Fall allergies share symptoms with covid; ragweed a leading trigger

Sep. 21—A stuffy, runny nose could be a sign that your body is coping with a flu or covid-19 infection, or it could be an overreaction to an allergen.

The maturation of pollen-packed plants like ragweed means the fall allergy season has arrived in Western Pennsylvania.

"If you have nasal congestion, sneezing and itching of your eyes, ears and the roof of the mouth, that's usually a seasonal allergy," according to Dr. Karen Lang, who practices family medicine with Excela Health in Greensburg.

"When you have fever, aches and pains and yellow-green drainage from the nose, you're probably into more of an illness," she said.

The Mayo Clinic notes some additional differences in symptoms: A sore throat is rare with an allergy but usually is associated with covid-19; nausea and diarrhea are other potential covid symptoms that aren't part of an allergic response.

Another clue that an allergy could be the cause of one's misery is an annual trend. "Sometimes it's really obvious, if every fall or spring you get symptoms," Lang noted. Tree pollen is a leading allergen in the spring while ragweed takes over as a primary culprit in the fall.

Ragweed blooms and releases pollen from August to November, with pollen levels in many parts of the country hitting their peak by mid-September, according to the American College of Allergy, Asthma and Immunology.

In many areas of the country, ragweed pollen levels are highest in early to mid-September.

Pollen.com offers an online tool that can be used to obtain a forecast for upcoming pollen levels in major U.S. cities. It indicates pollen levels are expected to be in the low-medium range Wednesday in Pittsburgh, with a pollen count of 4.6.

A pollen count measures the grams of pollen present per cubic meter in a 24-hour period. A high pollen count is 9.7 to 12.

"Most people suffering from allergies in the fall blame goldenrod, which is such a beneficial pollinator-friendly plant for the fall," said Patti Schildkamp, a Penn State master gardener based in Westmoreland County. "It is actually the ragweed blooming alongside it that is the culprit."

The two plants have some similarities in appearance, but the goldenrod blooms turn a bright yellow while the blooms of the common ragweed are a more subdued green.

Ragweed pollen is lightweight and can be carried on the wind for miles. It's estimated that one plant can produce up to 1 billion grains of pollen, according to the Pennsylvania Department of Environmental Protection. Release of the pollen peaks between 5 and 10 a.m.

Goldenrod pollen is larger and heavier and sticks to the pollinators that visit the plant.

Another potential allergy effect is oral allergy syndrome, or cross-reactivity. An allergy sufferer may experience itchiness or tingling in the mouth when eating cantaloupes, watermelon, bananas or sunflower seeds because those foods have proteins that share similarities with the ragweed pollen, according to the Asthma and Allergy Foundation of America.

University of Illinois State Master Gardener coordinator Sandra Mason offers advice to homeowners who find ragweed sprouting in their lawn or garden: "Cut, cultivate or pull ragweed so they do not 'go to seed,' to help reduce their population. Next season, mulch the area and remove plants in May or June before flowering."

Other plants that can trigger fall allergies include burning bush, pigweed and mugwort.

To limit exposure to the pollen from these plants, Lang said, "The smartest approach is to keep the air conditioning on and the windows closed.

"If you're going to do some outdoor work, put a mask on. That can really cut down on symptoms. With all the mask-wearing we've done during the pandemic, more people are probably comfortable with wearing a mask."

Lang noted the body's production of the chemical histamine is what causes allergic symptoms, so the first line of treatment to alleviate them would be an over-the-counter antihistamine. Original forms of these medications can make people drowsy, but newer versions avoid that side effect, Lang said.

Nasal steroid sprays also can be helpful and are available over the counter, she said.

Beyond that, doctors can offer allergy shots based upon the specific allergens that are affecting a patient.

A skin-prick test is a common method for identifying the cause of a person's allergy. A suspected allergen is applied to the pricked area to see if there is a reaction, Lang explained. Blood tests also can be used.

The testing can help to pinpoint allergens that may affect people year-round — such as mold, dust mites, pet dander and cockroach droppings.

A serum containing the identified allergen is given to the patient in increasingly large doses.

"Then, when you're exposed to it in the environment, you've already developed a tolerance to it," Lang said.

Jeff Himler is a Tribune-Review staff writer. You can contact Jeff by email at jhimler@triblive.com or via Twitter .