Managing Summertime Allergies
Various strategies can help manage the symptoms of seasonal allergies and make your summer a lot more enjoyable.
1. Awareness and Avoidance
Stay updated on local pollen forecasts available online such as the United Allergy Service Pollen Forecast or through mobile apps such as myAllergyPal®, and try to limit your outdoor activities on high pollen count days. Additionally, during these peak periods, keep your windows closed and use air conditioning to keep allergens at bay.
2. Allergy Medication
Over-the-counter antihistamines can be effective for relieving allergy symptoms like sneezing, itching, runny nose, and watery eyes. Decongestants may also help to relieve a stuffy nose. For those with severe symptoms, a provider may prescribe stronger medications or recommend allergy shots (immunotherapy).
3. Good Hygiene Practices
After spending time outdoors, be sure to shower and change into fresh clothes to remove any pollen that may have settled on your skin and clothing. It’s also beneficial to wash your hands often and avoid touching your face, especially your eyes, to prevent direct introduction of allergens.
4. Home Environment Care
Use high-efficiency particulate air (HEPA) filters in your home to trap pollen and other allergens. Regular cleaning and vacuuming also help to keep your indoor environment allergen-free.
The Solution: Lasting Allergy Relief
Despite best efforts to manage allergy symptoms, over-the-counter medications and preventative measures might not be enough for some individuals. In such cases, it’s crucial to take the next step—getting tested for allergies. By identifying specific triggers, you can not only avoid those allergens but also receive targeted treatment for more effective symptom relief.
Through your provider at an allergy center near you, United Allergy Services offers comprehensive allergy testing that can pinpoint the exact allergens causing your discomfort. This personalized approach allows for a more accurate diagnosis and effective treatment plan.
For some, the path to relief could lie in immunotherapy, a treatment approach that helps the body build tolerance to allergens. United Allergy Services offers allergy shots (subcutaneous immunotherapy) and allergy drops (sublingual immunotherapy) tailored to your specific allergen sensitivities. Over time, immunotherapy can help to reduce or even eliminate your allergic responses, enabling you to fully enjoy summer.
In conclusion, while summertime allergies can put a damper on this vibrant season, there are many avenues to manage and overcome them, including avoidance, medication, and medical treatments like immunotherapy. Don’t let allergies hold you back—explore options with your provider at a local allergy center to find the best treatment path for you.
Eosinophilic Esophagitis (EoE)
Eosinophilic esophagitis (EoE) is a recognized diagnosis that produces symptoms related to dysfunction of the esophagus. In EoE, large amounts of white blood cells, specifically eosinophils, collect in the inner lining of the esophagus resulting in inflammation. Typically, the esophagus is free from eosinophils and resulting inflammation, and so in EoE, a patient will begin to notice a difference in the way they can eat and swallow food. This condition can be difficult to diagnose as other conditions can present with eosinophils in the esophagus, and historically EoE has not been a common or well-known disease. Awareness has significantly improved however in the last decade, and patients are being recognized and diagnosed much earlier. This week, the FDA has approved the first ever treatment for EoE.
Symptoms of EoE
Many EoE patients also have symptoms of one or more allergic disorders like asthma, allergic rhinitis, atopic dermatitis (eczema) and food allergy. It is important for EoE patients to be properly assessed and tested for potential allergens as well as properly diagnosed for their atopic conditions. Similar to proper diagnosis, it is crucial that any and all allergic aspects of EoE can be properly treated in conjunction with management of the EoE. Patients benefit from a team of providers working together such as a primary care provider, allergy specialist, and gastroenterology specialist.
Early diagnosis of this chronic condition is important so patients can be educated and properly managed, sparing them from discomfort, malnutrition, and even life-threatening situations. An emergent situation can arise if inflammation becomes too great and causes narrowing in the esophagus, trapping swallowed food. In younger children, EoE typically presents with poor feeding, failure to grow properly, vomiting, reflux symptoms, and abdominal pain, whereas in adolescents and adults EoE most often presents with dysphagia (trouble or painful swallowing) and emergent esophageal food impactions.
Allergy Correlation
Airborne allergies can play a role, however adverse immune responses to food are the main cause of EoE in many patients. It can be more difficult to properly diagnose food allergies in EoE patients because many do not present with the typical symptoms associated with IgE mediated food allergy. Instead of immediate itching, flushing, hives and vomiting after ingestion of the offending food, the reactions can be delayed over hours or days. Milk, egg, soy and wheat are recognized as the most common triggers for EoE, however, conventional allergy tests often fail to detect sensitivity to the foods causing EoE. This is because most food allergy reactions in EoE are delayed and caused primarily by immune mechanisms other than classical IgE-mediated food allergy.
Diagnosis
Other than proper identification and diagnosis of atopic conditions, EoE must also be properly diagnosed itself as a disease. If EoE is suspected, a specialist performs an upper endoscopy, where a small tube with embedded camera is passed down the esophagus. The tube not only has a camera and light for inspection, but a small device to take samples, or biopsies of the esophagus. The biopsies of the esophagus are examined under a microscope for eosinophils and inflammation and are necessary to diagnose EoE. A provider looks for appropriate symptoms that were described above, visual inspection of the esophagus, and examination of tissue biopsies to make the final diagnosis of EoE.
Managing EoE
There are many viable options to managing EoE effectively. Food sensitivities or allergies can be managed by removing those offending foods from a person’s diet, but only under the direct guidance and supervision of a provider. A provider can advise eliminating a specific food, or a food group based on individual history, examination, and diagnosis. This elimination approach can be helpful to some, but it is important to only remove what is advised, and a medical provider will closely monitor a person and regularly discuss nutrition and intake. Many times, a dietician is added to the medical care team to make sure a person is still receiving all the necessary nutrients. A provider’s goal is to carefully add back any foods that can in fact be tolerated and are proven not to incite eosinophils in the esophagus.
Aside from adjustments to a person’s diet, there are some medications providers use to help provide symptom relief and management of the EoE. It is important to note that aside from the first medication being approved by the U.S. Food and Drug Administration (FDA) to treat EoE, typical options for treatment include proton pump inhibitors and steroids. Proton pump inhibitors (PPIs) reduce acid production in the stomach and have also been found to be able to reduce esophageal inflammation in some patients with EoE. PPIs are very commonly used as a frontline therapeutic for EoE patients. If PPIs do not work for a patient, another option may be swallowed topical corticosteroids. Swallowing small prescribed doses of corticosteroids so they come in direct contact with and treat the inner lining of the esophagus is the most common treatment.
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.
Allergies, Asthma, and Air Quality
As we move into the summer months, it is important to understand the connection between allergies, asthma, and air quality. While air pollution does not directly cause allergy or asthma, it can increase the risk of developing atopic disease. Air pollution can also trigger allergy or asthma symptoms or an asthma attack for persons with existing conditions. Air pollution usually increases during summer months. This pollution leads to an increase in related symptoms, urgent office visits, and emergency room visits.
Air Quality Components
Allergy and asthma symptoms can be triggered by two key air pollutants, ozone (found in smog) and particle pollution (found in haze, smoke, and dust).
- Ozone, a gas, is one of the most common air pollutants, contributes to smog, and is more common in cities where there are a lot of cars. In the summer months ozone can increase when intense sunlight and heat convert a mixture of tailpipe and power plant emissions with other chemicals resulting in unhealthy air. Allergy and asthma symptoms may trigger more easily because ozone is irritating to the lungs and can reduce lung function.
- Particle pollution is present and stable throughout the year but is typically worse near busy roads, during rush hour and around factories. It is also high when there is smoke in the air from wood stoves, fireplaces, or burning vegetation. These small particles can irritate the nose, throat, and especially the lungs, and also reduce lung function and cause asthma exacerbations.
Air Quality Reports
The United States Environmental Protection Agency (EPA) reports air pollution levels using the Air Quality Index (AQI). AQI reports the level of ozone and other air pollutants. When the AQI is 101 or higher, it is dangerous for people with allergies and especially asthma. Sometimes asthmatics can experience increased symptoms even when ozone levels are moderate (AQI 51-100). Many local news stations and weather forecasters report local air quality to advise the public about moderate or high pollution days.
Another resource, The American Lung Association has just released their annual State of the Air report. One interesting finding in the report is, “The addition of 2020 data to the 2022 “State of the Air” report gives a first look at air quality trends during the COVID-19 pandemic. Regardless of the shutdowns in early 2020, there was no obvious improvement.”
Combatting Air Quality Conditions
When air quality may be dangerous to people with allergies or especially asthma, they are deemed as “Action Days”. During Action Days, people with asthma should limit their time outdoors, especially in the afternoon or rush hour periods, stay in a well-ventilated, preferably air-conditioned, building, and most of all, do not intensely exercise outdoors. Also try to keep windows closed in your home and car, and instead utilize the air conditioning on the recycled setting.
There is also a risk that you could have poor indoor air quality within your home. Irritants can exacerbate allergy and asthma symptoms. These and allergy and asthma triggers are common items such as:
- household cleaners
- hair products
- perfumes
- air freshening sprays or plug ins
- scented candles/diffusers
- smoke produced from
- tobacco
- fireplaces
- candles
- cooking
- wood burning stoves
Not smoking or permitting smoking in the home is one of the easiest ways to protect the home from indoor air pollution. Finally, be mindful of high humidity and mold growth. These two factors can greatly impact indoor air quality. Installing exhaust fans in kitchens, bathrooms, and laundry rooms can help lower humidity. The use of a dehumidifier helps significantly as well.
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.
Earth Day and Climate Change Effects
Earth Day is this Friday, April 22nd. Earth Day is truly a mainstay in American culture, created by Past-President Richard Nixon. This year the Earth Day theme is “Invest in Our Planet”. We are called upon to have “unstoppable courage to preserve and protect our health, our families, our livelihoods…” One of the continued focal points of interest is trying to put a dent in rising global temperatures, with an average increase of 2.4 degrees Fahrenheit in the last 50 years. It doesn’t sound like a lot, but each degree brings bigger changes than many realize. The rising temperatures have a directly negative impact on allergy sufferers and those offering optimal allergy care to their patients.
Effects on the Planet
Warming temperatures results in longer growing seasons. Although people tend to enjoy nature’s natural beauty a bit longer, and farmers have additional time to harvest crops, the increase in temperatures prolong and worsen the suffering of those with pollen allergies and can cause an imbalance in the optimal growth range for crops and cause foods shortages.
Different plants require different conditions to grow, and when the climate continually changes, so do the arrangements and floristic zones of the world’s plants. As the planet warms, we continue to see the planting zones where these plants grow will continue shifting north. Shifting planting zones threaten things like accurate allergy testing panels, cocoa beans for chocolate producers, coffee beans, and maple syrup. Plant species, being entirely mobile beings, will be forced to move upslope or downslope, or species with arrange themselves in new combinations entirely. Finally, the rising temperatures also negatively impact plants by impacting the pollinators that assist with their growth. Warmer temperatures and changing climates have negative effects on pollinator species like butterflies and honeybees. This further shift growing and blooming seasons and further weakens the plant populations.
Allergy Amplification
As the planet warms, allergy season tends to begin earlier and last longer each year. Talk to your primary care provider about allergy testing and treatment options if you notice that your allergies are worsening. You may be a great candidate for immunotherapy, a solution to change the source of your allergy misery rather than treating just the symptoms.
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.
Football, Food, and Fall Allergies
Fall has arrived and so have shorter days, cooler weather, and football season! Unfortunately for some, football, food and fall allergies go hand in hand. This is especially true in the southern and western regions of the US where some weed allergens peak in the fall. The idea of sneezing and wheezing with itchy, watery eyes while watching a game or practice can be dreadful. Perhaps more concerning is visiting major sports venues if you or a loved one have food allergies.
Outdoor Allergies
It is common to check the weather forecast to plan for warm or cool temperatures when attending sporting events. A good habit may be to also check the local pollen counts in the area. Keep in mind that peak pollen times are typically in the first half of the day, specifically 5 a.m. to 10 a.m. Attending practices or games midday, in the afternoon, or in the evening may help to reduce exposures.
Avoidance for Fall Allergies
If you have a future MVP of your own, packing some wet wipes could be helpful. Wiping down their hands, face and neck can combat those distracting allergy symptoms when out on the field. Also, verify any allergy medication they take will not make them drowsy during their practice or game. Non-sedating medication options or allergen immunotherapy may be worth discussing with their provider.
After practices or games, changing out of the clothing worn while participating or spectating can help alleviate allergy symptoms. Also helpful is an immediate shower, particularly before crawling into bed. Showering will help to wash away any allergens that have adhered themselves to your skin or hair. This is especially important to keep them out of the immediate space and air you breath in all night.
Food Allergies
If food allergies are a concern, planning ahead can alleviate a lot of anxiety and allow for a smooth trip. Always make sure to carry a minimum of two epinephrine auto injectors if one is prescribed to you or a loved one. Make sure the epinephrine autoinjector is carried in a way it can be accessed and administered within 60 seconds of a need arising. The Food Allergy Research and Education (FARE) organization recommends “to reach out directly to the venue to learn more about their efforts” in regard to additional steps they may be taking to ensure your family’s safety at the game.
Food Allergy Tips
Some suggested topics to cover when you contact the venues are:
- Availability of allergy friendly games, sections, or suites
- Is power washing utilized for seating, and traffic pathways at the stadium?
- Are ingredient lists available upon request at the concessions?
- Policy for bringing in safe meals and snacks
- Locations for emergency responders
Planning and communication make it possible to avoid fall allergies and enjoy football season. Communicate with family, friends, coaches, players, and venues, and create a plan that is right for your family. However, missing out on football season does not have to be part of that plan. If you or your loved ones are not quite sure if allergies are playing a roll, or if the allergy medication is just is not cutting it, consider contacting your provider and discussing allergy testing and starting allergen immunotherapy.
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.
Ragweed and Fall Pollen Allergies
Back to school season is here! Shorter days, crisp, cool evenings, and beautiful fall foliage are on the horizon. This time also marks the onset of weed pollination and the resurgence of allergy symptoms that may have taken a vacation in the hot, dry July heat. The meteorological calendar says fall begins September 22nd, but weed pollen, the main culprit of the sniffles and sneezes during fall allergy season, is already here!
Pollen Offenders
Towards the close of summer, weeds start to pollinate. Weeds grow all summer, but their pollen is usually not released until later in the growing season. This can vary year to year but typically starts mid to late August. Ragweed, cocklebur, lamb’s quarters, pigweed, dock sorrel, English plantain, and sagebrush can all cause fall allergy symptoms and are widely spread across the U.S.
Specifically ragweed pollen is the predominate culprit of allergy symptoms from August through October, peaking on average in mid-September. Ragweed is one of the major drivers of allergy symptoms and releases huge amounts of pollen each and every day. The pollen produced by ragweed is small and light. It is released in large quantities into the air and carried for miles by the wind. Nasal congestion, runny nose, and itchy eyes are typically caused by wind-blown pollen which is easily spread for miles and miles.
Other Pollen Types
Goldenrod, which blooms at the same time that ragweed does, is instead insect-pollinated and therefore is not a significant allergen for most individuals. Insect carried pollen is produced by plants that have bright and attractive flowers. This kind of pollen is typically large and heavy, sticks to insects, and is transported during flight fertilizing other plants. These bright flowers are commonly thought to be allergy offenders, however because they do not release much pollen into the air they are not as likely the culprit of allergy symptoms.
Manage Symptoms
Checking local pollen counts is helpful to anticipate the level of exposure on any given day. Pollen counts are determined by collecting pollen on special rods. The pollen is then counted under a microscope and calculated in grains per cubic meter of air. Pollen counts tend to be the highest early in the day, or often when the wind picks up just before a large rainstorm. If you like dancing in the fall rain, or jumping in rain puddles, however, you are in luck. During a rainstorm and immediately following, pollen becomes still and dormant because the rain makes it damp and heavy. As the air becomes warmer and drier following the storm, however, the pollen count will rise again.
Pollen Avoidance
Those with weed pollen allergies should try to avoid heavily dense wooded areas or those with brush and shrubbery. These areas should be especially avoided in late August when pollen is the most dense and abundant. Pollen counts are never zero, nor will an allergy sufferer truly be able to avoid weed pollen in the late summer and early fall. However, contact may be lessened by taking simple steps to avoid pollen overload:
- Utilizing the air conditioner or heater
- Keeping the windows and doors at home and in the car closed
- Utilizing the dryer rather than the fresh breeze to dry clothing
- Changing clothes after coming in from being outdoors
- Shower prior to getting into bed or laying on upholstered furniture
These easy steps will help to decrease pollen exposures. Also, one benefit COVID-19 may bring allergy sufferers, is that wearing of some masks will help to minimize the amount of pollen reaching the nasal passages if being worn in outdoor settings.
Get Tested
If someone is unsure whether weed pollen is a trigger for their back-to-school nasal congestion, runny nose, post nasal drip, sneezing, and itchy watery eyes, taking an allergy quiz or seeing their provider for an allergy test may provide the clarity they are looking for!
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.
Back to School Action Plan for Allergies and Asthma
As the final days of summer break come to a close, families everywhere are preparing for children to return to school. Whether this is the first year a child is heading to school or the last, it is an exciting time for both children and parents. It can, however, also be a time of anxiety for a parent worried about a child’s asthma or allergy conditions. Below are some ways to prepare and communicate these concerns amid back-to-school excitement.
Make a Plan
Schedule an appointment with your child’s healthcare provider in the weeks leading up to the first day of school. During this appointment, discuss overall heath as well as specifics regarding allergies, food allergies, or asthma. This is also a great opportunity to request that the healthcare provider refill any asthma or allergy medications. The provider can complete medication permission forms required by the school nurse during your visit. It is important the school nurse can quickly and easily confirm the medication you provide is:
- non-expired
- prescribed for your child
- has clear directions on when, how, and how much to take
This is also the time to request your provider complete any additional forms required by the school. Examples are asthma action plans, anaphylaxis action plans, and food allergy alert plans with avoidance and substitution information. If your child is in their first year or is entering a new school, it is important to contact the school nurse directly. Also, if your child has complex requirements or action plans, you should visit with the school nurse yearly about their daily requirements. The nurse can discuss accommodation options available for children at the school. Other important policies to discuss include asthma inhalers, epinephrine auto injectors, classroom parties, field trips, and cafeteria rules.
Classroom Action
The classroom can be a source of exposure for children with allergies to dust mites, mold, and animal dander. Communicate with your child’s teacher about allergy triggers for their symptoms and what common symptoms to look out for. Don’t forget to ask if the classroom will have a resident pet. If so, what type of animal and any requirements that the pet come home with your child may be important. It is also important to understand if the school has air conditioning or if windows are typically opened on nicer days. If windows must be opened, then you can prepare your child accordingly with additional symptom control medication.
During your initial meeting with the teacher, you can begin setting appropriate expectations. Discuss things such as asthma action plans and any potential limitations for recess or physical education. Also, anaphylaxis action plans for food or stinging insects and any food avoidance requirements should be covered. You will feel confident knowing both the school nurse and teacher are fully informed of your child’s needs. The school nurse and teacher should have a consistent plan for where inhalers and epinephrine auto injectors are stored. Also confirm that there is a plan for administration of medication in a time of need. It is a good idea to ask about substitutes or classroom aides/parent volunteers confirm they are made aware of your child’s needs.
When to Stay Home
During a regular year it is often a challenge to decide when it is or is not appropriate to send a child to school with cold-like symptoms. That can be even more complex for a parent if your child has allergies or asthma. In this unique time when COVID-19 is still a major focus, another layer of complexity is added.
For children with asthma, it is safe to attend school with mild wheezing that occurs infrequently and is quickly resolving with the use of albuterol. However, it is appropriate to keep your child home from school if:
- they experience difficulty sleeping due to respiratory symptoms
- require albuterol every 4 hours to relieve them of things like wheezing, shortness of breath, or chest tightness
- have respiratory symptoms that are failing to resolve with albuterol use
Make sure to always inform the school nurse and the child’s teacher of any recent asthma exacerbations and how it was treated. Communicate any continued treatment if applicable.
If your child has an allergic reaction, make sure to inform the nurse. Also update the nurse on the allergen trigger if known, how the reaction was treated, and any ongoing treatment.
Wishing all the children a safe, healthy, and prosperous new school year!
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.
Grass Pollen Allergy: Making the Most of Summer
Summer is finally here! Longer days, days spent by the beach or the pool, and late nights catching fireflies are on the horizon. Allergies are usually associated with the spring or fall because pollen is most active during these times. However, summer allergies, especially to grass, are also common. This grass pollen allergy can cause some of the same troublesome allergy symptoms as in other seasons.
Allergy Season
Grass begins to pollinate in the late spring, typically April or May in the northern part of the country. The pollination period in the north will then typically continue through June or July. However, in southern regions, grasses may pollinate throughout many seasons and could trigger symptoms throughout the year. These pollination time periods are when those who suffer from a grass pollen allergy notice their symptoms at their worst.
Types of Grass Pollen
There are hundreds of different kinds of grasses throughout the United States. Fortunately, not all of them are the source of summer sneezing, congestion, and itchy eyes. Some grass pollen types are small, light, dry and can travel for hundreds of miles by the wind. One group of grasses, referred to as the northern pasture grasses, cause more allergy problems than any others. These grasses include:
- common timothy grass
- sweet vernal grass
- orchard grass
- perennial rye grass
- Kentucky bluegrass
Another type of grass, bermuda, is a southern grass and is responsible for many troubling summer grass allergy symptoms. Johnson grass is another main culprit for grass pollen misery.
Options for Homeowners
While common Bermuda grass usually triggers allergies, some hybridized versions produce little to no pollen. One common type of hybrid Bermuda grass referred to as the "Princess 77" variety is available for homeowners. Other good hybrid Bermuda grass varieties include "Tifway" and "Santa Ana". Buffalo grass may be a good warmer climate option. This warm-season grass survives droughts and requires little supplemental watering, making it ideal for areas with watering restrictions. Types like the "UC Verde" or "609" produces only female plants, eliminating the problems of flowering and producing pollen. Although less commonly found, this is ideal for grass pollen sufferers.
Measuring Grass Pollen Counts
Those that suffer from a grass pollen allergy can benefit from checking their local pollen counts regularly. Pollen counts are determined collecting pollen on special rods. The pollen is then counted under a microscope. The pollen count is then calculated in grains per cubic meter of air. Pollen counts tend to be the highest early in the day, or often when the wind picks up just before a large rainstorm.
If you like dancing in the rain, or jumping in rain puddles, however, you are in luck. During a rainstorm and immediately following, pollen becomes still and dormant due to the rain making it damp and heavy. As the air becomes warm and dry following the storm, the pollen count will become potent again
Manage Your Grass Pollen Allergy
Pollen counts are never zero, nor will an allergy sufferer truly be able to avoid grass pollen in the summer. However, some practices may help decrease pollen exposures. For instance, utilizing the air conditioner while keeping the windows and doors to the home and car closed. Also, utilizing the dryer rather than the fresh breeze to dry clothing will help to decrease pollen exposures. It is especially important to keep windows closed when you or someone close mowing their grass.
Although it may seem like a good idea to avoid cutting the grass as much as possible, mowing grass often and keeping grass short actually causes the grass to release less pollen into the air. If a nonallergic friend or family member isn’t available to assist in cutting your grass, consider wearing a mask. Wearing masks will help to minimize the amount of pollen reaching the nasal passages. It is greatly beneficial for grass pollen sufferers to wear a mask when cutting grass or doing other yardwork.
Other Helpful Tips
Those with a grass pollen allergy should try to avoid heavily dense grassy areas, especially in early summer when pollen is the most dense and abundant. Although summer brings warmer temperatures. when you are out working in the yard, out at a park, or hiking it is recommended to wear long pants or long sleeve shirts in a light breathable fabric. This added layer of protection helps reduce the amount of pollen that comes in direct contact with your skin. Similarly, wearing sunglasses and hats also reduce pollen that contacts eyes or nestles in your hair.
Grass pollen allergy sufferers should also make a habit of changing their clothes after coming in from being outdoors, and bathing prior to getting into bed/laying on upholstered furniture. Wash bedding in very hot, sanitizing cycles once a week in peak pollen seasons. It is also beneficial to remove shoes before entering your home. And do not forget your pets! They can be major sources of tracking grass pollen into your home. Make sure to wipes them down with a wet cloth or towel before they enter your home, and make sure to bathe them more frequently in high pollen seasons. And although not always feasible, the ability to keep your pets from sleeping in your bed, in your bedroom, or on your upholstered furniture will also greatly benefit you if you suffer from grass pollen.
Symptom Relief is an Option
If someone is unsure whether grass pollen is a trigger for their troublesome nasal congestion, runny nose, postnasal drip, sneezing, and itchy watery eyes (take our allergy quiz here), seeing their provider for an allergy test may provide the clarity they are looking for!
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.
Easter with Allergies
The Easter and Passover holidays are here! Holidays mean family centered fun, festive meals, and usually sweet treats to enjoy. For allergy suffers, however, they can sometimes be challenging to navigate. Aside from the usual pollen and food allergies, brightly dyed eggs, household pets, and sweet baby chicks and bunnies can also wreak havoc on the nose and chest. Here are some tips to navigate the upcoming holidays and ensure that you and your family celebrate safe and happy.
Easter and Food Allergy Considerations
Traditional holiday meals are at the cornerstone of Easter and Passover. Plan the meals out in advance and be mindful of any guests that may have a food allergy. Be flexible and try to switch ingredients for allergy-friendly alternatives, eliminate a recipe from the menu altogether, or take care to prepare allergy-friendly dishes separately from the other meals. If you are not sure if guests have a food allergy, consider printing recipes out for each of the dishes and allow people to determine if it’s a safe food for them to indulge in. Also consider avoiding a buffet style offering, or separating allergen safe foods from allergen containing foods in two different areas or tables.
Sweet Treats
These spring holidays typically mean chocolate and sweet treats to younger members of the family, or those young at heart. Try to again consider those guest and family members that may have allergies to things like chocolate, so they are not left sitting on the sidelines. Allergy to chocolate itself, or the cacao bean, is incredibly rare, however more commonly the offenders are milk, peanuts, tree nuts, soy, and corn. A little research will provide an array of options of dairy free or peanut/tree nut free brands of treats. Always check labels to see if the offending food in contained in the ingredients list, or mentions it was produced in a facility that also processes other allergen containing foods putting your loved one at risk of cross contamination.
Keep in mind most chocolate does contain soy in the form of soy lecithin to keep it solid at room temperature, and white chocolate commonly contains corn in the form of corn syrup. If the treats offered are of the homemade variety, it can be even more challenging for a food allergy sufferer due to lack of label to research ingredients.
If you suffer from food allergies, a good rule to follow if “If you can’t read it, don’t eat it”. Plan to bring some of your own safe snack or goodies, unless you can make sure your host prepared foods allergen free, safely away from other allergen containing food, and on a separate and thoroughly cleaned surface. In lieu of store bought or homemade edible treats, consider offering nonfood items for younger guests such as books, sporting goods, stickers, novelty items, or toys.
Easter Egg Related Allergies
Although the majority of food allergens are most offensive if ingested, it is important to consider that some people do have reactions or develop irritations from contact exposure to egg or the dyes used to make them bold and bright. If colorful dyed egg hunts are part of your spring holiday tradition, there are alternative ways to include everyone on the fun. Instead of using traditional eggs and egg dye, consider eggs made of wood, ceramic, or plastic, and consider natural dye alternatives. Other options include making gelatin eggs, egg sugar cookies for decorating, or decorating marshmallows in place of eggs. Also, consider replacing the hard-boiled egg on the Passover Seder plate with a ceramic or plastic egg to keep guests anxiety free.
If the above-mentioned allergies are life threatening for you or a loved one, always make sure to carry a minimum of two epinephrine auto injectors if it is prescribed. Make sure the epinephrine autoinjector is carried in a way it can be accessed and administered within 60 seconds of a need arising. If you or a loved one does have life threatening allergies, it is always a good idea to check with your health insurance and ensure you know where to seek medical care should the need arise if celebrating the Spring holidays out of town.
Pollen Considerations
Food allergens typically are the easiest to keep front of mind during the holidays, however equally as difficult for allergy suffers and arguably more difficult to avoid are the tree pollens and mold spores blowing in the air. These unwanted guests can ruin any picnic or outdoor gathering with nasal, sinus, eye, and chest symptoms. If there is both indoor and outdoor venues at the celebration location, try to minimize the time spent outdoors. If you are hosting the celebration, try to offer an indoor haven if planning to spend time outdoors, as well as keep windows and doors closed at the indoor space. Also, minimize the exposure to outdoor allergens while traveling to the destination by keeping windows up in the car and instead using the air conditioning.
Celebration Times
It is a good habit to always check pollen counts for the area where you will be celebrating. If you are planning the celebration, try to have it start mid-day or later due to peak pollen times typically occurring in the first half of the day (specifically 5am 10am). Also, it would be beneficial to plan the event outside of heavily grassy areas or those densely populated with trees. This may help to decrease the concentration of allergens in the air. If the celebration will be entirely outdoors with no indoor refuge, it is a good idea to make sure you are on top of your allergy medication or immunotherapy regimen before going. It may be wise to pack a few changes of clothing as well as wet wipes for the ability to remove pollen from your immediate environment every few hours.
Once you return home from the festivities, plan to shower or bathe before prioritizing any other activities. It is especially important to bathe before crawling into bed, to remove any allergens that have adhered themselves to your skin or hair. This is especially important before allowing them to have access to your pillow or sheets and being in the immediate space and air you breath in all night.
Easter and Passover Gifts or Decor
Many people choose to show their appreciation to their host or show their love to their family by bringing beautiful spring flowers or plants to the celebration. Unfortunately, people can have severe symptoms such as sneezing, along with nose and eye itching and watering related to the pollen, or just the smell of particular flowers. Even an asthma attack can be triggered from them. According to the American College of Allergy, Asthma and Immunology, there are many flowers you can get at a florist that produce little pollen. Look for tulips, roses, begonia, columbine, crocus, daffodil, and geraniums if you want to be safe.
Pet Allergies
We cannot forget about the cherished furry family members that may be in attendance for the spring holiday celebration. There may also be the propensity to give the give of baby chicks or bunnies this time of year. Dander, saliva, sweat, and urine from adorable dogs, cats, and even bunnies can trigger an allergic response in some people. If possible, try to keep pets confirmed to only a certain area of the celebration so that those that wish to enjoy them can, while those that are unable can find refuge elsewhere.
Make sure to thoroughly wash your hands before returning to an animal free area of the celebration, before partaking in shared food items, or before touching your face, mouth, or eyes. Also, make sure the recipient of a new spring pet is not triggered by them. Although recent literature has shown us a true allergy to bird feathers is rare, there are substantial amounts of dust mites found in feathers that can trigger unwanted allergy symptoms.
Allergy Treatment Options
If you or a loved are unsure whether tree pollen, grass pollen, mold spores, dust mites, or animal dander are potential allergy triggers and the cause of the nasal congestion, runny nose, post nasal drip, sneezing, and itchy watery eyes you have been suffering with, seeing your provider for an allergy test may provide the clarity they are looking for! Some providers may have the ability to access food concerns as well. And if you are already aware of true allergy triggers, but the spring allergy medication and avoidance measures are just not cutting it, there is still time to see your provider and discuss starting allergen immunotherapy.
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.
Tips for Balancing Baseball and Allergies
Spring means longer days, warmer weather, and the beginnings of baseball! Unfortunately for some allergy sufferers, the start of the long-anticipated baseball season also means the time of year when allergens such as tree pollen are at an all-time high. Sneezing, wheezing, and itchy, watery eyes can make games or practice challenging for you or your little leaguer. Even more concerning? The thought of major league games and contact with baseball’s favorite sidekick...peanuts! You can still enjoy this spring and baseball season with a little planning for your allergies.
Eliminating all outdoor sports and activities may seem like the best decision, and for many, it is. However, if skipping out on baseball or other outdoor sports due to allergies just is not an option, we can help. Here are some tips that will help allergy suffers enjoy watching America’s pastime and PLAY BALL!
Airborne Allergy Tips
Check the weather forecast before heading to the game. When checking out the weather, it is good practice to also check the pollen counts in the area. Keep in mind that peak pollen times are typically in the first half of the day, specifically 5am 10am. Attending practices or games midday or in the afternoon may help to reduce exposures.
Baseball and outdoor allergies don't have to be in competition with one another. If you have a little leaguer, packing wet wipes is good practice. Wiping down their hands, face and neck can be helpful to combat those distracting allergy symptoms when out on the diamond. Also, make sure your favorite player is not relying on allergy medication that could make them drowsy. There are non-sedating medication options, or allergen immunotherapy that are worth discussing with their provider.
After a long practice or game, it is beneficial to change your clothing as soon as possible. Also helpful is an immediate shower, especially before crawling into bed. The shower will help to wash away any allergens that have adhered themselves to your skin or hair. This is especially important so that the allergens aren't transferred to your pillow or sheets, remaining in the immediate space you breathe in all night.
Planning for Stinging Insects and Food Allergies
If your allergies include stinging insects or even food, planning ahead can alleviate a lot of anxiety. Always make sure to carry a minimum of two epinephrine auto injectors if there is a known insect or food allergy. Make sure the epinephrine auto injectors can be accessed and administered within 60 seconds if the need arises.
If food allergies are present, especially peanut, legume, or tree nut, it can make the lyrics “Buy me some peanuts and Cracker Jacks” send shivers down your spine. Fortunately, most large baseball stadiums across the country have become aware of the dangers and distress surrounding food allergies and have started to offer peanut-free games or special accommodations for food allergy families with peanut-free designated seating. The Food Allergy Research and Education (FARE) organization typically releases an annual guide outlining which major league and minor league baseball stadiums offer peanut aware sporting events. Along with utilizing their helpful guide, FARE recommends “to reach out directly to the venue to learn more about their efforts”.
Some suggested questions to have ready when you contact the venue about are:
- Are there any [peanut] allergy friendly games, sections, or suites available?
- Does the venue utilize power washing for seating, and traffic pathways at the stadium?
- Can you find ingredient lists or are they available upon request at the concessions?
- Do they allow families to bring in their own safe meals and snacks?
- Are emergency responders available to the public at every game, and are their sections closer to these personnel?
Planning and communication are key to enjoying baseball season and balancing your outdoor allergies. Talk to family, friends, coaches, players, and venues, to create a plan that is right for your family. However, missing out on baseball season does not have to be part of that plan. If you or your loved ones are not quite sure if allergies are playing a role, or if the over-the-counter allergy medication just is not cutting it, you have options. There is still time to see your provider and discuss allergy testing and begin allergen immunotherapy.
About the Author
Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, Pennsylvania. After spending eight years in clinical practice, she joined United Allergy Services as the vice president of clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology.
United Allergy Services is also on Facebook, LinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.
'Tis the season for Cedar Fever
In parts of Texas and surrounding areas, cedar allergies are one last health challenge in an already difficult year.
2020 has been one for the ages, headlined by the widespread impact of the COVID pandemic. While Americans and the rest of the world await a vaccine, there are other concerns that can impact their health in the coming months. One of those is cedar allergies.
Winter is generally not considered a peak season for environmental allergies. Grasses pollenate in the summer months, ragweed pollenates in the fall, and most trees release their pollen in the spring months. However, one tree that does so between December and February is mountain cedar. According to Thermo Scientific, cedar is one of the primary allergens in Texas, especially around the Edwards Aquifer region. It can also be found in parts of southern Arkansas and Oklahoma.
Cedar is identifiable by its amber-colored pollen, which becomes ubiquitous from December through February. Its effect, often known locally as “cedar fever”, can lead to symptoms like itchy, stuffy, and runny nose, as well as sneezing and itchy and watery eyes for allergy sufferers. In more serious cases, it can lead to sinus infections or trigger allergic asthma symptoms.
In a climate where people are already hyper-conscious of their breathing symptoms, cedar allergies cause additional stress. Could that congestion and coughing be allergies, or something worse? Providers that offer allergy testing can not only offer their patients short-term peace of mind but a path to long-term relief from the symptoms that bother their patients, now and year-round.
While many allergy sufferers will practice a combination of avoidance and self-medication to get through cedar season, those are only short-term measures to combat the symptoms rather than the disease. Allergen immunotherapy represents a path to a long-term better quality of life, including during cedar season. With concerns such as the flu and COVID existing simultaneously, patients have all the more reason to seek understanding--and relief.
5 Surprising Ways Hotels Can Make You Sick
When traveling, your hotel is your home away from home. But you and your family may have unwanted company -- your hotel room could be a haven for germs, parasites, and other threats to healthy travel.
Before you book your next getaway, know what dangers could be lurking in hotel rooms and how to avoid travel sickness.
Poor Air Quality
Sub-par air quality in your hotel room can quickly put a damper on your trip and increase the chances that you’ll get sick.
“Stale air is unhealthy. It invites irritants into the body,” says Gaylen Kelton, MD, professor of clinical family medicine at the Indiana University School of Medicine and IU Travel Medicine in Indianapolis. “It can aggravate allergies and just be a nuisance.”
Cigarette smoke is a common irritant. Most hotels in North America offer the option of non-smoking rooms, but they may be harder to find internationally.
“In China, even though there are no-smoking signs on the walls in the hotel rooms, they still reek of smoke,” says Dr. Kelton.
If you do smell smoke or stale air, Kelton says it’s best to resist the urge to turn on the fan or air conditioner. If the air filters aren’t changed regularly, you could make matters worse and blow more irritants into your hotel room. Instead, open a window to get some fresh air into the room.
Germs in Unexpected Places
Most people expect to find germs on places like door handles and toilets in a public place like a hotel. But research shows the highest concentrations of germs in hotel rooms are often in places many people don’t hesitate to touch as soon as they set their bags down.
A small study of nine hotel rooms presented at the American Society for Microbiology in 2012 showed remote controls, telephones, carpets, and bedside lamp switches contained high levels of fecal and aerobic bacteria. Those types of bacteria could lead to gastrointestinal illnesses, among others.
Researchers found that cleaning items on maids’ carts, like mops and sponges, also had high levels of both types of bacteria. That raises the risk of spreading potentially disease-causing germs from room to room while cleaning.
To prevent hotel room germs from spoiling your trip, bring sanitizing wipes and wipe down high contact surfaces when you arrive. Also remember to wash hands frequently.
Slipping Risks
Germs may actually be the least of your worries in a hotel room bathroom, says Kelton. Bigger threats to healthy travel are slips and falls on unfamiliar territory. “More accidents happen in showers from falls than anything else when traveling,” says Kelton.
In hotel room bathrooms, you may encounter a different setup than you're used to at home, and that can trigger falls, says Kelton. For example, you might have a walk-in shower at home, but at the hotel, you have to step into a tub shower. Or the floor may not have a mat or carpet and could become slippery when wet.
Another often-overlooked danger in the bathroom is scalds and burns. “Hotels have the hot water set at a higher temperature than at home, so you need to gauge the temperature appropriately,” says Kelton. “Kids may turn on the hot water all the way at home and be okay, but the hotel’s water is hotter.”
A final water warning for international travelers: Kelton says that if you aren’t going to drink tap water anywhere else on your trip, don’t do it at the hotel either. That means using bottled water to drink in your room as well as to brush your teeth.
Allergies and Sensitivities
Dust mites, down comforters, and other potential allergens might trigger the sniffles in particularly sensitive travelers — allergy and asthma sufferers, we mean you.
If you have allergies or sensitive skin, Kelton says it’s worth calling ahead to ask if the hotel offers allergy-friendly rooms or if they can tell you what cleaning products they use — harsh cleaning solutions or laundry detergents can also be irritating if you have sensitive skin. Some hotel chains will also allow you to pre-order foam rather than feather pillows.
Kelton also advises against trying the tempting free toiletries at hotels if you have sensitive skin. “Using a new soap or shampoo may cause some people to have a reaction,” he says.
Bed Bugs
What's most surprising about bed bug infestations is that they're still a problem. Since the late 1990s, they've had a worldwide resurgence. Bed bug infestations have now been reported in all 50 U.S. states, often in hotels.
The blood-sucking insects feed on people. Bed bug bites can start out as small pricks in the skin, but can grow and become inflamed and cause itching.
More than 40 disease-causing pathogens have been detected in bed bugs, but the good news so far is that there's no definitive evidence that they transmit any disease to humans.
To reduce your risk of becoming a bed bug’s dinner or means of transport to its next meal, follow these steps:
- Check the mattress, box spring, and behind the headboard for signs of bed bugs. Signs may include brown spots (which could be the bugs’ feces) and bed bug skins, as well as any live bed bugs. The bugs tend to harbor in mattress piping.
- Do not put your luggage or other personal items on beds or other soft, upholstered furnishings that may harbor bed bugs. Put clothing and luggage on dressers or luggage racks.
- Keep your suitcases, briefcases, and computers and their cases closed when not in use.
Taking these precautions involves some legwork (and detective work), but it all translates to a better travel experience.
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By Jennifer Warner
Medically reviewed by Pat F. Bass III, MD, MPH
October 24, 2013
everydayhealth.com