Thank you to the Main Line Parent community for your thoughtful questions about fall allergies and ragweed season. Dr. Manav Segal, board-certified allergist and immunologist at Chestnut Hill Allergy & Asthma Associates, provides answers to your most frequently asked questions.

 

For many allergy sufferers, summer fun is a distant memory because ragweed season arrived in mid-August, and it’s going to last longer and be more challenging due to a warm winter and hot summer. For parents, it’s even more difficult to help kids navigate the awkwardness of wearing a face mask with a runny nose and the need to sneeze; plus, how do you navigate ragweed season when it coincides with back-to-school and cold & flu season with symptoms that are similar to those of cold, flu and even COVID-19?

How and when does ragweed pollen trigger allergies?

• In the Philadelphia region, ragweed season ramps up in August, reaching its peak in September—and can linger through early October.
• Ragweed pollen is light as a feather, so it floats just about everywhere, making it nearly impossible to avoid.
• A warm winter and summer enable the season to start earlier and last longer.

 

What are the symptoms of seasonal allergies and how can I tell the difference between allergies, COVID-19, a cold or the flu?

• Typical allergy symptoms include sneezing, runny nose, and congestion.
• If your symptoms are generated by allergies:
  • You should not have a fever.
  • Your symptoms should respond to allergy medications.
  • You may discover that you feel worse outside and better inside, and you may recognize your allergy symptoms as being typical from previous years.
• Symptoms that may be present with COVID-19 that are not typical of seasonal allergies include persistent dry cough, fever, achy muscles, severe fatigue, nausea, vomiting, and diarrhea. COVID-19 symptoms do not improve with antihistamines, but allergies do.
• If you believe you are ill, in addition to staying home, drinking fluids, and utilizing fever reducers, we advise seeking medical attention, especially if you experience breathing difficulty.

How do you determine if you have an allergy to ragweed?

• Testing at an allergist’s office can help you discover what you are allergic to in order to avoid specific triggers. During allergy skin tests, your skin is exposed to suspected allergy-causing substances (allergens) and is then observed for signs of an allergic reaction. Results are positive or negative within 15 minutes.
• Testing can help determine treatments that are likely to work.
• Allergy symptoms can begin presenting themselves at two years of age. For infants and toddlers under two years old, it is less common for allergies to be causing nasal congestion. Other causes should be considered first. Discuss your concerns with your pediatrician.
• The prevalence of allergy symptoms increases into adulthood, and the condition persists into adulthood.

 

What’s the best line of treatment for seasonal allergies?

• Get ahead of the season by putting a plan in place now.
• For children, especially those two years and younger, parents should consult their pediatrician.
• AVOID: Whenever possible avoid the conditions that cause irritation:
  • Stay indoors when pollen peaks in the early morning.
  • Stay indoors on hot or windy days when pollen levels tend to be higher.
  • Wear eye protection when biking.
  • Keep windows closed when driving.
  • Remove and wash clothes you’ve worn outside.
  • Shower to rinse ragweed pollen from your skin and hair.
• TREAT: A number of prescription and over-the-counter medications may also help. Medications should only be used as directed by prescribing information or as directed by your doctor.
  • Non-drowsy antihistamines are the first line of defense.
  • Corticosteroid nasal sprays can also be used.
  • Decongestants are helpful for nasal congestion, but side effects are common.
  • Saline eye drops and cool compresses may help for ocular symptoms.
• SEE AN ALLERGIST: Consult an allergist when avoidance and over-the-counter medications are not helping. More serious allergy indications include asthma symptoms such as coughing, wheezing, and shortness of breath.
• IMMUNOTHERAPY: For some, immunotherapy can be a good option. Immunotherapy is long-term treatment that works like a vaccine to build tolerance to allergens like ragweed pollen and decreases allergic symptoms over time.

 

What if my child doesn’t want medication but shows allergy symptoms, should I let it go or insist on starting up their allergy medication?

You can monitor “symptom severity” as a way to guide allergy treatment. Less medicine is better.

 

That said, seasonal allergies may be affecting your child in ways you did not realize. Chronic nasal congestion can diminish sleep quality. This in turn will affect a child’s concentration and attention in school, as well as performance in sports or other activities.

 

Blocked nasal passages and mucus build-up due to poorly controlled allergy symptoms provide a good environment for viruses and bacteria. This may predispose children to develop viral infections, sinus or ear infections that might otherwise be prevented.

 

I am an adult with food and seasonal allergies. How likely is it that I will pass them on to my children and what can I do to prevent it?

 Parents should not blame themselves for their children’s food or seasonal allergies. While genetics does play a part in a child’s predisposition to allergies, it’s just one of the determining factors. In general, we are seeing an increase in the number of children developing food and seasonal allergies.

 

Other contributors include a decrease in exposure to infections and microbes in early life, delayed introduction of allergenic foods, and altered gut bacteria.

 

A proactive approach is to consult with your child’s pediatrician or see an allergist to discuss how to safely introduce allergenic foods. Early introduction of allergenic foods appears to play a protective role against the development of food allergies.

 

If my child or I have to sneeze around people, should we keep our masks on?

This is a valid question that many people are puzzled about. If you are near people, continue wearing your mask, plus follow typical guidance to cough or sneeze into your elbow or into a tissue. Dispose of the tissue and wash your hands as soon as possible. Additional guidance includes:

• Wash or sanitize your hands before putting on or taking off your mask.
• Avoid touching your face.
• When you remove your mask, take it off only by the ear straps.
• Wash your mask when you get home so it’s clean and ready for another use.
• Have a spare mask with you.

 

More questions? We are always happy to hear from you!

 

Dr. Manav Segal is a leading Philadelphia-area allergist and immunologist at Chestnut Hill Allergy & Asthma Assoc., who treats asthma and allergies in children and adults and provides breakthrough Oral Immunotherapy (OIT) to treat severe food allergies. Dr. Segal is Board certified by the American Academy of Allergy, Asthma and Immunology and the American Board of Internal Medicine, and is Chief of Allergy & Immunology at Chestnut Hill Hospital. http://www.philadelphia-allergy.com/

 

 

 

 

 

Chestnut Hill Allergy & Asthma Associates supports the Main Line Parent Community.