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Published: May 17, 2009 3:00 a.m.

5 questions

Paul Greenberger

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Greenberger

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With

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llergies and a new strain of the flu in the air, 5 Questions paid a visit by e-mail to Dr. Paul Greenberger, president of the American Academy of Allergy, Asthma and Immunology, to get the latest. Greenberger grew up in West Lafayette, is a graduate of Purdue University and Indiana University School of Medicine, and is now a professor at Northwestern University’s School of Medicine. Craig Klugman, editor of The Journal Gazette (and patient of Greenberger’s), did the interview.

1How does this spring allergy season compare with others in severity?

Tree pollens are in the moderate-high level, but they are each spring. The trees shed pollen even if the weather is cool.

Also, there are mold spores in the air, so that it is both the effects of tree pollens and mold spores that cause symptoms. I hesitate to declare that this spring season is worse than previous years. If patients have undergone allergen immunotherapy (shots), they may have few symptoms and need little or few medications, despite high levels of pollens or mold spores.

2Flu is in the news. Have you any recommendations for prevention, especially since a vaccine for the current strain is unavailable?

Swine flu and influenza are different, and the flu shot (for influenza) doesn’t protect against the swine flu. The Centers for Disease Control has recommendations for prevention but some are as follows:

Sick children and adults, stay home!

Wash hands frequently.

Don’t touch eyes, nose and mouth as they are entry points for flu viruses.

If you get a fever of at least 100 degrees with cold, flu symptoms, nausea or diarrhea, you may be spreading the virus even if you aren’t too ill feeling. Stay home.

3More and more people have asthma. What are the reasons for the steep increase?

The reason isn’t known, and there is much investigation going on.

One view is that viruses are more virulent (aggressive) and damage the inner surface of the bronchial tubes.

Another view is that the protective benefits of vaccinations have reduced the numbers of infections that children get; in the process, the immune (defense) system of the body is NOT focused on protection against infections and focuses on the allergic reactivity, leading to more asthma.

Recently, there was a study showing that exposure to violent acts was associated with more asthma, too.

4Is there any medication on the horizon that holds out hope for allergy sufferers?

Some are under investigation, but actually, not enough of the recommended medications are being used by people with asthma now.

Check out the Web site of the American Academy of Allergy, Asthma and Immunology (www.aaaai.org) for more information.

5What is the strangest allergy you’ve seen in your three decades of practice?

Maybe not strange but rare conditions! I investigate patients with the condition called idiopathic anaphylaxis (meaning a full-blown allergic reaction but no external cause such as peanuts, penicillin or yellow jacket stings). In other words, the patient awakens at 2 a.m. with itching, shortness of breath, lightheadedness and then passes out as the person goes into shock. We have been able to define the condition, set up a proven treatment plan, help put the condition into remission and identify some of the mechanisms of the unpredictable reaction.