MOLD ALLERGIES
Along with pollens from trees, grasses, and weeds, molds are an important
cause of seasonal allergic rhinitis. People that are allergic to molds
may have symptoms from spring to late fall. The mold season often
peaks from July to late summer. Unlike pollens, molds may persist
after the first killing frost. Some can grow at subfreezing temperatures,
but most become dormant. Snow cover lowers the outdoor mold count
dramatically but does not kill molds. After the spring thaw, molds
thrive on the vegetation that has been killed by the winter cold.
In the warmest areas of the United States, however, molds thrive
all year and can cause year-round (perennial) allergic problems. In
addition, molds growing indoors can cause perennial allergic rhinitis
even in the coldest climates.
When inhaled, microscopic fungal spores or, sometimes, fragments
of fungi may cause allergic rhinitis. Because they are so small, mold
spores may evade the protective mechanisms of the nose and upper respiratory
tract to reach the lungs.
In a small number of people, symptoms of mold allergy may be brought
on or worsened by eating certain foods, such as cheeses, processed
with fungi. Occasionally, mushrooms, dried fruits, and foods containing
yeast, soy sauce, or vinegar will produce allergic symptoms. There
is no known relationship, however, between a respiratory allergy to
the mold Penicillium and an allergy to the drug penicillin, made from
the mold.
Which molds are allergenic?
Like pollens, mold spores are important airborne allergens only if
they are abundant, easily carried by air currents, and allergenic
in their chemical makeup. Found almost everywhere, mold spores in
some areas are so numerous they often outnumber the pollens in the
air. Fortunately, however, only a few dozen different types are significant
allergens.
In general, Alternaria and Cladosporium (Hormodendrum) are the molds
most commonly found both indoors and outdoors throughout the United
States. Aspergillus, Penicillium, Helminthosporium, Epicoccum, Fusarium,
Mucor, Rhizopus, and Aureobasidium (Pullularia) are also common.
Mold Counts
Similar to pollen counts, mold counts may suggest the types and relative
quantities of fungi present at a certain time and place. For several
reasons, however, these counts probably cannot be used as a constant
guide for daily activities. One reason is that the number and types
of spores actually present in the mold count may have changed considerably
every hour. Many of the common allergenic molds are of the dry spore
type--they release their spores during dry, windy weather. Other fungi
need high humidity, fog, or dew to release their spores. Although
rain washes many larger spores out of the air, it also causes some
smaller spores to be shot into the air.
In addition to the effect of day-to-day weather changes on mold counts,
spore populations may also differ between day and night. Day favors
dispersal by dry spore types and night favors wet spore types.
Other Mold Allergies
Fungi or microorganisms related to them may cause other health problems
similar to allergic diseases. Some kinds of Aspergillus may cause
several different illnesses, including both infections and allergy.
These fungi may lodge in the airways or a distant part of the lung
and grow until they form a compact sphere known as a "fungus
ball." In people with lung damage or serious underlying illnesses,
Aspergillus may grasp the opportunity to invade the lungs or the whole
body.
In some individuals, exposure to these fungi also can lead to asthma
or to a lung disease resembling severe inflammatory asthma called
allergic bronchopulmonary aspergillosis. This latter condition, which
occurs only in a minority of people with asthma, is characterized
by wheezing, low-grade fever, and coughing up of brown-flecked masses
or mucus plugs. Skin testing, blood tests, X-rays, and examination
of the sputum for fungi can help establish the diagnosis. Corticosteroid
drugs are usually effective in treating this reaction; immunotherapy
(allergy shots) is not helpful
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