Summer means fun – school vacation and long lazy days filled with outdoor family outings, cookouts and adventure. Here in South Florida it likely includes days of sunny sandy beaches, sunscreens, pollens and insects. If you have allergies, take these simple precautions and make them part of your summer routine. Remember, an ounce of prevention is worth a pound of cure.
Flying and Crawling Critters:
For most people insect stings are just a nuisance as most people are not allergic. Red and black Imported Fire Ants are common in Florida particularly during the summer months and are members of the same family as bees and wasps. Allergic reactions to these insects can be severe with immediate onset of dizziness, weakness, unconsciousness, throat tightness, difficulty breathing, wheezing or hives. People with severe allergy should carry an epinephrine auto injector (EpiPen) to be used immediately, also, the emergency medical team should be called to the scene to continue medical surveillance as soon as possible because a severe reaction may be fatal.
Insect stings can also cause local reactions that may involve a large, painful, swollen area around the sting site. Local reactions are not a major concern as they do not pose a significant risk of life-threatening reactions. Also, remember that a normal or non-allergic reaction to Fire Ants includes redness and a postule at the sting site. Fire Ants build mounds in the fields and insect repellent does not work against them, therefore, be vigilant, avoid mounds, do not wear sandals or walk barefoot in the grass.
If you have experienced a severe reaction to an insect sting, talk to your doctor for a consultation with an allergist. Your allergist will likely perform skin tests or blood tests to confirm the allergy to the specific insect and recommend a preventative program of desensitization using venom immunotherapy or allergy injection which is close to 100% effective in preventing a subsequent reaction to stings of that insect. Your allergist will prescribe an EpiPen and advise you to carry it with you at all times.
Itchy Skin Rash:
Sunscreens are a common cause of both contact dermatitis and photo contact dermatitis. Sunscreens are products applied to the skin that absorb or reflect ultraviolet (UV) radiation. One can develop an allergic reaction to the active ingredient or to the fragrances and preservatives present in the sunscreen. If you experience an allergic reaction to a sunscreen, remove the sunscreen, wash the skin with soap and water and apply a cortisone cream. Follow up with your doctor for possible referral to an allergist or dermatologist to determine a safe UV protection alternative sunscreen. It is important to identify the chemical responsible for the allergic reaction so you can avoid using a skin product containing such a chemical in the future. Contact allergy tends to persist indefinitely and avoidance is the only preventive treatment available at this time.
Large amounts of pollen are released into the air by some plants for the purpose of fertilization. These pollen when inhaled by an allergic person trigger an inflammatory reaction in the mucosa of their nose, bronchial tree and conjunctiva which in turn causes sneezing, runny nose, itchy eyes, cough, wheezing and even asthma.
People with seasonal allergies experience symptoms during a specific season. Here in Florida people allergic to grass pollen experience more severe symptoms during the summer months when our grasses are pollinating. Those allergic to tree pollen are affected during the spring and those allergic to weed pollen are affected during the fall.
Most pollens are released into the air during early morning hours, so avoid being outdoors during the early mornings. Wear sunglasses to protect your eyes, avoid gardening and yard work especially during the morning hours, and change clothing, wash your hands and hair when you come home. Monitor the daily pollen and mold counts at allergyweb.com
Immunotherapy or allergy injection is a safe and effective preventive treatment that can significantly reduce allergy symptoms. Your allergist will perform skin or blood testing to accurately identify your specific sensitivities to aero-allergens such as pollen, house dust mites, and mold spores. Once your specific allergies are identified, your allergist may recommend immunotherapy or allergy shot which is a treatment program to desensitize you to your specific allergies. Immunotherapy should enable you to inhale the allergens in their natural environment with greatly reduced inflammation of the respiratory tract and therefore significant reduction of symptoms.
One man’s food is another man’s poison:
Food Allergy is relatively rare, it affects approximately 1% of the adult population and up to 6 to 8 % of children under 3 years. For reasons not well understood, the incidence of food allergy is increasing and peanut allergy is particularly increasing in some countries such as the United States. Any food can cause an allergic reaction but the foods implicated in the great majority of reactions are cow’s milk, egg peanut, tree nuts, wheat, fish and shellfish.
The allergic reaction is an immunologic reaction to a protein in the food. The reaction occurs shortly, usually within 4 hours but sometimes immediately after the ingestion of the food and can cause itchy hives in the skin, swelling, a lump in the throat, difficulty breathing, wheezing, tight chest, dizziness, loss of consciousness and even death. People with food allergies, like people with insect allergies, should always carry an epinephrine auto-injector or EpiPen to be used immediately after a reaction to accidental food ingestion. Also, Fire Rescue should be called to the scene to continue medical management as the duration of the effects of EpiPen is only about 15 min.
If you have a food allergy ask your doctor to refer you to an allergist. Your allergist will confirm the allergy to the suspected food by performing skin tests or blood tests. You should strictly avoid the culprit food, read all food labels and be vigilant of hidden sources of the food in restaurants and friend’s homes. Always carry the EpiPen and familiarize yourself with its proper use. Tell your friends that you are allergic and to which specific food. Make sure to inform teachers, camp supervisors, babysitters and anyone responsible for the care of your child that your child is allergic to a specific food or family of foods. Some people are allergic to peanut and all tree nuts or to all fish or all shellfish. Also, teachers and caregivers should have an EpiPen and be taught when and how to use it.
Prepare and make a checklist to not forget the necessary medications, sprays, and inhalers. If allergic to insects or foods, be vigilant of flying insects, Fire Ant mounds and inform everyone that you have a food allergy. And always, always bring your EpiPen. Have a wonderful and safe summer!
by Dr. Ubals (Retired)