A 50-year-old schoolteacher from Mumbai, Sandhya (name changed) often had bouts of dry cough and breathlessness. In May 2023, she was rushed to the hospital, where she required oxygen. Then, she was diagnosed with bird fancier’s lung. This is a type of hypersensitivity pneumonitis (HP) — an allergy that causes inflammation in the alveoli (small air sacs) of the lungs, seen in people who are exposed to pigeon feathers and droppings for a long period.
Sandhya had the symptoms on and off for years but kept dismissing them as common cold and flu. While discussing her case, Dr Mihir Gangakhedkar, consultant, pulmonology, Fortis Hospital, Mulund, Mumbai shared that the initial CT scans revealed HP. Going by her history, they were able to establish the cause. “Bird fancier’s lung can occur when a person breathes in any specific substance or an allergen that causes the body to have an allergic reaction,” he explained.
Should pigeons worry you?
Bird fancier’s lung is commonly seen in several cities. Dr Gangakhedkar explains, “A protein called avian antigen is present in pigeon feathers and droppings. This can trigger an allergic reaction in those exposed to it for long periods, resulting in this type of HP.” This is also what happened with Sandhya. Dr Gangakhedkar adds that the mere presence of pigeons in the building does not mean all the residents will be affected. “Only when someone is exposed to the antigen for years will they develop this issue. If the exposure can be controlled, you don’t need to worry about pigeons.”
Dr Jagadeesh Kumar, consultant pulmonologist, Apollo Hospital, Bangalore, adds, “The condition is not caused solely by pigeons. Exposure to parrots or other birds can also cause it.”
Are pigeon droppings dangerous?
Pigeon droppings can contain fungal antigens such as cryptococcus, which can lead to cryptococcosis. “These antigens can cause fungal infections in immunocompromised people or those on high doses of steroids for other health issues,” shares Dr Gangakhedkar. “It can even cause pneumonia and meningitis.”
Dr Kumar shares that in people with asthma, chronic obstructive pulmonary disease and bronchitis, exposure to pigeon droppings and feathers can trigger or worsen their condition.
Signs of bird fancier’s lung
In people with bird fancier’s lung, common symptoms include:
- Dry cough
- Breathlessness
- Fever
- Weight loss
- Headache
Experts share that in those with acute HP, symptoms may appear only when they are exposed to the antigen and disappear later. However, in those with a chronic issue, the signs may be persistent and even worsen over time. For example, in Sandhya’s case, none of her family members were affected as she had extended exposure when compared to the rest of them.
How to make diagnosing bird fancier’s lung easier?
“Bird fancier’s lung could initially be misdiagnosed as asthma or a lung allergy. Apt knowledge of the person’s surroundings can help narrow it down to make it easier to detect,” shares Dr Kumar. Dr Gangakhedkar adds, “The treating physician should be informed of all possible exposures to help him make an accurate diagnosis.”
Other than advising people to avoid the allergen, physicians commonly prescribe steroids to control and manage bird fancier’s lung. “In acute conditions, being on steroids helps them with recovery. In chronic cases, on the other hand, they may require oxygen or ventilator support. And in severe cases, they may require a lung transplant,” Dr Kumar informs.
How to limit exposure to bird fancier’s lung allergen
Pigeons are often found nesting in apartments and air conditioner vents. “It is important to clean the AC vents regularly and get them serviced to prevent pigeons from nesting there. Further, if pigeons do start nesting outside the windows, people can consider installing nets to limit exposure,” says Dr Gangakhedkar.
According to Dr Kumar, once pigeons start inhabiting an apartment or an area, limiting exposure to them can be complicated. “We advise people with this condition or other lung issues to move to a locality with less pigeon exposure. Moreover, if they have pigeons or parrots as pets, we suggest rehoming the pets to avoid further deterioration of their disease,” he shares, adding that avoiding the allergens is crucial in managing and preventing bird fancier’s lung.
Takeaways
- Bird fancier’s lung is a type of hypersensitivity pneumonitis caused by antigens present in pigeon droppings and feathers.
- Typical signs of the condition are dry cough, headache, breathlessness, weight loss and fever.
- Avoiding exposure to pigeon droppings and feathers can help in managing the condition.
