Itchy eyes, rashes, sneezing, wheezing, swelling and shortness of breath are among the symptoms shared by about 50 million Americans who all suffer from allergies. The vastly differing results range from temporary mild discomfort to anaphylaxis—a rapid onset allergic reaction, always serious, potentially fatal and requiring quick medical attention.
Pollen, bee stings, contact with latex and adverse food reactions from peanuts to shellfish can all be triggers. Allergies affect the skin, lungs, throat, sinuses, ears, nose or even the stomach lining, and can also trigger the symptoms of asthma.
Particularly worrisome are how environmental changes have increased allergens and the prevalence of allergic reactions, and affected how sufferers can address the problem.
The overall hike in allergy cases includes an increase in anaphylaxis, which has in some studies increased to 5% of all allergic reactions. The most serious reactions typically start within minutes, including loss of consciousness, low blood pressure, medical shock and severe swelling that interferes with or stops breathing.
The only treatment for anaphylaxis until recently was a dose of epinephrine, a hormone administered by injection. Its effectiveness is superior. But there’s a caveat in the treatment—an aversion to needles among patients and laypersons who may be required to provide an emergency injection.
But allergists’ concerns with the boost in pediatric and adult allergies recently received good news: the approval in August by the U.S. Food and Drug Administration of Neffy. It’s the first nasal spray for the emergency treatment of allergic reactions.
“Neffy is the first significant innovation in the delivery of epinephrine in more than 35 years,” says William E. Berger, M.D., a pediatrics and allergy/immunology specialist in Southern California and part of the Allergy and Asthma Network, headquartered in Fairfax, Virginia.
“It makes it more attainable, administering it is much easier and there are places other than patients that have it. Patrol cars have it, airlines have it, schools have it, clubs have it. Any place where young people may gather. It’s just very convenient to have the nasal spray.”
While various regions of the country, including gulf states, have climates that may seem conducive to fewer allergies, that’s not accurate. Southwest Florida isn’t immune. With longer and warmer seasons, grass, ragweed and tree pollens are more prevalent, particularly in the spring and fall. The allergens are carried through the breezy coastal winds.
Bayberry, oak and cypress trees provide the most active Southwest Florida allergens during spring months. Bahia, Johnson and Timothy grass and weed pollens, such as ragweed, pigweed and mugwort, are more prominent during summer months but can extend into winter. Airborne molds are present year-round, but levels increase during the rainy fall months.
The Naples Allergy Center, whose clinicians treat allergies, asthma, skin conditions and immunologic diseases, details the sometimes-misunderstood relationship between living in a year-round sunshine state and the potential for increased allergy issues.
“Unfortunately, what many of us never consider is how a new environment can affect our bodies,” the medical center states. “Along with common variables like food, pets, latex and medication, the unique climate, pollen count, mold and dust found in Southwest Florida may exacerbate allergies.
“Allergens you had previously not been exposed to may begin to affect you, as well. The Naples Allergy Center’s mission is to educate and treat both common allergies and those unique to the Naples area.”
Further environmental changes, shifts in precipitation to an increase in frost-free days, affect how pollens affect human health, according to The Centers for Disease Control and Prevention, the national public health agency headquartered in Atlanta.
More than 25% of adults and almost 20% of children in the U.S. have seasonal allergies, according to the CDC.
Allergy sufferers are affected when the immune system reacts adversely to an otherwise harmless substance (the allergen). The result: The immune system produces antibodies called Immunoglobulin E, or IgE, that travel to cells that release histamine. It is the released histamine that causes the allergic reaction.
Dr. Stephanie Leeds of Yale Medicine last year discussed the recent higher allergen levels and longer pollen seasons, citing warmer temperatures and increased carbon dioxide emissions. The pediatric allergy specialist called the trend “multifactorial.”
“With climate change, the general trend has been that we’re getting higher levels of pollen and longer pollen seasons, whether that’s due to warmer temperatures or increased carbon dioxide emissions; it’s probably multifactorial,” says Leeds.
Leeds’ assessment was earlier addressed in Proceedings of the National Academy of Sciences. Three years ago, the journal published a report detailing a 21% national increase in pollen concentration between 1990 and 2018. It corresponded to an average pollen season increase of 20 days.
Berger knows as well as anyone the dangers of allergic reactions, including anaphylaxis, and the increase in the percentage of sufferers. The introduction of epinephrine as a nasal spray is encouraging.
“This is a major advancement in the treatment of several allergic reactions,” Berger says. “Still, what’s critical for someone who may have allergies but isn’t sure is to get a proper diagnosis.”
