asthma

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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

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

When Your Writing Is Part of Your Healing

We recently ran an essay by Sarah Baker, exploring the links between her childhood asthma, her mother’s early death, the family chaos that followed and how it all played out physically and psychologically into adulthood.

Sarah told me the response to her post, which also raised the question of whether becoming a mother herself helped alleviate her asthma, was overwhelming and gratifying. Now, Dr. Annie Brewster, a Boston internist and frequent CommonHealth contributor who uses storytelling therapeutically, as a path toward healing, followed up with Sarah in a revealing audio interview. (For more on Brewster’s approach to personal storytelling for health, listen to her recent TedX Talk above).

Sarah Baker, around age 3, before her mother was diagnosed with a brain tumor.

Sarah Baker, around age 3, before her mother was diagnosed with a brain tumor.

Here’s a snippet from the interview, which you can listen to in full on Brewster’s website, Health Story Collaborative:

Annie Brewster: I’m really interested in what you said about that you never really consciously thought about this until you started to write about it. I’m really fascinated with the process of storytelling and how that sort of helps move somebody from one place or another. So, can you speak to the process that you went through in writing this and how that helped you and what it meant then to put it out there in a public way and get feedback on it; what that was like for you and what did it take to get to a place where you felt ready to take that on as a writing project?

Sarah Baker: I remember a number of years ago when I started writing, a friend of mine who is a successful writer said, “write what’s raw” so I always try to write what hits a chord in my heart. So writing about my childhood and writing about my mother’s death is what I tend to write about. This was the first time I wrote about my asthma and it was hard to write about it because I don’t have a lot of memory. I had to interview my Dad, I had to do some research, and I had to relive the trauma. I just kept working at [the story] and sometimes felt a little sick after writing but I just kept working. I usually write ten drafts before I show it to any one. I showed it to my husband and he reacted positively. I showed it to a class that I was in and to my teacher and they responded positively. I thought maybe I’ve struck something here. Then the story sat in my computer for a year; it did. And it was after I started taking a class about the book I’m working on that I decided to send it out. Maybe the year allowed it to percolate so it didn’t feel as scary. Continue reading

Live Near Logan? You May Face Higher Risk Of Asthma, Pulmonary Disease

The AP reports the not-so-great results of a new study on the health of residents who live near Logan International Airport. The bottom line is that respiratory problems that look a lot like asthma appear to be more prevalent among children who live in this “high exposure” area compared to those living further from the airport. For adults, the likelihood of developing chronic obstructive pulmonary disease was higher among those living in close proximity to the airport.

Produced by the state Department of Public Health, the report focused on 17 communities within a five-mile radius of Logan: Boston, Brookline, Cambridge, Chelsea, Everett, Hull, Lynn, Malden, Medford, Melrose, Milton, Nahant, Quincy, Revere, Saugus, Somerville and Winthrop.

Logan Airport Health Study

Estimated Exposure Areas Based on Assigning High, Medium, and Low Exposure Areas to Respondents. (Logan Airport Health Study, Department of Public Health)

From the report:

•Among children, study results identified some respiratory effects indicative of
undiagnosed asthma (i.e., probable asthma); children in the high exposure area
were estimated to have three to four times the likelihood of this respiratory
outcome compared with children in the low exposure area.

•Among adult residents, individuals diagnosed with chronic obstructive pulmonary
disease (COPD) were statistically significantly more likely to have lived in the high
exposure area for three or more years.

•There were no statistically significant differences in cardiovascular outcomes in the
study population across the high, medium, and low exposure areas.

•There were no statistically significant differences with respect to hearing loss in
either adults or children for those living in the high exposure area compared to the
lowest exposure area.

Continue reading

Unraveling My Childhood Asthma: Did Motherhood Cure It?

By Sarah Baker
Guest contributor

I recently started singing lessons — a rather mind-blowing pursuit, since for much of my life, singing was out of the question. How can you sing when you can’t even breathe?

At 18 months old, while my dad, mom, older brother and I were driving from Virginia to San Francisco for my father’s new Naval deployment, I started wheezing. The asthma attack landed me in the hospital.

Emergency room visits and hospital stays punctuated my childhood and early adulthood. I could have been a tour guide of any Intensive Care Unit: “Over on the right is a shot of adrenaline, or epinephrine — try that first. If that doesn’t work, try the nebulizer on the left and IV over there.” These visits became so routine that as I got older, I often told the doctors and nurses what medicines I needed: Prednisone. Albuterol. Theophylline. These were the mainstays, but there were many others over the years. I took them in such large doses that one time they made my blood toxic.

Circa 1970: The author, center, with her brother and mother, shortly before the discovery of her mom's fatal brain tumor.  (Courtesy)

Circa 1970: The author, center, with her brother and mother, shortly before the discovery of her mom’s fatal brain tumor. (Courtesy)

Emergency was a word my family understood. My mother was diagnosed with a brain tumor when I was 3 years old; she was 28. For five years, until her death, she battled her disease in and out of the hospital, too. I went to Bethesda Naval and she went across the state to Johns Hopkins in Baltimore. I don’t remember ever seeing her hospital nor do I recall her ever seeing mine.

A Motherless Child’s Stress

Asthma is a disease of the respiratory system. It is serious business. Seneca, the Roman philosopher and Stoic dedicated an essay to it, called “Asthma,” in which he said that of all the ailments he’d suffered, asthma was the worst of them all. “Doctors have nicknamed [asthma] ‘rehearsing death,’ he wrote.

But asthma also has a powerful psychological or psycho-social component; with symptoms potentially exacerbated by emotional stress. As a child, I never realized it, but looking back I see it clearly: for all my suffering, asthma distinguished me. Got me noticed. In a childhood of disorder — marked by my mother’s death, and family chaos and constant moving — my own illness provided order. It wasn’t until the birth of my first child that my symptoms truly ceased. Continue reading

How Obesity May Lead To Asthma — And Perhaps How To Break That Link

asthma inhaler

This just in from Boston Children’s Hospital: The immune system may play a key role in the asthma that can develop along with obesity — and that new understanding may point to possible ways to stop or treat obesity-related asthma.

A finding of broad potential impact in a country where one-third of the population is obese and more than 25 million people have asthma. From the Children’s press release on the study just out in the journal Nature Medicine:

A growing body of literature links asthma with obesity, but the reason for the link has been unknown. Both conditions have become more common over the last several decades. The new study, led by Dale Umetsu, MD, PhD, and Hye Young Kim, PhD, of the Division of Allergy and Immunology at Boston Children’s, explored obesity’s effects on the immune system.

The researchers studied mice that were fed a high-fat diet causing them to become obese. Unlike mice fed normal diets, the obese mice developed airway hyper-reactivity or constricted and twitchy airways, the predominant feature of asthma.
In the study, obesity appeared to alter the innate immune system—the body’s first responder to infection—in several ways to cause lung inflammation.

In addition, when IL-1β [a protein linked to inflammation] production was blocked with the drug anakinra (Kineret, Swedish Orphan Biovitrum), used to treat rheumatoid arthritis, the obese mice did not develop asthma.

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

Millions Of Asthmatics May Fare Well Skipping Daily Steroids, Study Finds

In a study that may overturn long-held guidelines for mild persistent asthma sufferers, researchers have found that people who inhale asthma medicine only when they have symptoms fare just as well as those who take daily inhaled steroids.

NBC News reports:

Just about everyone with asthma knows the drill. Take a daily snort of a prescription inhaler filled with a steroid that helps fight inflammation, to prevent trouble. Not everyone actually does this, but patients with mild, persistent asthma know they are supposed to.

A study published on Tuesday questions this common wisdom, and offers the potential for millions of adults to be freed of having to take daily medication, not to mention the savings to patients, their employers, health insurance companies and the government. Caveat: The findings don’t apply to kids with asthma.

“Daily treatment with an inhaled corticosteroid has long been believed to be the best treatment for mild persistent asthma, but it is not followed by the majority of patients,” said Dr. Homer Boushey of the University of California San Francisco, who worked on the study. Boushey also helped the National Institutes of Health set guidelines for managing asthma.

The news release elaborates on the study, published in the current issue of the Journal of the American Medical Association: Continue reading

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

hookworm

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

Why To Exercise Today: Study Finds Better Life With Asthma

runner with inhaler (Matthew Kenwrick/Flickr)

(Matthew Kenwrick/Flickr)

Here’s an eye-opener for many of the 34 million Americans diagnosed with asthma: You may naturally be concerned that exercise will worsen your wheeze, but a small study just out this week suggests quite the opposite. Rather, done carefully and with plenty of warm-up, working out may ultimately improve your breathing and even your mood.

Medpage Today reports here from the annual meeting of the American Academy of Allergy, Asthma, and Immunology:

ORLANDO — Patients with persistent asthma reported significant improvements in quality of life after four months of structured exercise in a gym, researchers reported here.

Among adult patients participating in the three-times weekly sessions, 78% reported improvements on the asthma quality of life questionnaire compared with 39.5% of controls (P=0.05), according to Thomas A.E. Platts-Mills, MD, PhD, and colleagues from the University of Virginia in Charlottesville.

“It’s very difficult to get patients with asthma to exercise, even though we know that stretching the smooth muscle in the lungs decreases airway resistance,” Platts-Mills said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

“We face three major obstacles to increasing exercise among asthmatics. First, patients think their asthma will worsen if they exercise. Second, gyms are resistant because they’re afraid patients will have an asthma attack. And third is the insurance companies, who are just resistant against paying,” Platts-Mills said. Continue reading