Many of us who suffer with springtime allergies look forward to the summer months as tree pollen season comes to an end in May, hoping the worst is over. But just as tree pollen levels taper, summer grasses bloom and spread their own microscopic pollen grains on the wind, causing those who are allergic to sneeze, sniffle or break out in hives. Then as grass pollen levels decline in August, weed pollens like ragweed and sage rise, often causing allergy attacks that leave us sneezing, with swollen itchy eyes, runny stuffy nose, and cough. Severe allergy symptoms can slow us down just as families prepare for the back to school rush and sports teams start practice.
Summertime in Texas also brings high humidity leading to rising levels of both indoor and outdoor allergens including mold spores and dust mites (microscopic creatures that can live in carpet and bedding and can be dominant indoor allergens year-round). Consultation and testing with a board-certified allergist is the first step to managing allergies – many treatments including natural non-medication options exist, and definitive desensitization with allergy shots and sublingual (under the tongue) allergen immunotherapy can help make summertime more enjoyable for those with environmental allergies.
Texas heat and sunny days can also create conditions that contribute to higher ozone levels. Pollution from vehicles and industry undergoes chemical changes in the sunlight releasing ozone which can trigger asthma attacks in those who are sensitive.
Although pollens are the biggest contributor to summer allergy symptoms, there is also a more dangerous allergy issue that some people face in the warmer months.
Pop up snow cone stands are a common feature of Texas summer, but we also face a less pleasant seasonal surge: FIRE ANTS! To some these are just an annoyance but to those with true fire ant allergy, a bite can be life threatening.
Severe allergic reactions to stinging insect attack cause >40 deaths per year in the US.
Up to 1% of children and 4% of adults experience serious life-threatening insect sting reactions at some point in their lives, including reactions to bee stings, wasp stings and ant bites. All these insects are more numerous and more active in the summer months.
Most of us have had the typical skin reactions to insect stings (including pain and swelling at the site of the bite or sting). Usually an ice pack, a little anti-itch cream, or even a dose of over the counter antihistamine is all we need to relieve the discomfort of stings.
Sometimes the swelling at the site of the sting can extend to a large part of a limb or body area- allergists call that a large local reaction. Of those who experience these large local reactions, a few (4-10%) may be at increased risk of having a more severe reaction in the future.
Two kinds of reactions can occur after stings: toxic reactions and allergic reactions.
Toxic symptoms can occur as a result of the effects of the venom itself which can include pain, burning, swelling and even headache or fever. The risk of a dramatic toxic reaction is higher if a person is stung multiple times in the same day, but it also depends on individual sensitivity to the poison in the sting or bite. Allergic reactions happen because the immune system is already on high alert and reacts to even a small amount of the insect venom in a bite.
To minimize the effect of ant or bee stings, and reduce the dose of injected venom, it is important to remove the bee stinger from the body (which can be left embedded in the skin) with a soft scraping or brushing motion (use a card or a long fingernail). Once the stinger is removed, clean the sting area with warm soapy water and apply itch cream and ice pack. Ants can also stay attached (hanging on by their jaws) and can sting again if not brushed off! So if you see the culprit, remove it immediately by brushing it away (preferably without touching it with your hand as it can hang on and bite you again!)
While it’s good to be knowledgeable and prepared to handle stings in the moment, we should also know when to get tested to see if a true allergy exists. If you have any kind of dramatic sting reaction, you should see an allergist and discuss it - sometimes it can be difficult to distinguish between a toxic or allergic reaction. If you or a family member has had any signs of anaphylaxis ( a severe allergic reaction )-- these can include dizziness, trouble breathing, nausea/vomiting, all over body hives, throat/face/ tongue swelling, or passing out – then call 911 and use an epinephrine auto injector if there is one available. If even a milder version of any one of these symptoms is present, a prompt evaluation is definitely required. Severe allergic reactions should be seen immediately in the ER or Urgent Care, and an allergist office visit should be scheduled to follow-up and test in the next few weeks. If you're not sure if your past reaction warrants evaluation, we encourage you to call or come in for a consultation.
Those with allergies to insects can have cross sensitization reactions. That means someone who is allergic to bees can also become allergic to wasps. So it may be recommended to get tested to all of these if you have had a reaction to one type of insect.
If you are found to have an insect allergy, we prescribe an epinephrine autoinjector in case of a severe allergic reaction, and for kids, we have a school reaction preparedness plan. We can offer venom immunotherapy (allergy shots) to desensitize you so that a bite or sting does not cause a life-threatening reaction. Venom Immunotherapy (VIT) has been shown to increase both safety and quality of life in people who are insect allergic. Those who undergo VIT report less anxiety and less lifestyle limitation than those with allergies trying to practice avoidance and anaphylaxis preparedness. VIT is especially recommended in Fire Ant allergy since these creatures are so difficult to avoid in our region. We can help you discover if you have an allergy to venomous insects.
Summer vacation, when kids are not in school is the perfect time to bring them to the allergy clinic for evaluation, testing and treatment. We treat all ages for many Allergy, Asthma & Immunology conditions, including Food and Environmental allergies, asthma, eczema, hives, autoimmune conditions, immunodeficiency, and gut microbiome disturbances. We at Holistic Allergy & Immunology can help your family have safe healthy summer and prepare you for back to school and the fall allergy season. Our unique approach offers tailored, integrative, precision healthcare for the whole family.
By Dr. Atoosa Kourosh of Holistic Allergy & Immunology