Attack of the Really Annoying Pollens
Longer. Stronger. And maybe both.
These are the predictions for this year’s allergy season in Southern California.
Already, some local physicians say, they are seeing a 25% to 50% increase in the number of patients suffering from seasonal allergies than they normally care for at this time of year--patients like Deanne Adlen-Chalk, 33, a Santa Monica book publicist who never leaves home without her survival kit: “Eyedrops, a box of tissues, cough drops to lubricate my throat.” She also takes daily medication to combat her allergies to pollens, molds and dust mites.
Blame it all (except the dust mites) on El Nin~o.
The rains have spurred the growth of molds, grasses, weeds and trees. And that means an explosion in mold spores and pollen grains. These tiny triggers can leave sensitive types suffering from itchy eyes, runny noses, scratchy throats, stuffed-up ears and sinus problems--and also cause big problems for those with asthma. More than 25 million Americans have seasonal allergies; about 15 million have asthma.
In Southern California, allergy season typically starts off with tree pollens, prevalent from about February through May, with high pollen counts typical for pine, mulberry, birch family, juniper, cedar, sycamore, oak, liquidambar, ash, butternut, walnut, poplar, palm, acacia, cottonwood and eucalyptus. Grass pollens usually kick in from February to October, the weed season coinciding in summer through fall with high counts typical from sagebrush and Russian thistle.
There’s nothing typical this year, however. By mid-March, pollens from grasses, weeds and trees had already reached very high levels in the Los Angeles area, according to Cathy Pollak, health educator at the Asthma & Allergy Foundation of America, Los Angeles chapter.
As of April 15 to 16, the latest dates for which pollen counts were gathered by the Asthma & Allergy Foundation, pollen counts for trees and grasses remained high, while pollen from weeds was moderate and from mold spores, low. Pollen counts can change within short time periods, depending on weather conditions. Pollen counts taken April 13 to 14, for instance, recorded moderate tree pollens, high grass pollens and low weed and mold spore pollens.
“It’s going to be terrible,” says Dr. Bernard Geller, a Santa Monica allergist on staff at Santa Monica-UCLA Medical Center and St. John’s Hospital and Health Center. “I don’t know if the season will go on longer [than normal], but it will be much more intense.”
Dr. Jennifer Derebery, an ear specialist at House Ear Clinic and Institute who specializes in allergies, gives a bleaker outlook: “We’re not going to get much of a rest from allergies this year.”
Or maybe next year, either. Even if El Nin~o goes away tomorrow, she says, next year’s tree pollen levels will be high.
“Rainfall the preceding year determines the amount of pollen in a given season for trees,” she says.
But before you curse the storms, consider input from Dr. Eugene Kenigsberg, a USC clinical professor of pediatrics and chief of the allergy department at Kaiser Permanente, Woodland Hills.
“The allergy season may be very bad,” he says, “but if the rains keep coming, we could have breaks. The rain has a scrubbing effect.” It washes away pollens, so rainy days are often respites for those with allergies, he says. But these are only temporary, he acknowledges. “Between rains, I do see a significant increase in patients.”
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Thankfully, the medication arsenal has expanded once again.
Nasonex (mometasone furoate), a topical anti-inflammatory nasal spray made by Schering-Plough Corp. and approved by the U.S. Food and Drug Administration late last year, joins a host of similar products available only by prescription. Patients who suffer persistent allergy symptoms most days of the week are candidates for these topical steroid sprays, says Kenigsberg. The sprays can alleviate the chronic swelling of the nasal lining (which can lead to other problems such as sinus infections) in those who are susceptible. At doses prescribed for allergies, the primary effect of the steroids is confined to the nasal area, with “negligible systemic effects,” he adds.
Pulmicort (budesonide), manufactured by Astra USA, is a new prescription-only dry powder inhaler for reducing airway inflammation for those with asthma.
Patanol (olopatadine hydrochloride), a prescription eyedrop for those with allergies affecting the eyes, was launched last allergy season but was not widely available until last fall, says a spokeswoman for Alcon Laboratories Inc., the manufacturer. It’s meant to prevent itching due to allergies.
Other prescription options include oral antihistamines (such as Claritin or Zyrtec) that don’t cause drowsiness.
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Over-the-counter options abound. But sufferers should use over-the-counter nasal decongestants (such as Afrin) sparingly, says Derebery. After more than four days, they can cause a “rebound” effect as the brain begins to compensate for the action of the decongestant, which works by constricting the blood vessels to reduce swelling and symptoms. The brain “overrides” the action of the decongestant, opening up the blood vessels, Derebery explains, making symptoms worse.
Another OTC option, Nasalcrom (cromolyn sodium) nasal spray, previously available only by prescription, works by stabilizing the nasal cells before they can react to allergens.
When choosing OTC medicines, pick products based on the symptoms you are trying to treat. Sounds simple, but Kenigsberg says patients, even doctors, often confuse the aim of antihistamines, meant to treat runny noses, sneezing, scratching and sniffling, with decongestants, meant to relieve congestion such as a stuffy nose.
Alternative remedies for allergies abound, with suggestions including garlic, ginkgo, stinging nettle and other preparations. Geller often fields patients’ questions about herbal remedies and cautions that there is a dearth of scientific data.
Amounts of ingredients in herbal products can vary from brand to brand, says Kenigsberg, who advises patients to do research and be cautious. Bee pollen, a product suggested by some as anti-allergenic, “actually contains pollen related to a number of the allergenic weeds,” he says. “There are cases of allergic shock, even progressing to death, which have occurred with this particular product.”
Simple environmental strategies can help.
“Minimize pollen exposure,” Derebery says. To do this, keep windows closed, and avoid outdoor exercise and yardwork early in the morning, when pollen counts are elevated.
*** UNPUBLISHED NOTE ***
This story has been edited to reflect a correction to the original published text. The correct spelling for a certain tree type is liquidambar.
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