Spring has finally arrived—a welcome relief after a cold winter. Yet, as Long Islanders and other New Yorkers know, the onset of milder weather also heralds the start of the springtime pollen season, which bodes misery for all those who suffer 
with hay fever.
The term “hay fever” is actually a misnomer. This condition is not caused by exposure to hay, nor is it associated with fever. The correct medical term is “allergic rhinitis” and it affects about 20 percent of the adult population and up to 40 percent of children. In fact, children miss two million-school days each year because of this condition.
While children do not inherit a specific allergy from their parents, they do inherit the genetic predisposition to be an allergic person. The specific allergies that an individual develops are influenced by a number of factors, including the timing, intensity and duration of exposure to environmental allergens, such as pollens, mold spores, dust mites, feathers and animal dander.
Each region of the country has its own pollen season. Here in the Northeast, trees pollinate in the early spring, grasses in the late spring, mold spores and common weeds are prevalent in the summer months and ragweed in the fall.
Four Cardinal Symptoms
Children plagued with allergic rhinitis may exhibit the following:
1. Nasal congestion
2. Watery nasal secretions
3. Nasal itchiness
4. Sneezing.
In addition, many children suffer with post-nasal drip, cough, sore throat and itchy, watery eyes. These kids have difficulty sleeping at night and trouble concentrating at school. Upper respiratory infections—or head colds—caused by respiratory viruses, can mimic symptoms of allergic rhinitis.
Allergy or Cold?
There are some important differences that distinguish allergic rhinitis from head colds. Upper respiratory infections usually occur in the winter and are often accompanied by fever and thick, yellow or green nasal discharge. Head colds are contagious, so other family members may have identical symptoms.
Allergic rhinitis is not associated with fever and nasal secretions are clear and watery. With seasonal allergic rhinitis, there is a relationship between the severity of symptoms and the pollen count— the higher the pollen count, the worse the symptoms.
The best treatment for any allergic disease is to identify the cause of the allergy and then, if possible, avoid that allergen. The most accurate method of identifying specific allergies is to take a thorough history and then perform selective prick skin testing guided by that history. Blood tests can also be used to identify allergies, but are less sensitive than skin testing for environmental allergens.
It’s difficult to completely avoid airborne pollens, but you can limit your child’s exposure by keeping in mind the following: Tree pollen counts are highest in the morning hours, ragweed at midday and grass pollen in the afternoon, so outdoor activities should be avoided at those times and windows kept closed. Air conditioners should be kept on and filters changed frequently. Also, dog and cat owners should bathe their pets frequently since they can carry pollens in their fur.
James Fagin, M.D., is an attending physician within the Division of Allergy/Immunology at Schneider Children’s Hospital and Director of the Hospital’s Center for Childhood Asthma.
