Not every sneeze is covid-19! An ENT talks about about respiratory allergies

Allergic rhinitis is a very common disease but has a significant impact on the patient’s quality of life and performance. The World Health Organization (WHO) reported that around 400 million people worldwide suffer from allergic rhinitis. Despite the fact that it affects people of all age groups and is seeing a rapid increase among children and young adults, people continue to brush it off as a trivial problem.

Symptoms: Respiratory allergies versus covid-19

There are multiple overlapping symptoms of allergic rhinitis and coronavirus infections but both the diseases are different from each other.

In the case of coronavirus infection, one would usually observe prodromal symptoms such as fever, body ache, tiredness and headache which is absent in cases of allergic rhinitis. In addition, anosmia, which is absent or diminished smell sensation, is considered as one of the key symptoms of coronavirus.

Allergic rhinitis is often a chronic problem with either perennial symptoms or with seasonal exacerbations. Runny nose, sneezing and itchy nose are common symptoms in allergic rhinitis. Symptoms usually occur on exposure to particular allergens such as air pollutants, dust mites, pollens or pet dander. 

Understanding the risk of indoor pollution 

Since the advent of the coronavirus pandemic, there have been significant changes in work culture with people increasingly adopting the option of working from home.  Though this has brought down outdoor pollution levels, there has been a significant increase in exposure to indoor allergens. Dust mites, fungus and cockroaches are a few of the common indoor allergens. Wood polish, paints, floor cleaners, agarbattis, and mosquito coils are also sources of indoor pollution that are often ignored by us. 

Nearly 70 per cent of the burden of allergic rhinitis is due to sensitivity to house dust mites. House dust mites are tiny mites that grow mainly on the beddings. They feed on human skin debris. They are also found on carpets, soft toys and cushioned furniture. These house dust mites leave their faecal matter which has specific proteins which can cause allergy in sensitized people.

Another common allergen that we come across is pollen. Pollens are nothing but male gametocytes released from plants for the purpose of reproduction. It is important to keep in mind that not all plants cause allergies. Most of the ornamental plants do not cause allergy. Castor oil plant (Ricinus communis), Prosopis julifera, and Congress grass (Parthenium) are some important pollens that cause respiratory symptoms. 

So, how can you avoid these allergens?

It may be impossible to eliminate allergens completely from the environment, but one can create a hypoallergenic environment that can reduce the exposure to these:

• Frequently washing of the bedsheets in hot water (50-60*C) and sun drying can denature the protein of house dust mites. 
• Mite encasing covers can be used to create a barrier between the bed and bedsheet.
• Eliminating soft toys and carpets from the room can also reduce the possibilities of triggering respiratory allergies as they could be potential sources of house dust mite growth.
• One should avoid exposure to early morning air if they have pollen allergy.
• Using spectacles is also advisable in order to avoid contact of pollens with the eyes.
• Reducing out-door activities during peak pollinating season will be beneficial in keeping allergies under check. 

Can allergies be left untreated?

It has been very well proven that allergic rhinitis, if neglected and left untreated for long periods, has the potential to develop into more chronic respiratory issues such as sinusitis, asthma, chronic obstructive Pulmonary Disorder (COPD), etc. Hence, one should always consult a doctor if they have persistent symptoms of runny nose, sneezing, itchy nose or eyes. 

Skin prick allergy tests are generally used to identify the triggering allergen. There are very effective and safe medication options available to control the symptoms of allergies which can be used for prolonged periods. Some patients might also require desensitization to the triggering allergen known as immunotherapy.