Pollen throws caution to the wind

Come February and March, the outpatient unit of the medicine department at Maulana Azad Medical College is filled with persons turning up with symptoms of sneezing, redness and irritation of the eyes, itchy throat, breathlessness, dry cough and in some cases tightness of the chest and fever.

Dr Suresh Kumar, head of department of medicine, Maulana Azad Medical College, New Delhi, says that those are the tell-tale signs of pollen grain allergy in Delhi during the flowering and harvesting season. Experts usually refer to pollen allergy as seasonal allergic rhinitis.

“Between February and April, during the wheat harvesting season, we get 10-15 cases related to respiratory illnesses, hypersensitivity, increased asthma attacks, chronic obstructive pulmonary disease, skin allergy and nasal-bronchial allergy,” says Dr Kumar.

Pollen allergy symptoms

The pollen allergy season in the US is between March and May, when it is time for trees to shed pollen. This is the time when many suffer from allergic rhinitis or hay fever. As explained by Asthma and Allergy Foundation of America (AAFA), the allergy continues between April and June when grass pollen fills the air, followed by the weed pollen released into the air during July and November. According to AAFA, people with pollen allergies only have symptoms when the pollen they are allergic to are in the air. It also lists out pollen allergy symptoms:

• Runny nose (also known as rhinorrhoea — a clear, thin nasal discharge is seen)
• Stuffy nose (due to blockage or nasal congestion)
• Sneezing
• Itchy nose, eyes, ears and mouth
• Red and watery eyes
• Swelling around the eyes.

In some cases, swelling of the lips is also seen along with other typical symptoms like sneezing. Dr Vasunethra Kasargod, a pulmonologist from Bangalore says that the majority of those suffering from pollen allergy experience symptoms in the early morning hours (5am to 8am), while some may see the same in the evening, too. This is usually when maximum pollination occurs.

Pollen allergy does not necessarily mean upper respiratory symptoms such as sneezing, but it can also affect the lower respiratory system in the form of asthma, says Dr Kasargod.

Understanding pollen allergy

Allergens trigger an immune response and cause the immune system to overreact. Pollen, released from plants, trees and weeds, is one such allergen. It plays a vital role in plant fertilization and propagates through the winds. On inhalation, it affects those sensitive to the specific allergen.

Why is pollen allergy not a problem for all? Dr Sanjay Bhatia, ENT surgeon, Fortis Hospital, Mulund, Mumbai, says that some people have high immunological reactions to certain allergens, so they are more susceptible while others are not. “It is based on the environment, the agent and the host. A receptive host can react in a specific environment but may not have allergies upon moving away. Someone who has no allergy in Mumbai may suffer from an allergy if they go to a foreign place like Europe. The allergy may not be identified in one place, but in another location, it may get picked up. And the allergies are usually seasonal, during the fall and summer,” says Dr Bhatia.

According to Dr Kasargod, the most common pollen allergies seen in the city are due to a grass weed called Cynodon dactylon and a weed called Parthenium. “Pollen is produced from flowers. The flowers can be from trees, grass or shrubs. It [pollen] is rampant in Bengaluru, especially because of the windy conditions that facilitate its propagation,” says Dr Kasargod.

Pollen from flowers, trees, crops and grass can contribute to allergies. Strong wind in the forest can also lead to pollen propagation. Dr Kasargod points out that flowering plants usually do not disseminate pollen in the air, and they do not propagate the pollen allergy. “Flowering plants propagate pollen through insects, unlike grass and weeds that propagate it when the wind blows. When people allergic to pollen breathe the latter, they develop an allergy,” says Dr Kasargod. He adds that not all flowering plants cause pollen allergy as they depend on insects like bees to propagate the pollen and not the wind. Agreeing with him, Dr Kumar mentions that saying that no flowering plant can cause pollen allergy is partially true, as some flowering plants can also cause the allergy.

Who is susceptible to pollen allergy?

While pollen allergy does not affect everyone, it is prevalent in two percent of the population, says Dr Kumar. “Those with pre-existing childhood allergies are especially vulnerable to pollen allergy. other factors are hypersensitivity, a family history of the condition and inherent problems in the immune system. Dysregulation of the immunity of T-cells (white blood cells that play a key role in the immune system) may also lead to this,” he says. He adds that the high pollution levels in Delhi may also be a contributing factor. “Children, young adults and older patients are more susceptible to pollen allergy,” he cautions.

Geography also matters in allergic reactions, says Dr Kasargod. “Cassia fistula, a plant that grows rampant in Bangalore is not seen much in Mumbai and Delhi. Hence, the geographical locations of certain plants in specific areas also need to be factored in,” he adds. He recounted the case of a 28-year-old man working in Bangalore who had a pollen allergy which led to asthma. He was concerned when he had to relocate to Canada in the latter part of 2021. “As he had asthma, he was worried about moving to a country known for its cold climate. He came to me asking for precautionary measures. However, to his surprise, when he moved to Canada, he showed no signs of such an allergy, which indicated the absence of exposure to the allergens in Canada,” says Dr Kasargod, who had treated the man in Bangalore.

Preparing for the allergy season

Doctors do advise those vulnerable to allergies to prepare ahead of the allergy season. “I suggest that susceptible people start taking nasal sprays and anti-histamines 10–15 days before the allergy season, as directed by the physicians,” says Dr Bhatia.

“While a complete cure is difficult, some can remain allergic throughout their lives, and it may stop only when their exposure to the allergen stops,” says Dr Kasargod.

Experts suggest that those vulnerable to pollen allergy should keep track of the pollen count through forecasts and use interactive pollen allergy maps. “If a person is allergic to a particular allergen, their reaction to it remains the same. Only when they move out of the trigger area will there not be an allergic reaction. The best thing to do is to avoid the trigger by not going out much during the allergy season, keeping clothes worn outside separately after coming home, and using air purifiers and a high-efficiency particulate air (HEPA) filter at home. Wearing a mask also helps,” says Dr Bhatia.

Takeaways

Pollen shed from trees, weeds and grass are one of the common allergens affecting many every year. The seasonal allergen is propagated through the winds. As pollen allergies have symptoms such as sneezing, runny nose and nasal congestion, there are chances that it may get confused with a viral infection, and one must visit a doctor and avoid self-medication. Those allergic to pollen should try and limit exposure and take necessary anti-allergic medication and nasal sprays advised by the doctors. 

Last updated on 16 April 2024