Are you at risk for a stinging insect allergy reaction?

Every summer millions of Americans experience the great outdoors and may not even realize that as many as 3-5 percent Americans have an allergy to stinging insects, which are reported to be on the rise.  For the majority of us, a sting may cause localized pain, swelling and discomfort lasting for hours or a few days, however, there are a small number of individuals each year who experience a fatal reaction or a potentially life threatening allergic reaction, requiring treatment in an emergency room after an insect sting.  Recently, a professional skateboarding champion after an allergic reaction to a wasp sting turned fatal. 

Stinging Insect Allergy

If you have been sensitized and are “allergic” to the venom from five types of stinging insects, you are certainly at risk for a potentially life-threatening allergic reaction known as “anaphylaxis!”  These stinging insects are: yellow jackets, honeybees, paper wasps, hornets and fire ants. 

Helpful Tips to Avoid Insect Stings

1. Stay away from stinging insects nests, when possible;
2. Remain calm and quiet and move slowly away from the stinging insect;
3. Avoid brightly colored clothing, scented personal products, colognes, etc. when outdoors;
4. Consider “closed toe” shoes;
5. Avoid loose-fitting clothing that may accidentally trap insects;
6. Use caution when eating outdoors, especially avoiding sweetened drinks;
7. Have a prescription epinephrine autoinjector (Twinject or Epi-Pen) available for immediate use, if needed;
8.  Go to the American Academy of Allergy, Asthma and Immunology link for additional information on insect allergy, prevention and treatments at:
            http://www.aaaai.org/patients/publicedmat/tips/stinginginsect.stm.

Allergy testing and treatment for stinging insect allergy

Any person who has a history of a serious reaction to an insect sting needs to be properly evaluated by an expert, your local allergist/immunologist, can do in-office allergy tests to better understand if you are at risk of a serious allergic reaction. He/she will then develop an avoidance and management plan for a stinging insect allergy.  Allergy shot therapy is a highly effective treatment and may help to reduce future reactions to insect stings in 97 percent of those patients receiving shots. 

For additional information about insect allergy, strategies and preventing a reaction and finding an allergist/immunologist in your area, go to: www.allergyandasthmarelief.org

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Parents of every background, religion, and nationality have one common wish for their children: to remain healthy throughout their lives. Unfortunately, many parents are forced to face their worst fears when a child is diagnosed with a medical condition that requires ongoing treatment or specific care. This could include seizure disorders, diabetes, or life-threatening allergies. It could also include a developmental disability such as autism, in which case your child may not be able to communicate his pain or discomfort. Regardless of the condition, there are certain steps parents of children with specific medical needs should take to ensure proper care and immediate action.

Fill out school and activity medical forms in detail.
You may think these forms get stored away, never to be referenced again. School nurses, educators, and instructors will read these forms to make themselves aware of your child’s specific conditions and learn about their responsibilities regarding your child’s care. Ask to sit down with this person so you can go over the form together in case they have any questions beyond what is printed. These forms are also crucial for substitute nurses or teachers, in case your child requires care while under their supervision.

Provide your child with proper identification.
Some conditions could render your child without the ability to communicate to emergency medical responders. Consider various types of identification, such as necklaces, bracelets, or shoe tags that list the condition, doctors’ or parents’ phone numbers, or medication. Consider which one best fits your child’s needs. If your child will be spending a lot of time swimming at camp, the shoe tag may not be best as she won’t have her shoes with her most of the time. Younger children may fare better with a bracelet over a necklace as the necklace may be uncomfortable. Ask your child’s pediatrician about pertinent information to be printed on the identification tag.

Train everyone who works with your child.
This means bus drivers, camp counselors, coaches, scout leaders, babysitters, and religious education teachers. Explain to your child that you are doing this in order to keep her safe, not to parade her special needs. Knowing that everyone is prepared to help her should make her feel safe but keep in mind it could make her feel like she is in an unwanted spotlight. Consider speaking with her close friends about her needs so they can be aware of warning signs she is in danger. Be sensitive to your child’s feelings about her condition but assure her you are acting in her best interest. Have these conversations discreetly and remind caregivers of their commitment to confidentiality. Caregivers will have access to only the information that will keep your child safe.

Have a family emergency plan.
Some children have medical conditions that require a call for emergency medical attention. Create a plan for this occurrence and practice with your family frequently. Make sure everyone has a job in case your child requires immediate medical attention. Jobs could include opening the front door for emergency responders, calling a neighbor or other adult family member, or gathering all the siblings in another room. Seeing a family member in need of emergency care can be frightening but having a plan will reduce everyone’s anxiety.

Ask your child’s pediatrician or specialist for important tips to share with those working with your child. He may have brochures to share or other printed materials to provide your child’s caregivers and educators.

Communicate with your child about his condition but don’t make it the only topic of conversation. It is important for your child to be educated about his needs but it should never define him. The most important thing for you to remember is he is a child first. Never address him as “diabetic” or “autistic.” He is a child with diabetes or a child with autism. Addressing him this way is a sign of respect for him as an individual.

Having a child with ongoing medical needs can be frightening and stressful for a parent. Being prepared and informed will make you empowered and able to care for your child. Educating people who interact with your child will make you secure about her care in your absence and, for any parent, that feeling is priceless.

Jennifer Cerbasi teaches at a public school for children on the autism spectrum in New Jersey. As a coordinator of Applied Behavioral Analysis programs in the home, she works with parents to create and implement behavioral plans for their children in an environment that fosters both academic and social growth. In addition to her work both in the classroom and at home, she is also a member of the National Association of Special Education Teachers and the Association for Supervision and Curriculum Development.

Let’s face it: The best defense is a good offense.  In the case of allergies, that means you’ll need to develop a plan for allergic conditions such as stinging insect allergy, bug bite and mosquito reactions, food allergies, poison ivy and other rashes — especially if you have a history of an allergic reaction. 

Pesky mosquitoes can cause small or large bite reactions. Are you allergic to mosquitoes? Don’t scratch to avoid localized infection.  Topical steroid creams and cool compresses may offer supportive relief.  Don’t smell so nice and avoid scented products and colognes.  Also, prime biting times are generally dusk and dawn. Use insect repellents and wear long sleeves and pants — especially if in the woods or in a heavy mosquito area. 

If you have a history of reacting to stinging insects such as a honey bee, wasp, hornet or yellow jacket, you certainly need an evaluation with an experienced insect allergy specialist.  Frequent testing can reveal whether or not you will need to receive allergy injections to reduce your risk of a future life-threatening reaction, if stung.

Are you allergic to sunscreen and other products you may be using outdoors and at the beach? Skin allergies to the suspect ingredient can be easily diagnosed through office-based skin patch tests to identify the skin allergen that is likely to be causing the reaction or rash.  Sometimes it even is a fragrance or preservative present in the product used. 

Poison ivy reactions are on the rise due to climate change.  Know what these problematic plants look like, especially if you react to them.  You may try various over-the-counter barrier- or lanolin-type creams that are now designed to prevent the oil in the poison ivy/sumac family of plants that cause the horrible itching, rashes and blisters associated with this condition.  Some individuals with severe reactions will need prescription medication for proper treatment. 

Stay tuned for other mid summer strategies to keep you well. 

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Each year millions of us have the not so enjoyable experience of getting bitten by a mosquito, especially during the summer months almost everywhere! Are there more mosquitos or more of us getting bitten? Yup, according to a recent study which found a three fold increase in bites over the past decade or so?  This could be just another effect of global warming. 

What is the reason why some of us experience a larger reaction (increased area of swelling and redness at the bite site) vs. those who seem to have pretty low key reactions? The answer may be in whether or not you are sensitive to the proteins present in the insect’s saliva; hence you are allergic to mosquito bites!

There are a variety of reactions mosquito bites may cause, varying from a small amount of redness, swelling and itchiness, all the way up to those who experience extensive redness and swelling.  Rarely, a full blown generalized allergic reaction (Skeeter’s syndrome) can be seen as well.  In fact one of my patients recently required emergency department treatment, including intravenous medication for a severe reaction to her bites. 

Get tested for mosquito allergy!

Recently, I have begun performing an in-office, quick, simple skin test to determine if you are truly “allergic” or sensitive to mosquitoes.   Always consult with your health care provider if you experience large generalized reactions after getting bitten by a mosquito, or another insect.  Evaluation is mandatory for those who have experienced a generalized allergic type reaction to any biting, or stinging insect.   Be prepared if you seem to get lots of bad mosquito bites.  Have a mosquito bite treatment plan in place.

An ounce of prevention is worth a lot.

That means defensive measures really work and may give you a leg up in avoiding “the bite!” First, those who smell nice (use scented products) and sweat a lot may be more attractive to mosquitoes.  Second, prime biting times are usually dawn and dusk.  Third, wearing long sleeves and pants (tucked in to shoes) reduces exposed areas, particularly if you will be hiking or walking in a wooded area. 

How to repel

There is a variety of DEET-containing insect repellent products ranging from a concentration of 5-10 percent, all the way up to 30-40 percent.  The strength of the DEET will dictate how long (hours) you may remain “bite-free.”  Alternatively, natural (eucalyptus oils, etc) insect repellent products are available.  Use these products as directed on the label.

Now if you are unlucky and get bitten, bite treatment can provide significant relief.  Cleaning the area of the bite is essential, and using an over the counter or a prescription strength steroid cream will reduce itch and localized discomfort.  Remember, a cool ice compress will also reduce swelling.

Hope this helps to keep you bite free, and take the “sting” out of summer!

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Many of my patients have a variety of questions regarding their skin care, especially those with sensitive skin.  I recently sat down with my colleague Dr. Bobby Buka, section chief of the department of dermatology at Mt. Sinai School of Medicine, and discussed various steps you can take to improve your skin’s health AND appearance if you have sensitive skin. 

Don’t over do it!
Dr. Buka feels a balance of skin care products is the key and not to “overdo it” with too many different lotions and facial care treatments — especially if you have sensitive skin.  “Too many of my patients end up with ‘itchy red bump syndrome,’ a condition that results from putting too much stuff on your face,” says Dr. Buka.  He further explained how the skin’s delicate balance can be upset by well-intentioned patients who apply more than 3 products to the face at the same time. His rule of thumb is to use no more than 3 items per application.  Your skin can’t possibly absorb more than 3 products anyway, so Dr. Bukka says chill out, 2-3 targeted items to the skin’s surface are plenty.

Some patients who also have seasonal or year-round allergies, as well as sinus problems, may also experience below eyelid puffiness or “shiners” that can wreak havoc with your appearance. When those affected are actually tested, many individuals have allergies as well as possible contact or skin allergy to products used in the eyelid and facial areas. Covering up these dark circles with facial cosmetics (foundation, etc.) won’t fix the problem.  Dr. Buka and I often collaborate to develop a long-term solutions patients with sensative skin-related issues.  

Drink up!
Finally, stay hydrated — this means what may seem like a massive amount of water each day — 8 glasses! So drink up, your skin and (your internal organs) will thank you for it.  But sensitive skin or not, protection against UV rays remains the single most important thing you can do to protect your skin and delay the signs of aging! Dr. Buka and I recommend SPF 30 or higher for patients — not only when planning to spend the day outside, but also as part of their daily skin regimen.  So get out there and take charge of your sensitive skin care for optimal health, and look better!

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

The search for a “presidential dog” has dominated the headlines since President Obama’s campaign.  It has been reported that President Obama’s 10-year-old daughter, Malia, is allergic to dog hair, and thus starts the search for a “hypoallergenic” dog.  Many of my patients find themselves with the desire to have a pet, despite a pet allergy as well. 

There is a myth that pet allergies are caused by animal hair!  It is actually a protein found in pet skin/dander, saliva and urine that causes the allergy.  Hairless dogs are still going to have at least some allergen. Some dog breeds, are said to be “hypoallergenic,” as they shed less, but no dog breed is completely 100 percent hypoallergenic.  

In some cases, there are individual differences between breeds, and a particular pet allergy sufferer may do better with one breed as compared to another.  Lastly, it has been postulated that perhaps female dogs might produce less animal allergen, but the jury is still out on this one! 

You may look for breeds with shorter hair and less shedding, although there isn’t any real scientific evidence this will really help.  Some allergists have also advocated that there may be an advantage to keeping a dog that tends to keep their coat throughout the year. Also, there is a consideration to selecting a smaller dog, as these animals may shed less dander than a bigger dog.  Other factors discussed are the animal’s temperament or disposition that might make frequent bathing more feasible.

Tips that can help reduce dog allergy suffering:

• Create a pet-free bedroom

• Wash bedding in hot water

• Bathe your dog frequently and have a non-allergic family member perform grooming

• Use a HEPA air purifier, double bag and/or HEPA vacuum cleaner/home A/C,  and as well as vacuuming carpets, cleaning walls

• Shampoo carpeting frequently or better yet, go with wood or washable tile/linoleum flooring

• Increase time your pet spends outside, when the weather allows
 
• Visit an allergist to discuss treatment options
 
Nevertheless, there are no guarantees that an individual who is truly allergic to pets (about 10 percent if those with allergies) will tolerate living with a pet dog or cat.  What I have found helpful is actually trying out a pet on a “temporary or trial basis” for a future pet, to ensure a successful ending to this story.  An even better strategy is to begin allergy treatment before getting a pet if you are allergic, including allergy injections! 

For more information on pet allergies go to: http://www.aaaai.org/media/news_releases/pressrelease.asp?contentid=8326

For for home and animal allergy management tips check out: http://www.allergyandasthmarelief.org/animal_allergens.html

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

So what is in the air? Look out for seasonal tree pollens now wherever you are and learn more about these allergy culprits that are likely to be not only in your backyard — but also in your nose and eyes!  

Plant pollens such as trees, grasses and weeds are not the only allergens that affect the us while working in the garden. Many mold spores also affect people in the outdoors, seasonally, or even year round.

If there is an existing pollen problem in your landscape, replace that plant with a less allergenic selection.  A system that may help you do this and indicates the likelihood of a plant’s potential to cause allergy is the Ogren Plant Allergy Scale.

A pollen-producing tree in your own yard will expose you to up to ten times the amount of pollen as would the same tree planted just down the block from your home! 

Here are some more allergy sufferer’s tips for you and your yard:

• Wear a pollen mask while gardening
• Keep grass cut short
• Avoid touching your eyes and nose while gardening
• Plan outdoor time for rainy, wet, cloudy and windless days — which usually have lower pollen counts
• After yard work, leave your clothing outside of your bedroom, brush off your shoes and rinse your glasses. Also, wear gloves to minimize local contact and reduce irritation to the skin of your hands and arms
• Limit your gardening to short intervals on “high” pollen days
• If you are allergic to mold spores, avoid damp places and stagnant water
• Proximity and location of pollen-producing trees, shrubs and plants will affect your exposure to seasonal allergens
• Planting female trees in one’s own yard may trap incoming airborne pollen from male plants

Other resources are www.aaaaai.org and www.allergyandasthmarelief.org

Happy planting!

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

The first step is to reduce outdoor seasonal “triggers” by identifying the plants and flowers that will cause you discomfort. Get tested to choose the “right” plants, shrubs and flowers that are better for you. By knowing your allergies you can also plan ahead and modify your gardening schedule. This involves having the knowledge regarding peak periods throughout the day to the culprit allergens as well as staying tuned to learn the pollen count in your town or city.

Pollen counts from the previous day are available for main cities via the American Academy of Allergy, Asthma and Immunology (AAAAI) as well as in local newspapers and with the daily weather reports on radio and TV. The Web site for the National Allergy Bureau is www.aaaai.org/nab.

You may need to adjust your planting and/or gardening activities as seasonal symptoms such as itchiness of the eyes, nose and throat, sneezing may be worse on windy, dry, sunny and clear days may be associated with greater airborne pollens as wet, cloudy and windless days can see a reduction in outdoor plant pollens.

Colorful flowers:
Plants with bright, showy flowers are better for people who have allergies. Their pollen is large and because they are pollinated by insects, the pollen is seldom airborne. Plants that cause allergies usually have flowers that are small and insignificant looking and have no color for attracting nectar.

The following trees, shrubs, and plants have been found to be BETTER for people with allergies:

If you are considering adding trees to your landscape, you should AVOID planting the following:

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

With allergy season just around the corner, let’s take a minute to review some early tips to help you survive allergy misery.  Many sufferers have allergy symptoms that affect your eyes and eyelids and can be quite troublesome. Allergy medications may often work better if you start them just before the season begins. 

Right now, we are seeing early tree pollens such as juniper, cedar, elm, alder and maple in many regions of the country.  The late winter pollens cause “early” spring suffering even before the trees grow leaves! 

Here are a few practical tips:

• LIDS OFF: Gently irrigate your eyelids (while your eyes are closed) with a mild, tear-free “baby” shampoo to remove excess allergens and pollutants which may have accumulated.  Check with your provider (especially if you wear contact lenses or have other eye problems) to learn whether anti-allergy eye and/or moisturizing drops may also be helpful and safe.

• BLOCK YOUR EYES: Wear sunglasses to block pollens from entering and getting into your eyes.

• WASH WISELY:  Rinse off your eyeglasses and shower and shampoo your hair every night to remove allergy causing pollens that collect during the day.

Stay tuned for more late-breaking successful seasonal allergy survival tips to come …

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Researchers from Addenbrooke Hospital in Cambridge, England reported in this month’s edition of the journal, Allergy, that by studying a small group of peanut-allergic children, they have found a possible way of reducing the risks associated with accidental peanut ingestion.

The study authors pointed out that an allergy to peanuts may affect the entire family, particularly when a child has a food allergy.  Families affected by food allergies have a great deal of pressure put upon them, as well as anxieties associated with this condition.

How to cope with food allergies:

Eating out of the home requires planning and education to avoid an allergic reaction.  I often tell my patients to be a “label detective” and understand food labels ― or when dining out, present a “food ingredient card” to the server or kitchen staff to alert them, in order to reduce unwanted exposure to peanuts and other food allergens.  Don’t forget to always ask questions about ingredients and food preparation if you have a history of food allergies.

Bottom line: the only 100 percent successful treatment for food allergies in 2010, is education, prevention and avoidance, as well as preparedness for possible allergic reactions. There is a great need for more research as it is too soon to know whether this approach will ultimately work for the many millions with allergies to peanuts and nuts! 

Check out some additional strategies as well as one of the upcoming food allergy conferences taking place this year hosted by the Food Allergy and Anaphylaxis Network at:  http://www.foodallergy.org/conferences.html. 

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.