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Posted by R. Power on Friday, May 23, 2014
Once in a while our customer service department receives calls asking what we suggest for traveling with allergies, most often, peanut allergies. As of now there is not much we can say aside from informing your airline of your allergies, wearing a mask and asking your doctor for any additional medical advice. But now we can tell our curious callers to fly with Swiss! Swiss Airlines has proudly earned ECARF (European Centre for Allergy Research Foundation) quality seal of approval in becoming the first allergy-minded airline on the globe!

Switzerland has a history of being a very innovative and efficient country, so it doesn’t surprise me that they would make such an impression with the airline industry as they have done with chocolate, banks and pharmaceuticals.

Here’s what their allergy-minded airline includes to minimize the presence of allergens within the cabin and lounge areas:
  • High efficiency air conditioning to filter out pollen, pet hair and dander and any airborne particulates on board.
  • Removal of air fresheners for flyers with chemical sensitivities.
  • Selection and use of hypoallergenic fabric for upholstered items.
  • In the lavatories they provide soap friendly for those with sensitive skin.
  • Your meal, snack and drink selections are free of glucose, lactose and a variety of other common allergens.
  • Swiss Airline cabin crew members are trained to respond, and are equipped with the histamine tablets in the case of allergic reactions and emergencies.
I think this is a great idea for an airline to specialize a plane for allergy prone travelers. Perhaps this will start a trend for other airlines, especially here in the U.S. If not, well, then twist my arm, I guess I'll have to book a flight to Switzerland to fly allergy-free. On second thought, how would I bring back my precious Swiss chocolate covered cheese snacks?

Author: R. Power

Just a reminder for those local to the Atlanta area, if you have peanut allergies but want to catch a game at Turner field Saturday as part of your Memorial Day Weekend, they do have a Peanut Free Section. Check out the Braves site for more details, and Have a Happy Memorial Day!

Posted by kevvyg on Wednesday, February 26, 2014
Yesterday, a US Food and Drug Administration advisory panel voted not to recommend Primatene HFA for over-the-counter sale. This is the latest in the attempt to bring a bronchodilator back to the over-the-counter market. There were two additional votes on the drug, and the mixed results could be reason for hope in seeing a new bronchodilator on the market in the future.

Primatene Mist - OTC BronchodilatorMany of you may recall seeing Primatene Mist on drugstore and market shelves when you were younger. For me, it was a common occurrence as my cousin, who suffers from severe asthma, would often have this inhaler with him. After spending time in the backyard with my cousins and brothers playing football, he would pull out his inhaler, flip the top and use it if his asthma flared up.

In 2011 Primatene Mist was phased out and removed from store shelves. These pocket-sized inhalers used chlorofluorocarbons (CFCs) to propel the epinephrine out and into the lungs of the asthma sufferer. As part of an overall move away from CFC-based propellants, the axe finally fell on Primatene Mist in December of that year. Since then, the manufacturer, Armstrong Pharmaceuticals, has been attempting to gain OTC status for a replacement inhaler, the short-acting beta2-agonist (SABA) bronchodilator, Primatene HFA. Currently, the only forms of this type of drug available are prescribed. If you have asthma, you might be familiar with their names, albuterol and levalbuterol. However, there is some need for an OTC alternative, particularly in case of emergencies or when people run out of their prescription at inopportune times.

In addition to ultimately voting no to OTC use, the 25 member advisory panel also voted on the efficacy and safety of the new inhaler. While there is still another ongoing clinical trial, the panel discussed the results of two other clinical trials that showed significant results. On a vote over the efficacy, 14 yes votes won out.

Lastly, the panel discussed and voted on the safety of the proposed drug. Like most drugs, Primatene HFA did show some side effects, though even with the most severe side effect being tremors, all cases were mild. Other side effects were infrequent. A larger safety issue was likely found in the correct use of the inhaler. While the new inhaler uses an ozone-friendly propellant, the new formula is a suspension that can settle. Consequently, the inhaler must be primed four times before the first use and twice after two weeks of nonuse. It must also be washed and dried each day, and both of these present significant hurdles when it comes to ease-of-use and proper use. With regard to labeling, some members felt that patients may be led to believe that it is for daily use when only actually intended for intermittent use. All of these things resulted in 17 panel members voting no, in terms of safety.

The end result, for now, is that the new Primatene HFA will not be in pharmacy and store shelves any time soon, but the drug does show promise. It does work, and there is a need for it. Undoubtedly, Armstrong will revisit the inhaler and attempt to address issues of misuse or mishandling.

Author: K. Gilmore

Posted by R. Power on Monday, February 10, 2014
Immunotheraphy Treatment Offers Hope for Peanut Allergy SufferersMothers with children who have peanut allergies can find hope for relief in recent allergy studies. In a study recently published in the Lancet, Dr. Andrew Clark and his team conducted clinical trials testing immunotherapy treatments for children with peanut allergies. A treatment group of children with this allergy were fed small yet increasing amounts of peanut flour for a 6 month period. After the treatment, over 80% of the children were able to safely eat the equivalent of 5 peanuts a day, which is at least 25 times the quantity of peanut protein they could tolerate before the experiment. "As kids take an increasing amount, their immune systems start to change," said Dr. Clark. "They can tolerate peanuts more robustly."

Immunotherapy has been a successful form of allergy relief for wasp-sting allergies and grass pollen. At its core, immunotherapy is a long, slow process of reintroducing tiny amounts of a particular allergen to patients. Over time, the amounts of the substance patients ingest or are exposed to increases with that hope of leading to a higher, long term tolerance of the allergen. With regard to peanut allergies, this has been the most successful study so far, and gives hope to parents who are constantly on the lookout for even trace amounts of peanuts that can send the severely allergic into anaphylactic shock. In the future this type of treatment could relieve much of the worry associated with trace amounts of allergens causing severe reactions and help lift many of the precautionary diet restrictions those with food allergies often have to impose.

While we wait for more research, long term test results, and potential FDA approval for this treatment, avoidance remains one of the best options for those dealing with food allergies. Though peanut butter might not be one the menu just yet, here are some Peanut/ nut substitute suggestions without the risk of allergic reactions.
  • Sunflower seed butter
  • Soy nut butter
  • Hummus
All of these substitutes are easily found in local grocery stores, generally near the peanut butters. If any of you readers have suggestions on sunflower seed butter or soy nut butter brands, let me know, I’d love to try!

Author: R. Power

Posted by kevvyg on Tuesday, February 04, 2014
Circassia LTD - SPIRE Treatment - Cat AllergiesThis is a topic we've mentioned before throughout the years and originally back in 2011, a novel treatment for cat allergies that is less invasive, less time consuming and as effective as more traditional allergy shots. British drug maker, Circassia LTD, is currently accepting patients for a phase-three clinical trial with this new treatment. What does this mean for those with cat allergies? Potentially - a lot.

Like traditional allergy shots, the idea behind the treatment is to desensitize people who are allergic to cats. The big difference between this and traditional shots is two-fold. First, the shots are not subcutaneous, meaning they are more shallow and do not go beneath the skin. Second, the length of the proposed treatment would be significantly shorter, four to eight months as opposed to the more traditional three to five years worth of shots. This can not only make the process more convenient but hopefully less costly and invasive.

The current trial is accepting people who have had cat allergies for at least two years, have a cat living at home with them, and are between the ages of 12 and 65. As the largest clinical study of this treatment to date, the CATALYST (Cat Allergy Study) is accepting over 1100 volunteers from seven countries.

For people coping with cat allergies, this could be a dramatic step forward in treatment. Often times allergists recommend removing your cat from the household, and as one of the most common household pets, those with cat allergies often have allergic reactions outside of their own homes. One of the Most Common Household Allergens - Cat DanderCat dander is one of the smallest of common household allergens, and to make matters worse, it's "sticky". This means that in places where cats have been, it's often extremely difficult to remove cat dander since it adheres to walls, furnishings, and flooring, nearly everything in a room. Nearly one in three households have cats. In addition to allergies, there is also a link to asthma reactions and cats, with one study showing over a quarter of asthma attacks being triggered by cat allergen. So, the potential that a shorter, less invasive and successful treatment holds a great deal of hope for the millions with allergies or asthma.

The basis of the treatment is the proprietary ToleroMune technology. Molecules called SPIRES (Synthetic Peptide Immuno-Regulatory Epitopes) generate regulatory T cells. These T cells control the allergic response and stimulate tolerance of specific allergens.

Circassia is also working on a similar treatment for dust mite allergies, and back in September of 2013 they announced results of their phase-two trials. In this study, patients who had received four doses of the treatment over 12 weeks showed significant improvement one year after the start of the trial. This smaller phase-two study will likely in the steps of the cat allergy trials. With success, they will move on to larger, clinical, phase-three trials. In addition dust mites, Circassia has also finished phase-two trials of the same treatment for ragweed and grass allergies.

While we continue to patiently wait and hope, avoidance and more traditional measures, like the use of a high quality HEPA air purifier or antihistamines remain some of the best way to reduce allergic reactions to cat.

For more information on these phase-three clinical trials, contact your local certified allergist or visit the clinicaltrials.gov website

Author: K. Gilmore

Posted by kevvyg on Monday, January 20, 2014
Wet Conditions Early, Making Cedar Pollen Season Miserable NowIt's winter time, and while many of us are struggling with bouts of bitter cold and snow, for some this is prime allergy season. It may seem counterintuitive for allergies, especially any type of pollen allergies, to be worse during the winter months, but one type in particular causes problems for many through the winter months. Making matters worse is that many mistake their allergies for a cold or the flu. (Like something out of an old comic strip, "Is it a cold? Is it the flu? No, it's cedar allergies!") So what's aggravating your allergies? If you live in the Southwest, it could very likely be cedar.

Cedar or mountain cedar pollen is actually a type of Juniper. These trees often soak up summer and fall rains then in December and January begin releasing pollen. With rains being heavier than usual throughout much of the South, the cedar pollen levels are higher than usual in places like North and Central Texas.

Like many allergies, cedar pollen can produce symptoms that are often mistaken for the cold or flu. Runny nose, headache, and sneezing are all common with cedar pollen allergies. While these often typify the common cold, check with your allergist or physician if these symptoms are persistent. For those thinking they have a touch of the flu, do you notice a fever or severe body aches? If neither of these are present, then you're likely dealing with a cold or allergies, not the flu.

Coping with cedar allergies can be a tough task, particularly with higher than usual pollen counts and winds spreading the allergen far and wide. One avoidance measure you can take is using an allergy mask. Thiscan help to block the pollen, and all masks do retain some heat, so during the colder winter months, they can also help cut down on cold weather induced asthma. Not many people have their windows open this time of year but think about replacing your HVAC filter. This can help to keep dust and pollen levels down in the home. Check with your allergist or doctor. If you've skipped by some preventative measures and find yourself feeling miserable, your doctor can help. From allergy shots to antihistamines, there are a variety of treatments available to help get you feeling better sooner.

For more information of juniper pollen.

Author: K. Gilmore

Posted by kevvyg on Monday, December 30, 2013
WellaPets - Kids Games About AsthmaAre you the parent of a child with asthma? Would you be interested in trying a new app/game that is not only entertaining for your child but also teaches them about asthma triggers, treatment and how to better manage asthma? In development by LifeGuard Games, there is a fun, new app that needs your input - WellaPets.

You start by creating a virtual pet, and in this case, a tiny fire-breathing dragon. But here's the catch. Your little dragon has asthma and can't breathe fire like the other dragons, at least, not initially. The game takes you through a series of challenges and a variety of mini-games that teach your child not only some tips for controlling your pet's asthma, like through the use of an inhaler, but also points out triggers throughout the home that can aggravate your dragon's asthma. So with the virtual pet, your child can learn, explore, and interact, all while managing a pet with the player's chronic condition - asthma.

Screen Shot of WellaPetsThough game is fun and interactive, the educational aspects are blended in and help reinforce general knowledge about asthma but also focus on themes like self-efficacy (taking control of and managing your condition) and communication with parents.

There is science behind this, and research about similar games for children and young adults coping with diabetes and even cancer have shown positive results.

So if you have a young child dealing with asthma and would like to help by trying the game and giving some feedback, there's just three easy steps.
  1. Sign up here
  2. After you've signed up, use the mobile device that you want to play on (ie. iPad) and visit TestFlight to complete the process
  3. Play the game for two weeks and fill out the survey when you're finished!
This week you can complete steps 1 and 2. The game and survey questions will be sent out very soon (first week in January).

For more information about WellaPets.

Author: KevvyG

Tags: Asthma
Posted by kevvyg on Thursday, November 21, 2013
Link Between Asthma and Fertility?There are a variety of connections between allergic disease. Asthma linked allergies, eczema linked to asthma, etc. but one interesting relationship that has not been studied too much is the link between asthma and infertility. It has long been noted that women who suffer from asthma often have a more difficult time conceiving, but there has been little research to study this connection. Researchers in Denmark recently published a study focused specifically on women with asthma which more clearly demonstrates this association.

Using a group of 15,000 twins, Danish researchers looked at things like time to pregnancy, the outcomes of those pregnancies in wide range of the participants, including those with asthma, allergies and people that lacked both of these. Even when researchers adjusted for differences in things like socioeconomic status, body mass index, and other factors, an association between asthma, how well the asthma was being treated and time to pregnancy emerged.

The shortest time to pregnancy, TTP, was demonstrated in women without asthma. The longest TTP was for women over 30, with asthma that wasn't being treated. These two variables, treatment of asthma and age, also played a role in the association. Asthmatic women who were over 30 generally tended to see a longer TTP than those who were under the age of 30. And, women who's asthma was untreated, also tended to see longer TTP than those who were treating their condition.

While not definitive, this study highlights a few things. First, if you're a woman with asthma, treat it. Not only can effectively treating your asthma improve your quality of life, but it make lessen the effect that asthma has on fertility. Second, age matters. The older you get, the greater impact allergic disease, like asthma, can have. Lastly, the study broadly indicates that a systematic disease that can create systematic inflammation (like asthma) can have an effect on a seemingly unrelated process like reproduction.

To read the abstract of this study.

Author: K. Gilmore

Tags: Asthma
Posted by kevvyg on Friday, November 15, 2013
In an increasingly rare display of bipartisan support, a new piece of legislation concerning food allergies has finally become law. On Wednesday, President Obama signed into law the School Access to Emergency Epinephrine Act, the first law that encourages public schools across the nation to stock emergency epinephrine, a potentially lifesaving product for those going into anaphylactic shock.

For the last several years advocates within the food allergy community have pushed not only this federal initiative but also laws and measures passed at the state and local levels, to address this issue. And now, they have a federal law to aid in this push.

The new law incentivizes states to adopt laws requiring schools to stock auto-injectors by tying these moves to preferential access to federal asthma education grant funds. Currently, only four states require auto-injectors to be stocked in schools, while another 26 states allow schools to voluntarily stock these life saving devices. The hope is that this law will push all states to adopt epinephrine stocking requirements and end school tragedies that could likely be avoided.

Author: K. Gilmore

Posted by R. Power on Friday, October 04, 2013
Typically, a research piece about botulism would fall outside of the scope of topics we cover, but with this most recent article's focus on vacuum cleaners and the suggestion that they maybe be potential vectors for disease (like botulism), we found this noteworthy. Yes, you read that right, a possible link between your vacuum cleaner and botulism. Most people think of vacuums as a tool to get rid of carpet frizz, dust, pet hair, stale crumbs under the coffee table, and the occasional gummy worm. They leave our carpets refreshed and clean feeling, and hardwood floors walkable for the bare feet again. But what we can't see or feel is what Caroline Duchaine and her research team from the Queensland University of Technology and Laval University wanted to study.

Vacuum cleaners can release large concentrations of particles, both in their exhaust air and from resuspension of settled dust (Duchaine et al. 2013). The aim of this study was to evaluate particles emitted into the air from various vacuum cleaners. Tests and measurements were made based on dust inside dust bags or dust bins (some were bagless) and from air emitted from the machine while in use. Clostridium botulinum Under a MicroscopeDuchaine and her team quantified how much bacteria and mold could be found within these tests with a particular focus on Clostridium botulinum, Salmonella spp and Penicillium/Aspergillus. While Salmonella is fairly commonly known, the other two are related to botulism and mold, respectively. For infants/toddlers and those with allergies or compromised immunity, this study can be somewhat worrisome.

There have been previous studies on vacuum cleaners that have established that dust bags can be a reservoir for certain types of microbes, and in one particular instance during the 1950's vacuums have gotten attention for this, as a dust bag was the sole source of a Salmonella outbreak amongst infants in a hospital ward.

Before, you toss your vacuum, consider some of the findings on this study. No appreciable levels of the microorganisms, with the exception of mold spores (which varied more widely in terms of measurable amounts), was found in the emissions. While there were some present, the concentration was extremely low. In the dust bag though, the story was a bit different. Concentrations of the different microbes found were fairly consistent, regardless of brand (of vacuum), and this leads researchers to believe that "vacuum emissions could potentially lead to short and more intense bioaerosol exposures than those due to resuspension of settled dust" given the emission rate of most vacuums.

At this point, it is likely worth noting a couple things. First, brands of the vacuum cleaners used were not disclosed. The near two dozen units were collected from the homes of staff and students at the university. The age of the vacuums tested ranged 6 months to 22 years and the prices from $75 to $800 (AUD - Australian), and each vacuum was tested as it arrived. Additionally, samples could not be obtained from all the units involved. A little over half of the models tested produced measurable results, in terms of emissions and dust bag content. The next thing to keep in mind is this. For test purposes, researchers used HEPA filter air through the vacuums, to ensure uniformity but also to introduce as pure of a medium as possible.

This was an interesting research topic, since dust is often overlooked as a conglomerate of debris with no life or benefit. But here we have live microorganisms amongst nonliving material. This could also shed some light onto what kind of vacuum do you want to purchase. If this blog has got you thinking about switching your vacuum to something a little more vacuum sealed, here are few things to consider.

Filtration matters - The fact that researchers used HEPA filtered air in their tests is telling, particularly when you compare it to the size of some of the microbes examined. Mold spores typically range in size from 3 to 40 microns while Clostridium botulinum, a rod-shaped microbe, can be .5-2 microns wide by 1.6 to 22 microns long. Certified HEPA filters capture 99.97% of particles 0.3 microns and larger.

Self Sealing Dust Bag, Automatically Seals When You Open the CanisterVacuums With a Bag Should Be Better - The entire point of the research piece was to focus on bioaerosols that vacuums can create and emit throughout the home. What is the point of trapping microbes only to expose yourself to them when you empty the dust bin?

Particularly Sensitive Groups, Pay Heed to What You Clean With - You often get what you pay for, and not all vacuums marketed as "HEPA" are equal. Some have been independently tested and certified (like Miele or Dyson), and other haven't. Even if you decide to pay for a vacuum with high end filtration, you are likely selling yourself short if you then use cheaper, aftermarket replacement dust bags or filters.

Lastly, On the Microscopic Level, Seals Matter - Vacuums that features seals to prevent air leakage and those that have dust bags that seal when you go to remove them are going to be advantageous.

Although this research does shed some light on potential bacterial exposure, don't fret because these types of infections are very rare. Overall, this statement from the study says a lot, "The vacuum characteristics here are likely to be the main predictor of emission, rather than dust content." However, if you're in a position where you have to crash on the floor at a friends or grandmas... you may want to consider a blowup mattress!

To read the full research article.

Author: R. Power

Posted by kevvyg on Monday, September 16, 2013
We first mentioned this amoeba over a year ago in connection with the death of a woman in Louisiana. Friday, the Louisiana Department of Health and Hospitals (DHH) announced that the microbe had been found in four locations in the St. Bernard Parish water system. The Atlanta based Center for Disease Control (CDC) confirmed the presence of Naegleria fowleri in the public water supply, and all of this follows the death of a 4-year old from infection, back in August. So what is Naegleria fowleri, and what can you do to prevent exposure to this potentially deadly microbe?

Naegleria fowleri Under a MicroscopeA single cell amoeba, Naegleria fowleri is often found in bodies of warm, freshwater, but can also be found in soil. Typically, it enters the body through the nose. Once deep in the nasal passages, it makes its way to the brain and causes the often fatal disease, primary amebic meningoencephalitis (PAM). Symptoms of PAM can easily be misdiagnosed since the early stages resemble bacterial meningitis, and often can be mistaken for the flu.

The areas where the microbe likes to inhabit does not only include lakes, rivers, ponds and streams. Another potential source is drinking water. If you grew up like I did and have a well, there is potential there for the organism to make an appearance since this water is rarely, if ever, chlorinated. Public water supplies, like those that tested positive in Louisiana, are typically safe if properly chlorinated. Typically Seen More During the Summer Months, Naegleria fowleri Prefers Warm, Fresh Bodies of WaterOne potential problem, though, is that if not properly monitored and maintained, residual chlorine levels can dip below recommended levels. This opens the door for potential infection, and this is what the CDC found to be the case in this Louisiana parish.

Overall, the risk of infection is extremely low. Each year, millions swim in lakes, ponds, and streams all across the U.S., but in the last decade, there has been an average of less than four cases a year. When infection does occur, it often makes headlines due to the mortality rate. This can make Naegleria fowleri seem far more common than what it is. Still, there are a few preventative measures you can take to make this low risk, even lower.
  • Avoid Getting Water Up Your Nose - Sounds pretty basic right? This means if you're swimming, avoid diving or swimming underwater. You can also wear nose plugs or clips to help prevent this, and it's probably a good idea to keep an eye on the little ones. If they were like me and my brothers when we would play with the garden hose, inhaling water isn't uncommon.
  • Keep Swimming Pools Clean - Maintain adequate disinfection, for regular swimming pools - 1-3 ppm of free chlorine and a pH of 7.2 to 7.8.
  • If Using A Sinus/Nasal Rinse or Neti Pot - Follow user instructions. Use only distilled or sterile water, which can be readily purchased at just about any grocery or convenience store, or simply boil your water. Tap water is fine for nasal irrigation, if boiled, then cooled, before use.
Again, risk of infection is extremely low, and those using public water supplies generally have little to worry about. Risk from showering, cooking or consuming even contaminated water is almost non-existent. Unless you inhale water, it often doesn't make its way deep enough into the nasal passages to prevent any problem, and if consumed, the body's digestive system is more than capable of destroying it.

And in terms of swimming, if you weren't afraid of the water before, don't be now. Though slightly better odds than being struck by a meteor, risk of infection is pretty low. To put this into perspective, on average just under 40,000 people die a year from drowning. About 3 die a year from Naegleria fowleri.

In Louisiana, officials are increasing the chlorine in the water supply to not only kill the microbe but to also bring residual chlorine back up to recommended levels.

To see the DHH Press Release or for more information on Naegleria fowleri.

Author: K. Gilmore

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