Allergists see ragweed-allergic patients through autumn

Ragweed season begins in early- to mid-August, and while patients are encouraged to start their medications earlier in the summer, some patients with symptoms will see allergists through the fall, according to information from the American College of Allergy, Asthma and Immunology.

“Our known ragweed patients generally have already been to see me in June and July to remind them to start their medications in August before the season starts,” Janna Tuck, MD, an allergist from Cape Girardeau, Mo., and ACAAI spokesperson, told Healio.com/Allergy. “If they start medication before the season they generally have a good fall.”

Janna Tuck

The patients who are seen later in the season are ones “who suffer from fall symptoms but have avoided seeing the allergist [and] finally ‘had enough’ of symptoms,” Tuck said. “Many times the primary physician recognizes their symptoms as allergic or sees the pattern of a sinus infection every September might be a ragweed allergy but these referrals come … late September to November. So for new ragweed-allergic patients, we have a slow but steady influx of patients from September to October.

“Our concern is this: If we can’t or don’t see them during ragweed season when they are miserable they may cancel their appointments and then the cycle of misery reoccurs the next fall,” Tuck said.

According to a press release from the AAACI, hay fever affects more than 23 million Americans, up to 15% of the population.

“People who suffer from hay fever need to be aware that symptoms can start in mid-to-late summer,” Michael Foggs, MD, ACAAI president, said in the release.

Michael Foggs

Foggs advised that patients should take medication two weeks before symptoms begin and continue for two weeks after the first frost.
Other tips from ACAAI regarding fall allergy symptoms include:

People with allergies should be advised to avoid triggers, and car and home windows should be kept closed. After spending time outdoors, they should shower, change and wash their clothes. An NIOSH N95-rated filter mask is recommended for outdoor work.
Antihistamines are recommended to treat milder symptoms, including sneezing, itchy and runny nose, eye itching, tearing and redness, itchy skin, hives, and eczema, according to the press release.
For more moderate to severe hay fever symptoms, the ACAAI recommend immunotherapy, in which each injection can be customized to an individual’s allergic needs, according to the release. An alternative to shots for patients with ragweed allergy is available in sublingual immunotherapy tablets, recently approved by the FDA. The pill’s first dose must be taken in an allergist's office to observe for and treat an allergic reaction, should it occur, the release stated. The ragweed pill therapy must be started about 12 weeks before ragweed season begins, according to the release.

“If the patient has more severe symptoms, hopefully we have been able to convince them to do allergen immunotherapy (shots), which are tremendously effective for ragweed allergy,” Tuck said.