Pet and pest allergy - practice parameters - Twitter summary from 2013 #AAAAI meeting

This summary was compiled from the tweets posted by allergists/immunologists who attended the 2013 annual meeting of the American Academy of Allergy Asthma and Immunology (AAAAI) (see the list at the end). The tweets were labeled #AAAAI. The text was edited and modified by me.

Pet allergies

Did you know? Cat allergens can be found even in homes without pets, work and classrooms. Pet allergens can be passively transferred on clothing.

Editor’s note: Cat allergen can be found anywhere, but the question is: does it cause symptoms anywhere?

Cat allergen in home declines slowly after pet removal. However, extensive cleaning and removal of carpeting can help. It takes up to 3-4 months for the cat allergen level to go to baseline.

Is there such a thing as a hypoallergenic pet? Quick answer: No. Allergens are present in all pets, regardless of pedigree and breeding. If you wash your pet to reduce allergen, get used to doing it at least weekly.

There might be an inverse association between cat allergen exposure and sensitization. However, genetics play a role here as well. For example, if mom has asthma, kids' exposure to cat in early life (before age of 5 yrs) increases risk of wheezing/asthma. On the other hand, some studies demonstrate protective effect of cat on asthma development. In very atopic children, risk of exposure likely outweighs benefit.

Interestingly, children with early life dog exposure appear to have fewer infections of respiratory tract and middle ear.

Already sensitized? Don't get a pet, lest you increase the risk of asthma.

Measures to reduce exposure to allergen

Pet removal remains the first line strategy. Keep pets out of bedroom - very important!

Allergen encasings for bedding should have pore size smaller than 6 microns, and they should be washable. HEPA filters should have a filtration efficiency of 99.97%. Duct cleaning has not been specifically proven to reduce pet allergen exposure.

Practice parameter on rodents

Elizabeth Matsui presented on the Practice parameter on rodents.

Mice can squeeze through holes only 1/4 inch in diameter. Rodents prefer seeds and grains as food source. The major mouse allergen (Mus m 1) is 4 times higher in male mice, primarily found in urine.

Prevalence of mouse allergen ranges from 75-100% in US homes. However, concentration of allergen is highest in big cities. Mouse allergen can be detected in the air. The median levels in some homes approach levels seen in mouse laboratories. There is 20% rate of occupational sensitization to mouse.
Rat allergen is less important in allergic disease, because they reside primarily outdoors.

Mouse sensitization is a risk factor for allergic disease (wheeze, eczema, rhinitis). Mouse allergen exposure is associated with asthma morbidity.

SPT for mouse epithelia has 47% sensitivity and 83% specificity.

The best way to decrease exposure to mouse allergen is Integrated pest management: assess and modify facilitative factors, use traps and rodenticide. Integrated pest management does reduce allergen levels.

Cockroach allergy

Ginger Chew presented on cockroach allergy. 10% of US population is sensitized to cockroach.

High-level sensitization to cockroach is associated with increased healthcare utilization. Cockroach exposure is associated with illness, even in the absence of allergic sensitization. Remember, exposure to cockroach can also occur in the school setting!

Integrated pest management helps reduce exposure to cockroach, but must be continued to be effective. Most integrated pest management strategies do judiciously use pesticides.

Allergists are on Twitter - follow them

Allergists increased Twitter use 470% in one year - 25 allergists reached 250,000 individuals from the 2012 #AAAAI meeting (see the references here). This summary was compiled from some of the tweets posted by the following allergists:

This is a list of the allergists who used Twitter to post updates from the 2013 #AAAAI meeting. The list is open for edit, please feel free to add your own info.

I would strongly encourage you to post updates on Twitter from the CME conferences that you are planning to attend in the future. Here is how to do it: Twitter for Physicians: How to use Twitter to keep track of the latest news and scientific meetings, and share information with colleagues and patients.

Disclaimer: The text was edited, modified, and added to by me. This is one of a series of posts that will be published during the next few weeks.

Comments from Twitter:

Dr John Weiner @AllergyNet: Another superb summary by @Allergy

@Allergy: Thank you, John, there will be a few more summaries over the next week - all are labeled #AAAAI here:

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