This month, as part of our #InConversation LIVE series on Facebook & YouTube, we spoke with Dr. (Major) Rajesh Kumar Bhardwaj, ENT Specialist at Sitaram Bhartia Institute of Science and Research to understand his views on seasonal allergies and what can be done to overcome them.
Watch the video below or read on.
We have seen quite a few cases of viral fever accompanied by cold and cough of late. Does this have any relation to COVID-19 or is it just the regular flu?
This is the flu season and traditionally we do see many people coming down with the ‘Flu’, which is basically ‘the influenza’, commonly caused by the rhino virus and other respiratory disease viruses. This influenza or seasonal flu has been in existence for years together and this is the time it happens. The surprising part is that last year we did not see so many cases, perhaps because of the restrictions and strict lockdown measures. But this year we have gradually seeing cases of seasonal flu. So if you have a cold with fever, you have the typical symptoms of flu, particularly if its associated with cough.
Initially because of the very dreadful second wave, we again thought we were dealing with more and more cases of COVID-19 but fortunately on testing them, we found out they were RT PCR negative for coronavirus and then subsequently when we tested them for H1NI and H2N3 we found they were positive for these viruses and so we finally came to a conclusion that we are back in the flu season.
These patients are suffering from seasonal flu and traditional treatment and simple, symptomatic treatment is all that they require and this is not COVID-19.
Are the flu vaccine and the COVID vaccine interchangeable? Would the flu vaccine protect you from COVID-19 or vice-versa?
First of all for the coronavirus, the two doses of the vaccine, whether it is Covaxin or Covishield or Sputnik, are all that you need to use for the Coronavirus. There is sufficient evidence to show that it protects you from catching a severe form of the disease and reduces chances of hospitalization and chances of mortality arising out of this infection.
The flu virus is different. It is a different strain or a virus itself so the immunity that the vaccine for the coronavirus gives you is not the same as what the flu vaccine gives you. So these are two different vaccines and to clarify further, we have been using the flu vaccine on the vulnerable population, specifically on children between two and six years of age, and those who are 70 years and above, those who have comorbidities like respiratory disease or diabetes, especially those who had acquired pneumonia in the last winter. These people were considered candidates for the flu vaccine.
This year, as per recommendations from many governing and health care bodies, because of the pandemic, we are making a general recommendation that we should get the flu vaccine, for 2021-22 is now available from different companies because the virus has been identified.
We are recommending you take the vaccine to keep you safe – not to get immunity from the COVID-19 virus – but to get immunity from the seasonal flu, because of which you will not get the flu and your immunity will not go down.
The basic concept is that otherwise your immunity will go down and you will become prone to contracting COVID-19.
How should doctors counsel the parents of children who have allergic rhinitis and what can be done to prevent these allergies?
The number of children getting allergies have increased tremendously in the last 30-40 years. Prior to that, maybe 1 in 10 children would have symptoms of allergy including the nasal bronchial allergies and bronchial asthma. At present, more than 30% of children are suffering from an allergy and that number may rise, so now we have to be more vigilant about allergy symptoms in children.
There are couple of things to do, the first of which may be a specific allergen test to find out what they may be allergic to. We can have guidelines depending on what time of the year they fall sick or what kind of symptoms they have and based on that we can counsel the child and the parents. There may be some difficult decisions that the parents and child may have to make, such as about furry animals. Furry animals are a trigger for allergies in children and adults, and parting ways with them can be a sensitive issue.
The role of air purifies is a bit controversial in the sense that removing allergies due to bad dust and air quality is in contradiction to the advice for COVID-19. For COVID-19, we want people to open their doors and windows to ventilate their homes so that the virus pases through and does not rest on any surface. For air quality, however, our recommendation has been to keep your doors and windows closed. There should be an air purifier in the room that you spend the most of your time, and it should be an air purifier of a higher caliber. For example, if there is an air purifier for a room of 120-150 square feet, then make sure that the room you use it in is slightly smaller than that so that the air purifier is efficient.
Make sure to clean the filters of the air purifier frequently. The new generation air purifiers can work through an app, they tell you about the air quality in real time, and you can definitely monitor the air quality in the room.
Try to remove flowering plants and strong smelling substances from the child’s room such as dhoop or agarbattis as the strong smell and smoke may be harmful for children and adults, with an allergic predisposition.
When do seasonal allergies occur and what can be done about them?
Seasonal allergies typically happen in the months of March, April and October-November, what we call Holi time and Dusshera, when the season is changing and the air quality may be decreasing. In the Spring time, we’re worried about pollen, strong smells and flowering plants, so there are different reasons for allergies at various times of the year.
Seasonal allergies are easy to diagnose because people come with a specific symptom. We need to be vigilant and ask the patient relevant questions. Sometimes if the patient is keen, then we can also run some tests. This is done at two levels, one wherein we do a CBC and IGE to determine the body’s response to outside allergens. If the IGE is elevated, we proceed with an allergen test, which is basically for allergic rhinitis (nasal allergies) or for asthma or we do a comprehensive test so we can begin avoidance measures.
Are there any specific allergies related to the ear, nose and throat that you are seeing now?
We are nearing the end of the monsoon season and this is when it gets humid. There is a small subset of people who are allergic to humidity. While we usually recommend a humid environment for the nasal mucus as well as for the lungs to function efficiently but there are maybe 5-10% of people who cannot tolerate high levels of humidity, and who may require medication.
At this time, I would advise people to watch out for सीलन. सीलन is the seapage that happens in the house when water from above your apartment (in a multi-story building) leaks into the walls, makes them wet and enables the growth of fungus and mold. Mold is one of the most common substances to which humans are allergic, so that is something to be aware of.
Treatments may differ from allergy to allergy. Broadly speaking, how can we treat most allergies?
Allergen avoidance is the main aspect of treating allergies. Most patients learn to figure out what is causing a particular allergy over a period of time. It may be a strong smell in the kitchen, a furry animal or a pet, a flowering plant in the house or a seasonal change when they know they will fall sick, so whatever it is that they can avoid, they should avoid. They should keep their doors and windows closed so that outside pollutants and other allergic substances do not enter the house. They should also invest in a good air purifier, so that the room in which they spend the most amount of time remains clean.
Treatment can either be in the form of oral medicines or some local treatment but it would be better if the doctor decides this part. The good news is that Immunotherapy is a new form of treatment that has been introduced in other parts of the world, and will probably enter India in a year or two. Immunotherapy with oral medication or sublingual immunotherapy may be the mainstay of treatment for people with allergies, especially if they have a single allergen allergy.
What is your take on home remedies for allergies?
Home remedies should be a part of the regimen for patients with chronic allergies. For the most common organs, the nose, throat, lungs, there are certain steps we can take, such as:
- Saline gargles: These are safe and effective in treating throat allergies. So if you have n itchy and scratchy throat if you were in a polluted area or if you’ve eaten spicy food and the spices didn’t agree with you, you should definitely gargle with half a glass of warm water with half a teaspoon of salt and you can gargle once or twice a day.
- Steam inhalation for nose and lung problems: Steam works by going into the mucus plug, and loosening it. Anything that you add to steam, whether it is eucalyptus oil or something else is a flavouring agent and serves no useful function. Steam inhalation is also advised only once or twice a day. Hot steam in excess is harmful for your body, for your lungs and nasal passage, and it kills cells. Your skin may break up into spots so we do not recommend this through the day. Once or twice is all you need.
In this context, it becomes important to highlight that people should not add too many spices such as cardamom, cinnamon, ginger etc to hot boiling water, in the form of a काढ़ा in the hope of getting rid of the COVID-19 virus. Hot boiling water can cause ulcers and may not be tolerated by your oral mucosa.
We hope you enjoyed this segment of our #InConversation LIVE series with Dr. R.K. Bhardwaj on Seasonal Allergies. Don’t hesitate to get in touch with us at 011 4211 1111 or +918800816657 to schedule a consultation with Dr. Bhardwaj for any of your allergy related concerns.