Bad Allergies, Yes. Worst Boston Year Ever? Experts Say No, But Perfect Storm Of Trees, Grass, Mold

"At this moment there's a lot of tree pollen in the air and a lot of grass pollen in the air," says Dr. Mariana Castells, an allergist at Brigham and Women's Hospital. (Courtesy Lukasz Szmigiel/Unsplash)

“At this moment there’s a lot of tree pollen in the air and a lot of grass pollen in the air,” says Dr. Mariana Castells, an allergist at Brigham and Women’s Hospital. (Courtesy Lukasz Szmigiel/Unsplash)

I got a call from the school nurse this week: my daughter had an itchy rash on her arms and neck and red blotchy patches around her mouth.

“My best guess is it’s allergies,” the nurse said, suggesting Benadryl and hydrocortisone cream. “This is a particularly bad season. Kids who never had allergies are coming in. Kids who take Zyrtec or Claritin in the morning are still coming in — their eyes so inflamed and irritated.”

Mention allergies these days and you’re sure to get a story: a colleague left Cape Cod early this weekend, because her allergies got so bad. “The pollen was everywhere,” she said. “It was even on my dishes.”

Micheline Maynard, a senior producer at Here & Now, sent me an email detailing her own allergy hell:

Last week, I had a bout of allergies that had me weeping in the newsroom, and sneezing and coughing. (I was apologizing to my colleagues and saying, “I’m not crying!”) Claritin did nothing, and I took half a Sudafed 12-hour, which helped a little.

I went to Michigan over the weekend, which is basically the same latitude as Boston, and enjoyed a problem-free weekend. I slept with my windows open, I did things out in the garden, and felt completely recovered. No coughing, sneezing, no headache.

Within an hour of getting back to Boston on Monday, my head was completely stuffed up. I was sneezing and coughing, and feeling generally blah… I actually Googled “severe allergies” because I’d never experienced anything like it.

Dr. Elisabeth Poorman, a CommonHealth contributor and third-year medical resident at Cambridge Health Alliance, said she’s experiencing bad allergies this year, “and [I] never have since moving from Atlanta, where pollen is a way of life.”

So is this season truly the most awful for allergy sufferers — the worst one ever — or, as one doctor suggests, do a high percentage of reporters and their friends just happen to have allergies, hence the outcry?

Continue reading

Asthma, Lyme Disease, Salmonella: How Climate Change May Worsen Your Health

EPA Administrator Gina McCarthy speaks  in Washington in 2014. (Manuel Balce Ceneta/AP/File)

EPA Administrator Gina McCarthy speaks in Washington in 2014. (Manuel Balce Ceneta/AP/File)

The link between climate change and extreme weather is widely known. But as the planet warms, what about the risks to your own personal health?

I asked U.S. Environmental Protection Agency Administrator Gina McCarthy, a Boston native in town to deliver the commencement address at UMass Boston (her alma mater), to give some specific examples of how climate change can impact human health. Here, edited, is our conversation.

RZ: So, feel free to get scary here, what should people know about climate change and their own health?

GM: As temperatures rise, smog gets worse and allergy seasons get longer, which makes it harder for our kids to breathe. We know that increasing the ozone, the ground level smog, makes it difficult for kids — and also the elderly — to breathe, it impacts their lung function. So, you’re going to see a dramatic rise in the number of kids with asthma who experience bad air days.

So, the allergy season gets longer, and this is related to the warmer temperatures as well as the later fall frosts, which means plants produce pollen later in the year. The length of the ragweed pollen season has increased in 10 of 11 locations studied in the Central U.S. and Canada.

This season is awful: I have a little allergy this year for the first time. I found myself sneezing, my eyes watering. Even the dog went on some kind of antihistamine. I felt sorry for her.

You also mentioned ticks, what will happen in their world?

Warmer temperatures also bring increases in vector-borne diseases — Lyme disease, mosquito and tick-borne diseases, and expanded seasons. What we see is that the Lyme disease areas are expanding and the number of cases is increasing. Among the states where Lyme disease is most common [New Hampshire, Delaware, Maine, Vermont, and Massachusetts], on average, these five states now report 50 to 90 more cases per 100,000 people than they did in 1991.

You can clearly see the geographic region expand. Also, West Nile Virus is expanding. Our climate assessment tracks geography and seasons getting longer, expanding. As temperatures get higher, the entire ecosystem changes. I was in Aspen, the winters are getting shorter.

Screen shot 2015-05-28 at 1.11.33 PM

Are there any other diseases we should brace for?

There are also water and food borne diseases: salmonella, that relates to food potentially sitting out, the higher the temperature the more salmonella outbreaks. The same with water — anything that’s a bacteria — it’s going to increase in warmer weather. Continue reading

What New Peanut Study Means For Kids With Food Allergies — And What It Doesn’t

In this undated photo provided by Cambridge University Hospitals NHS Foundation Trust, Dr. Andrew Clark of Cambridge University, right, performs a skin prick test, which is used to diagnose food allergies, on Lena Barden, 12, during clinical trials at Addenbrooke's Hospital Clinical Research Facility, Cambridge, England. An experimental therapy in Britain that fed children with peanut allergies small amounts of peanut flour has helped more than 80 percent of them eat a handful of the previously worrisome nuts safely. (Cambridge University Hospitals NHS Foundation Trust/AP)

In this photo provided by Cambridge University Hospitals NHS Foundation Trust, Dr. Andrew Clark of Cambridge University, right, performs a skin prick test, which is used to diagnose food allergies, on Lena Barden, 12, during clinical trials at Addenbrooke’s Hospital Clinical Research Facility, Cambridge, England. (Cambridge University Hospitals NHS Foundation Trust/AP)

By Richard Knox

Erin Brazil is frustrated. She’d hardly had time to digest the peanut allergy study that got heavy media coverage this week when, she says, she got “inundated by calls and emails and Facebook posts saying ‘There’s a cure, there’s a cure!’ ”

Brazil is a Boston food-allergy activist whose 4-year-old son Gabriel is severely allergic to peanuts and other foods. So she knows better than anyone that the new study, while a landmark in the field, represents no cure. “It doesn’t do anything for Gabriel,” she says.

What it does mean is that many future children will be able to avoid a life of worry about whether the merest trace of peanut protein — even an invisible smear from a candy bar left by another child on playground equipment — could send them to the emergency room gasping for breath.

I can finally look a mother in the eye and give her some advice that I feel confident in.

– Dr. Hugh Sampson

And the new study means that the recommendations parents have been given over the past 15 years — to withhold peanuts until the age of 3 in children deemed at risk — “were exactly wrong,” says Dr. Wayne Shreffler, director of the Food Allergy Center at Massachusetts General Hospital.

“I strongly suspect they made things worse,” Streffler adds, because at-risk children who were deprived of peanut exposure in food during infancy were more likely to suffer a lifelong allergy from later exposure to, say, house dust. It’s almost impossible to avoid it.

In 2008, the American Academy of Pediatrics withdrew its recommendation to withhold peanuts until age 3, but until now there’s been no solid evidence in favor of deliberately feeding peanuts to at-risk kids. That’s what the new study strongly suggests parents should do — strictly under the supervision of their pediatricians. That flip-flop is widely expected to be enshrined in the next set of official guidelines.

It’s a big change, but not only does it offer nothing to children like Gabriel who already have peanut allergy, it provides no answer to the really big question: Just why have food allergies soared lately, more than quadrupling among the current generation of American children?

Even though the study doesn’t solve that mystery, allergy experts say it’s certain to accelerate research already under way to unravel the causes and devise treatments, if not outright cures.

Six million U.S. children currently have food allergies, one out of every 13 kids, according to the largest recent study. Peanut allergy is the most common, and the most troublesome — not only because it’s so hard to avoid exposure, but because peanut allergy is usually permanent, unlike those involving other foods. And peanut allergies are more likely to be fatal.

That explains why allergists are so enthusiastic about the new study. Continue reading

The Politics Of Gluten

LaShawn Wiltz/flickr

LaShawn Wiltz/flickr

A close kid relative of mine can die if he eats gluten. Actually, this child is so allergic to gluten that you can’t even cook pasta if he’s in the room or he’ll break out in a rash, or worse. He’s been to emergency rooms, both in the U.S. and abroad, due to his allergies, and it usually happens when someone hands him a so-called “gluten-free” cookie or snack that actually wasn’t.

So gluten is a hot topic in our family. Recently, though, skepticism has been rising about the very notion of gluten allergies, or sensitivities. Exhibit A in this arena is Michael Specter’s latest New Yorker story on the current gluten-free craze, which has enraged more than a few parents whose kids have real and scary reactions to gluten. Specter writes:

While there are no scientific data to demonstrate that millions of people have become allergic or intolerant to gluten (or to other wheat proteins), there is convincing and repeated evidence that dietary self-diagnoses are almost always wrong, particularly when the diagnosis extends to most of society. We still feel more comfortable relying on anecdotes and intuition than on statistics or data.

Speaking on Here & Now yesterday, Specter reiterated the article’s takeaway that the national gluten-free obsession is mostly just the latest fad diet.

Maybe. But here’s some reaction from a parent who thinks Specter should have taken a broader view:

“My son has gone into anaphylaxis from accidentally ingesting gluten four different times over the course of his life.  Each time we had to administer an emergency Epipen injection and rush him to the ER.  I don’t think he was reacting to a fad…

It is fine to debate the merits of going gluten free as a diet or lifestyle choice for some. But for others it is a clear medical issue, with the most serious consequences. The number of Americans suffering from celiac or severe gluten allergy seems to be growing fast, and that merits substantial funding and research to figure out why and find cures. It would be a mistake if that fact were to be lost amid the current efforts at “de-bunking” the risks of eating gluten for some.”

Not Kitten Around: Cat Vaccine May Someday Treat Allergies In Humans

Belal Khan/Flickr

Belal Khan/Flickr

By Nicole Tay
CommonHealth Intern

I love cats.

Unfortunately, feline biology doesn’t quite agree with my own. So, while I would love nothing more than to snuggle up to an adorable furball of histamines, my itchy eyes and swelling throat protest. Like me, an estimated 10 percent of the population is allergic to cats — more specifically, allergic to the fel d 1 protein found in a cat’s saliva and sweat. This protein accounts for about 95 percent of all allergic symptoms in cat-sensitive humans.

The normal function of fel d 1 remains unknown, however, in humans. It can trigger an allergic (itchiness, sneezing, hives, etc.) or even asthmatic immune response. Through the cat’s regular self-grooming, the protein spreads all over the animal’s fur, which in turn ends up, well, everywhere.

But researchers at the Swiss company HypoPet, in partnership with U.K.-based Benchmark, may someday offer relief for us allergy-prone cat lovers. In a recent news release, Benchmark announced the development of a new cat vaccine which targets and neutralizes the fel d 1 protein. Continue reading

Suck On This: Pacifier-Licking Parents Have Less Allergic Kids, Study Finds

Admit it, you’ve done this: your kid drops her pacifier on the floor and, too exhausted to schlep to the kitchen sink to rinse it, you just give it a good lick and hand the binky back.

Well, it turns out this not-so-pretty cleaning method you turn to when no one else is looking may, in fact, be one helluva gift for your child’s immune system.

Joe Suspence/flickr

(Joe Suspense/Flickr)

Researchers in Sweden report that “children whose parents sucked on their pacifiers to clean them had one-third the risk of developing eczema (the most common early manifestation of allergy), at 18 months of age, compared to children whose parents did not use this cleaning practice.”

It gets better. Infants who were born vaginally and were lucky enough to have a parent suck clean his or her pacifier got an added boost, the study found: “The prevalence of eczema was approximately 2.5 times lower at 18 months of age in vaginally delivered children whose parents sucked their pacifiers than in caesarean section-delivered children whose parents did not have this habit (20% vs. 54%),” the study says.

The takeaway from the study, published online today in the journal Pediatrics, is this: It looks like early exposure to parents’ saliva may help stimulate a baby’s immune system, Continue reading

Worms And Germs: Their Absence May Explain Ills From Allergies To Asthma


Hookworm attached to the intestinal mucosa. (CDC’s Public Health Image Library via Wikimedia Commons)

First he hooked me with the hookworms. Who knew there was a whole underground network of people who, in hopes of curing allergies or Crohns disease, go to great lengths — such as stomping about in outhouse offal — to get themselves infected with nasty parasites?

Then he arrested me with the alopecia. I’d glanced at the author photo on the jacket, and something looked a bit off: He wasn’t just completely bald, he also lacked eyebrows and eyelashes. On page 2, he explained that he had alopecia universalis, an auto-immune disease that left virtually no hair on his entire body.

Moises Velasquez-Manoff, author of “An Epidemic of Absence”

But what kept me reading all through vacation — and really, I’d rather not spend my leisure time with whipworms and “orofecal” bacteria — is that in his new book, An Epidemic Of Absence, author Moises Velasquez-Manoff turned my head around. Ah, the pleasing sound of mental gears grinding as the paradigm shifts!

To me, as a mother and as a health reporter who has written too many sad stories of infection, germs and parasites have ever been the enemy. But now they suddenly looked more like old friends, who could help us more than hurt us — as Velasquez-Manoff sought to test when he went to Tijuana to get infected with his own colony of hookworms.

The book is subtitled “A new way of understanding allergies and autoimmune diseases,” but my summary subtitle would be “A new ‘Theory of Everything‘ about the diseases that now plague modern humans, particularly children: Allergies, asthma, autism, obesity, and more.”

You may have heard of the Hygiene Hypothesis, the theory that allergies are rising so dramatically because modern society is too clean, and our under-challenged immune systems tend to over-react. Velasquez-Manoff takes it many steps further. He argues that without the parasites and bacteria that we co-evolved with for millennia, our immune systems become poorly regulated — in particular, unable to tamp down inappropriate inflammation. And chronic inflammation is linked not just to allergies and asthma but to obesity, cancer, depression — possibly even autism, as he wrote in the New York Times last week. (There’s also an excerpt and a Q&A in Wired this month.)

“An Epidemic Of Absence” is a first-class job of science-writing. It takes studies and turns them into riveting stories, moving from the how to the why or the correlation to the causation. But to fully appreciate them, you need to read the book. For now, let’s be ruthless pragmatists: If you accept this theory — and I guarantee that you will by page 300 — what do you do about it?

‘We don’t need to be fastidious. Routine hygiene is okay; excessive hygiene may be detrimental.’

The author asks that very question on page 303, but then gets a bit futuristic, imagining farm gardens inside high-rises and doctors who genotype pregnant women and adjust their microbe population accordingly. He mentions that he’s the father of a young daughter, and that he would never purposely infect her with hookworms as he did himself — but if he knew that it was a sure preventive treatment, and that she was destined for Crohn’s disease and horrible allergies, he might think differently. I wanted to press him about how — if at all — his work translates into health decisions now, in his own family’s life. But first, a word from a scientist.

One of the heroes in “An Epidemic of Absence” is Dr. Joel Weinstock, chief of gastroenterology/hepatology at Tufts Medical Center and a leading researcher on using worms to treat inflammatory diseases.

Dr. Joel Weinstock (Courtesy of Tufts Medical Center)

(He’s currently enrolling patients for a major trial using pig whipworms — which die off automatically after two months — in Crohns disease. Earlier studies have found the worms to be safe, he said, and initial results look promising. Later this fall, he said, whipworm studies will begin on ulcerative colitis, and within a few months, on psoriasis and Type 1 diabetes. Contact: 617-636-4593.)

I asked for his practical advice, and took away two main lessons: We must be patient and wait for more solid science. And for the meanwhile, his opinion, which he emphasized is not backed up by data, is “We don’t need to be fastidious.” (Music to my ears! That’s an adjective never once applied to me in my entire life.)

How does that translate?

“It’s okay to have pets in the house. Kids don’t have to wash their hands every time they touch something. If food falls on the floor you don’t have to worry if someone picks it up and puts it in their mouth. Playing in the mud around the house is safe. Everyday, routine exposures to things around us may be helpful. And there’s already data suggesting that if you have multiple animals in the house, you’re less likely to get immune-mediated disease. Continue reading

Flavors Of Spring Misery: How Allergies Differ From Colds

Cold or allergy? The symptoms can be similar, but colds include fever and last only for days. Allergies don't include fever and last for weeks.

Your nose feels like an ever-streaming faucet. Your sinuses are overflowing cranial pools. Your brain is stuffed with mental batting. Ah, spring!

But which is it? Allergies or a cold? Children’s Hospital Boston sent over the lovely Venn Diagram above, and also connected me with Dr. Andrew MacGinnitie, associate clinical director of its Division of Immunology.

“If it’s starting now,” he said, “It could be a cold but it’s probably allergies, because I’m hearing from people who have spring allergies that the trees are starting to bud and the tree pollens are starting to get out there.” The allergies normally don’t kick in until April, he noted, but the mild weather appears to be having an effect. And if you feel this way every spring, that’s still further indication that it’s allergies.

Other points of distinction: A cold will typically last a few days and be gone; seasonal allergies tend to last weeks. And colds often cause fever while allergies don’t (Hay fever is a misnomer, he notes, though it does convey how systemically ill people feel.) Tree pollen allergies tend to peak in May; it remains to be seen how this year’s weather will affect that.

At what point, I asked, do you say, ‘I don’t think what I have is just a cold?’ Continue reading

Real Health Risks In That Iconic Pepper Spray Image

Yes, my bet is that when the time comes to pick the defining image of 2011, the U.C. Davis pepper spray cop photo by student photographer Brian Nguyen will be it. (I can’t post it here because the rights are reserved, but the YouTube version is above, showing a uniformed officer streaming the orange pepper spray into the faces of seated protesters on no visible provocation. The Atlantic has the photos here.)

Megan Garber of the Nieman Journalism Lab does a superb job here of summing up the power of that image and its possible effects on the Occupy movement. (The post also includes some of the black humor that has sprouted around the image on the Internet, including one caption that reads, “Didn’t you hear? Pepper spray is a vegetable now.”)

In case you hear “pepper” and think of benign sprinkles on mashed potatoes, Deborah Blum, a Pulitzer-winning science journalist, sets you straight here on the Speakeasy Science blog. Deborah delved into toxicology for her latest book, “The Poisoner’s Handbook,” and shares a central lesson: “The dose makes the poison.”

We might hear “pepper spray” and think of the mild discomfort of a jalapeno, but she points out that on the widely used “Scoville Scale” of a pepper’s burn, where eating-peppers might rate in the hundreds, the police pepper spray would rate in the millions.

“It may be time to demand a more serious look at the risks involved,” she writes, citing recent papers on potential health effects. They include permanent damage to the cornea from repeated doses, and exacerbation of allergies, among others. She writes: Continue reading