For some it's sneezing all the way
By: Judy Foreman
12/14/1998

You're running around getting ready for Christmas or Hanukkah or Kwanzaa or Ramadan - or just a generic holiday party.

You shop. You cook. You get the candles from the bottom drawer, the decorations from the basement. If Christmas is your tradition, you probably get a tree, too, all fragrant and piney.

You certainly don't need something else to worry about - like holiday allergies.

Sorry about that.

While people typically associate allergies with the pollen that causes wheezing and sneezing in spring and summer, many of America's 50 million allergy sufferers are actually miserable all year long because of allergies to mold, dust mites, pet dander, and in some places cockroaches and their droppings.

On top of those perennial miseries, some poor souls find their allergies or asthma get worse during the holidays.

For instance:

  • The sap of Christmas trees contains terpenes (compounds that are also found in turpentine), which contribute to the lovely scent but can also be strong irritants to the nasal passages of susceptible people, says Dr. Ira Finegold, director of the allergy section at Roosevelt-St. Luke's Medical Center in New York and past president of the American College of Allergy, Asthma and Immunology. Some trees may also carry mold.

  • If you have food allergies - the big culprits are peanuts, tree nuts like walnuts and pecans, shellfish, fish, eggs, milk, wheat, and soy - you have to be careful year-round.

The trouble is, says Anne Munoz-Furlong, founder of the Food Allergy Network in Fairfax, Va., food is central to most holiday gatherings and cooks get extra-creative at the holidays.

This means you have to be extra-vigilant about piecrusts that may contain hidden nuts. Ditto for imported chocolates (with uninformative labels) and eggnog fluffed up with raw egg white, which is even more allergenic than cooked egg white.

  • Smoke, from Hanukkah candles, cozy fireplaces, and after-dinner cigars or cigarettes, can also be an irritant to people with asthma and other respiratory problems.

  • So can dust and mold on ornaments, especially if you store them in dusty, moldy places like a basement.

  • And of course, perfume or after-shave may seem the perfect gift, until the recipient runs gasping from the room.

While some allergies have such a dramatic onset they're impossible to miss, others can be difficult to diagnose, especially in the winter when you're more likely to attribute sneezing and runny noses to colds.

But if your "cold" lasts more than a week or so - especially if your nasal discharge is clear and you have no fever - you may have allergies.

Dust mites are a major culprit. Even if you keep your own home scrupulously clean, when you visit other people over the holidays who aren't as vigilant you may get an allergy flareup.

The mites reside in bedding, pillow cases, bedclothes, and feed off tiny particles of human skin that have been shed, says Dr. Robert K. Bush, chairman of the indoor allergen committee of the American Academy of Allergy, Asthma and Immunology. Dust mites also thrive in carpets, says Bush, a professor of medicine at the University of Wisconsin in Madison.

Animal dander - shed from a pet's skin, saliva, and urine - is another problem you may have under control in your own pet-free home, but not when you go visiting.

HEPA (or high-efficiency particulate arrestor) machines may help clean the air of some allergens, but they're not cheap ($200) and you shouldn't expect the host or hostess to buy one when you visit. They are also "of limited utility," because some allergens like dust mites settle to the ground and don't circulate much in the air, says Bush of Wisconsin.

What can help, if perennial or holiday allergies get to you, is to see an allergist - now, before the holidays arrive. At the very least, he or she may be able to help identify the problem and prescribe medications that can help. Claritin, Allegra or Zyrtec are a few of the many available. Over-the-counter medications such as Nasalcrom may help, too. And if you start soon enough, you may also get a series of desensitization injections.

For severe allergies, ask your doctor about a prescription for an EpiPen (pre-measured epinephrine) and carry it with you, especially to holiday parties.

Remember: Allergies are no joke. Airborne allergens and irritants can lead to serious inflammation of the bronchial tubes and sinuses (the cavities around the eyes and nose). Once the sinuses are blocked, mucus can't drain properly and drips into the lower respiratory tract, causing bronchitis and asthma. Asthma kills 5,000 people a year.

Food allergies are no joke either. About 5 million Americans have them and an estimated 100 to 125 die every year, typically from a reaction called anaphylactic shock, in which blood pressure falls, you lose consciousness, and may develop hives, wheezing, vomiting and diarrhea, and severe shortness of breath. The flip side of all this is that there's lots you can do to minimize allergies. And at least so far, there's no evidence that anybody is allergic to reindeer. Or mistletoe.

Avoiding holiday allergies

  • Christmas trees, wreaths, boughs - keep your distance if they're a problem. Consider getting an artificial tree instead.

  • Wash off dusty, moldy ornaments, too.

  • If you have food allergies and get invited to parties and potluck dinners, take a dish you know is safe and be first in the buffet line. Take a hearty portion, then don't go back - by then, the serving utensil may have been used on another dish that could trigger your allergies. Or eat before you go.

  • Don't cave in to pressure to sample a tiny bite unless you're sure it contains no allergy-triggering ingredients.

  • Keep an EpiPen with you.

  • Use smokeless and unscented candles if regular candles are irritating. Don't insist on a fire if anyone in the room has asthma, emphysema or other respiratory problems.

  • See an allergist if over-the-counter remedies don't help.

For more information, contact:

  • 1-800-842-7777, the American College of Allergy, Asthma and Immunology. Ask for a new brochure called "You can have a life without allergies." On the web, it's http://allergy.mcg.edu

  • 1-877-9-ACHOOO (1-877-922-4666), the National Allergy Bureau, run by the American Academy of Allergy, Asthma and Immunology. Ask for a brochure called "Because Allergies Last All Year Long." On the web, www.aaaai.org/nab

 

Judy Foreman’s column runs every other week. Past columns are available on www.myhealthsense.com.

Listen to her live call-in webcast radio show every Wednesday night from 8:30 to 9:30 EST on http://www.healthtalk.com.

To General Medicine 1998