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Seasonal Allergic Rhinitis (Hayfever)

The Asthma Center, Allergic Disease Associates, P.C.
Professional Arts Building
205 North Broad Street, Ste. 300
Philadelphia, PA 19107-1553

215-569-1111
http://www.asthmacenter.com

Commonly called hayfever, allergic rhinitis describes allergy symptoms experienced primarily in the nose and eyes. The term hayfever is misleading because it is not caused by hay, nor is it accompanied by a fever. It is the result of the body’s reaction to the presence of allergens, foreign particles such as pollen, dust mites, mold spores and pet dander. When a sensitive individual inhales one of these allergens, the body reacts by releasing histamine and other chemicals .These chemicals cause the common hayfever symptoms - runny nose, itchy, watery eyes, sneezing, swelling and congestion. Over 45 million Americans (more than 15% of the population) are affected by this condition each year.

Fall Hayfever
From mid-May through October, Ragweed and other weeds (English Plantain, Pigweed, Cocklebur, Sheep Sorrel, Lamb’s Quarters, Yellow Dock, and Sagebrush) are the main triggers of allergy attacks.

Ragweed is the most common pollen causing hayfever in the United States.It affects about 75% of allergic rhinitis sufferers. Over one quarter of a million TONS of ragweed pollen are produced per season in the United States.

Ragweed blankets most of the United States, sparing only the southern-most tip of Florida, Northern Maine and the northern West Coast. The ragweed plant looks like a young tomato plant and thrives in poor soil conditions. A single ragweed plant is capable of producing one billion pollen grains per season.Invisible to the naked eye, these microscopic grains have a diameter of approximately 1/25,000th of an inch. Being very light, ragweed pollen is dispersed by the wind and can travel up to 500 miles in some cases. Ragweed plants are hard to eliminate because the seed retains its germinating powers for years.

The beginning of ragweed pollen season in the Northeast depends on the relative length of night and day. As summer days shorten and nights lengthen, ragweed begins to bloom. In the Delaware Valley, based on the past 5 years’ ragweed pollen data collected by The Asthma Center (an accredited pollen monitoring station for the Academy of Allergy, Asthma and Immunology), our ragweed season usually begins mid-August and lasts 8 weeks through October. Weather conditions such as current temperature, rainfall and wind may affect day-to-day pollen counts, but these conditions do not shorten the ragweed season. However, an early hard frost can kill most ragweed plants in one night.

Spring Hayfever
Allergic rhinitis that occurs during the spring is sometimes called rose fever.Similar to hayfever, the term rose fever is also misleading. It is true that roses are in full-bloom during the spring hayfever season. However, roses and other bright flowering plants spread pollen through insects such as bees instead of the wind.

The common allergens that affect individuals in the spring are generally pollens from trees and grasses. These pollen grains are spread by the wind and cause typical hayfever symptoms. The beginning of the spring time hayfever season can be as early as February and last until June.Pollen data from The Asthma Center pollen and mold spore monitoring station has established a second spring season for grasses, starting in August and ending in September. Weather conditions can cause day-to-day variations in the counts.

Pollen Counts
Pollen counts, as reported by The Asthma Center at http://www.asthmacenter.com, represent the concentration of pollen in the air during a specific time. Our pollen counts are reported in grains per pollen per cubic meter of air collected over a 24-hour period. Pollen counts tend to correlate with the severity of symptoms.Counts less than 10 are low levels of pollen in the air. This level will provoke symptoms only in those with extreme sensitivity. Counts in the 10 - 30 range represent moderate amounts of pollen in the air. This level will provoke mild to moderate symptoms in sensitive individuals.Counts greater than 30 represent high levels, and counts greater than 60 represent very high levels of pollen in the air. These levels can produce allergy symptoms in even the most mildly sensitive individuals.Mold spores are also reported with our pollen counts.

Treatments for Allergic Rhinitis
A wide variety of allergy medicines are available for the treatment of hayfever.It is estimated that hayfever sufferers annually spend $2 billion on over-the-counter medications and nearly $300 million on prescription medications. Knowing what medication to take depends on your symptoms. Over-the-counter decongestants and antihistamines are the most frequently used medications. Decongestants provide relief for nasal congestion. Antihistamines relieve watery, runny nose, sneezing and itchy eyes. These medications are not without adverse effects.Individuals with heart disease, high blood pressure, glaucoma, prostate problems or pregnant and nursing women should consult a medical doctor before taking any of these medications.

Stronger antihistamines and decongestants are available by prescription when over-the-counter medications do not work. They offer allergy relief with no or minimal sedation. A variety of nasal steroid sprays like Flonase, Rhinocort Aqua, Nasonex, Nasarel, Nasacort AQ and Astelin are effective for the treatment of hayfever symptoms.

Avoidance of pollen is also a hallmark of allergy treatment. However, this is often easier said than done. Some helpful maneuvers include the following:

  1. Using air-conditioning units and air filters in indoor spaces as much as possible and avoiding work or play outdoors during early mornings.
  2. Keeping windows and doors closed can significantly reduce pollen entering the indoor environment. Keeping windows and doors open is about the same as being outdoors.For example, when windows are open, inside air contains about 70% as much pollen as the outdoors. The air inside a moving car with open windows contains roughly 90% as much pollen as the air outside.
  3. Plan your outdoor activities (such as gardening and mowing the lawn) in the late afternoon and evening when pollen counts are at their lowest.Using a dust or surgical mask may also help reduce direct inhalation of pollen.
  4. Large amounts of pollen may be attracted to clothing and the fur of pets. To reduce this exposure, clothes should not be hung outside to dry. Changing your clothes after spending time outdoors can also be helpful. Outdoor clothing should then be immediately stored or laundered. Storing shoes worn outside in a closed closet or cabinet away from the bedroom and living area is also important. Bathing pets regularly or keeping pets exclusively either outdoors or indoors during the allergy season can also be helpful in reducing the amount of pollens entering the indoor environment.
  5. Keeping your indoor environment clean during the allergy season is important. Allergies may be triggered by exposure to pollen plus indoor irritants like cigarette smoke, perfumes and house dust. Vacuuming frequently with a high-efficiency vacuum with a microfilter collection bag and/or using an air cleaner in living areas are also helpful.

Specifically for those with ragweed allergies, traveling or vacationing to areas with minimal ragweed pollens may help symptoms.Less ragweed pollen seems to be found around large bodies of water, so the seashore is a likely area for relief for pollen sufferers.

Severe allergies often do not respond to medications or pollen avoidance. Allergy injections may be used to desensitize an allergic individual to particular allergies. This form of therapy can effectively block allergic reactions.

The program involves a series of allergy injections of increasing amounts over time. Those on allergy injections should be reevaluated periodically for continued indications for allergy injections. Allergy injections are currently the most effective long-term treatment available for hayfever sufferers.