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What is it?

Latex is a milky sap produced by the rubber trees.  It is combined with several chemicals in the manufacturing process to give latex its elastic characteristic.

Where is it found?

Natural rubber latex is used to make many common consumer products including balloons, toys, tires, elastic clothing waistbands, erasers, rubber bands, baby bottles, nipples used on baby bottles, pacifiers, athletic shoes, soles of shoes, condoms, etc.  It is also utilized in the manufacturing of many medical and dental devices such as gloves, dental dams, airway and IV tubing, stethoscopes, and catheters.  Synthetic rubber products (e.g., house paint) are not made with natural latex.

What causes allergies?

The immune system sees the protein in latex as a foreign invader.  To help protect us from foreign aggressors, the immune system mounts a defensive attack against the allergenic proteins found in natural rubber latex by making antibodies (i.e., immunoglobulins) to fight it. When we are exposed to latex products, these antibodies attack the proteins in the latex, releasing chemical mediators into the bloodstream (e.g., histamine, leukotrienes) which are responsible for the symptoms during allergic reactions.

Who is at risk?

• Health care workers and others who wear latex gloves. Natural rubber proteins can attach to the cornstarch powder used in latex gloves and can become airborne and cause reactions through inhalation.
• People who have had multiple surgeries, such as children with spinal defects.
• Rubber industry workers

What are the symptoms?

• Itching (i.e., pruritus), rash, and/or hives (i.e., urticaria)
• Nasal congestion, runny nose, and/or itchy nose
• Wheezing, shortness of breath, chest tightness, and/or coughing
• Swelling (i.e., angioedema) of parts of the body such as the throat, lips, eyes, and tongue.
• Nausea and/or dizziness
• Anaphylaxis, a severe life-threatening reaction manifested by a multiple organ system allergic reaction which may include a drop in blood pressure, breathing difficulty, generalized itching, hives, swelling, and/or abdominal cramping, as well as other symptoms.

The above symptoms usually begin within a few minutes after latex exposure and are categorized as an immediate hypersensitivity reaction.  The reactions usually occur only after a number of exposures, but the severity of reactions can worsen with repeated exposures.

Physical contact with latex can also cause soreness and blistering of the skin which usually begins 2 to 3 days of exposure.  This type of reaction is called allergic contact dermatitis.  It is similar to the reaction that is caused by poison ivy, poison oak, and poison sumac, which is referred to as a delayed-type hypersensitivity reaction.

Are foods a problem?

People who are sensitive to latex can also adversely react to certain fruits and vegetables such as apples, avocados, bananas, chestnuts, carrots, celery, kiwi, melons, papayas, potatoes, and tomatoes due to the sharing of similar proteins (i.e., cross-reactivity).

How is the condition diagnosed?

When the history is suggestive of a latex allergy, a blood test can be done to confirm the diagnosis.  Furthermore, allergy skin testing can also be done in individuals who have a negative blood test but the index of suspicion for a latex allergy is high.

What treatments are available?

As one cannot be desensitized to latex, avoidance of latex exposure (both contact and inhalation) is the only way to protect individuals from untoward reactions.

• Health care workers should wear synthetic and non-powdered gloves which do not contain natural rubber products.
• Patients with a history of previous reactions should be exposed only to non-latex medical products and devices and operated upon only in non-latex environments.
• The latex-allergic individual should wear a medical alert bracelet, so that people are aware of their allergy.
• The latex-allergic person should always carry an EpiPen, Auvi-Q, and/or Adrenaclick self-injectable device for emergency treatment and know to then go immediately to the closest emergency room.

The board certified allergy specialists at Black & Kletz Allergy have 3 convenient office locations in the Washington, DC, Northern Virginia, and Maryland metropolitan area and are very experienced in the diagnosis and treatment of latex allergies.  Black & Kletz Allergy treat both adults and children and have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  We offer on-site parking at each location and the Washington, DC and McLean, VA offices are Metro accessible. There is a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line. Please call our office to make an appointment or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day.  Black & Kletz Allergy has been serving the Washington, metropolitan area for more than 50 years and we pride ourselves in providing excellent allergy and asthma care in a professional and pleasant setting.

Now that it is Winter and the temperatures are cold, one may think that they do not have anything to worry about when it comes to allergies and asthma in the Washington, DC metropolitan area like in the cities of McLean, VA (Tysons Corner, VA), and Manassas, VA.  Unfortunately, this is not true, as the cold weather can mimic allergies in many individuals and produce the same symptoms that occur in allergic people.  In addition, during the Winter, there are many allergens that still exist (i.e., dust mites, molds, pet dander and saliva, cockroaches, rodents) which cause allergic and asthmatic symptoms in susceptible individuals.  Furthermore, there are a lot of viruses that are prevalent in the Winter that can also cause symptoms that can be confused with allergies.  These viruses are also responsible for upper respiratory tract infections (URI’s) that are known to exacerbate asthma in many asthmatics.

It is well known that cold air can cause a runny nose and watery eyes.  The runny nose is a result of the vascular constriction caused by the cold air.  Non-allergic individuals that have these symptoms may think they have allergies.  Allergic individuals that have these symptoms may truly be having these symptoms because of the vascular constriction or because they are at increased exposure to allergens found during the Winters such as dust mites, molds, pet dander and saliva, cockroaches, and rodents.  Cold air is also a very well know trigger in many asthmatics and in these patients can cause wheezing, shortness of breath, chest tightness, and/or coughing. Exercising in the cold air is another important trigger for many asthmatics.

During the Winters in the Washington, DC, Northern Virginia, and Maryland metropolitan area, it is common for people to contract a multitude of viruses that cause upper respiratory tract infections.  The most common viruses that are responsible for URI’s include the rhinovirus, influenza virus (i.e., flu), parainfluenza virus, coronavirus, respiratory syncytial virus (i.e., RSV), picornavirus, adenovirus, coxsackievirus, and echovirus.  URI’s cause many symptoms that are the same as allergic rhinitis symptoms such as nasal congestion, runny nose, sneezing, sinus headaches, clogged ears, cough, and fatigue.  In addition, URI’s are known to exacerbate asthma in many asthmatics.

Three other conditions that the cold can cause that can be misconstrued as an allergy include hives (i.e., urticaria), swelling episodes (i.e., angioedema), and generalized itching (i.e., pruritus).  These skin conditions can be caused by exposure to cold air or cold water. There a many factors that can cause hives, swelling episodes, and/or itching; some of which include medication allergies, food allergies, certain infectious diseases, autoimmune disorders, and thyroid abnormalities.  In the Winter in the Washington, DC metro area, one must also think of the cold weather as a cause of these skin conditions.

The board certified allergists at Black & Kletz Allergy have more than 50 years of experience in diagnosing and treating allergies, asthma, hives, swelling episodes, generalized itching, URI’s (including sinus infections and bronchitis) in both adults and children. Whether they are caused by the cold or caused by other factors, Black & Kletz Allergy has the experience and expertise in treating these conditions.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA and offer on-site parking at all locations.  The Washington, DC and McLean, VA offices are Metro accessible and we provide a free shuttle that runs between our McLean, VA office and the Spring Hill metro station on the silver line.  To schedule an appointment, please call us or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day.  Black & Kletz Allergy is proud to provide high quality allergy care to the Washington, DC, Northern Virginia, and Maryland metropolitan area residents in a friendly and professional setting.

The onset of winter in the Washington, DC, Northern Virginia, and Maryland metropolitan area brings with it an increase in the frequency of respiratory infections. In comparison to individuals without an underlying long-term health condition, people with a history of allergies, asthma, diabetes, as well as individuals with suppressed immune systems are more susceptible to respiratory tract infections.

Some common respiratory infections during the Winter include:

Sinus infections (acute rhinosinusitis): According to Centers for Disease Control and Prevention, about 1 in 8 adults are diagnosed with sinus infections yearly, resulting in more than 30 million diagnoses in the U.S. More than 90% of these cases are viral. Antibiotics are not guaranteed to be of any benefit, even when they are caused by bacteria.

Bacterial cause is more likely when the symptoms are:

Management:

Bronchitis:

Inflammation of the lining of the bronchial tubes that carry air in and out of the lungs causes a cough lasting several days or weeks.

Medications for relief of symptoms may include:

Non-specific upper respiratory tract infections (URI’s):

Most adults experience two to four URI’s (e.g., “colds”) each year. More than 200 different types of viruses are known to cause the common cold.

Prominent “cold” symptoms consist of nasal congestion, clear runny nose, post-nasal drip, sore throat, cough, fever, headache, and/or body aches.

Treatment is mostly geared towards relieving symptoms, as the condition usually resolves spontaneously after a few days to one week and antibiotics are not needed.

Decongestants combined with first-generation antihistamines may provide short-term relief of nasal symptoms and cough. Anti-inflammatory medications (e.g., ibuprofen, naproxen) can relieve fever and aches. Nasal saline irrigation can sometimes be helpful.

Pharyngitis (throat inflammation):

About 90% of throat infections are caused by viruses. Only about 5 to 10% of cases are due to bacteria which are commonly referred to as “Strep throat.”

Rapid Antigen Detection Test (RADT), also known as a “strep-test” may be necessary to distinguish between viral and bacterial pharyngitis, as the clinical features are similar in both conditions.

Antibiotics are not recommended for patients with a negative RADT result. For those with a positive RADT result, amoxicillin or penicillin VK are the drugs of choice as they are very effective against streptococcal bacteria. For penicillin-allergic patients, antibiotics in the macrolide class, as well as clindamycin, may be utilized. The duration of treatment for bacterial pharyngitis is typically 10 days.

The board certified allergists at Black & Kletz Allergy have 3 convenient locations in the Washington, DC, Northern Virginia, and Maryland metro area and are very experienced in managing various respiratory infections. They are experts in checking the immune systems in individuals that develop frequent and/or unusual infections, since they are also immunologists. Black & Kletz treat both adults and children and have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. We offer on-site parking at each location and the Washington, DC and McLean, VA offices are Metro accessible. There is a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line. Please call our office to make an appointment. Alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day. Black & Kletz Allergy has been serving the Washington, DC, Northern Virginia, and Maryland metro area for more than a half a century and pride ourselves in providing excellent quality allergy, immunology, and asthma care in a professional and friendly setting.

As we enter the Winter season, while many people see an improvement in their allergy symptoms because of the lack of pollen in the air, many other individuals experience a worsening of their allergy symptoms due to the increase in the amount of perennial allergens that are present during this time of the year.  Specifically, people with sensitivities to dust mites, molds, pets, and cockroaches tend to do worse in the Fall and Winter months.  Despite the fact that all of these allergens are omnipresent in the Washington, DC, Northern Virginia, and Maryland metropolitan area, and are present year-long, during the colder months, individuals tend to “close up” their homes and workplaces more than in the Spring and Summer months.  During the Fall and Winter, people generally keep the windows shut, turn on the heat, and go outdoors less often.  These factors all play a role in increasing the exposure to more quantities of dust mite, mold, pet dander, and cockroach allergens. Hence, individuals may be bothered more in the Fall and Winter.

It is noteworthy to mention that all of the above allergens are found only indoors, except molds and occasionally pets.  When the leaves fall from the trees in the Fall and get wet, molds will grow on the decaying leaves.  In the Washington, DC metro area, the leaf mold is a major allergen that causes a great deal of suffering for many allergy patients.  When the leaves are disturbed by either raking them, rainfall, or via the wind, the mold spores are more likely to become airborne, thus increasing the likelihood of them causing allergy symptoms in individuals with mold sensitivities.  It is therefore recommended that a person with mold allergies should avoid exposure to leaves, particularly if they are or have been wet.  They should also keep the humidity of their homes below 35%, if possible as there is direct correlation with increased humidity and the amount of mold growth.  In the home, mold growth tends to be more abundant in basements, bathrooms, and kitchens due to the increased moisture found in these places.

The main culprits of dust allergy are the dust mites prevalent in the Washington, DC metropolitan area.  There are 2 very common species of dust mites in the Washington, DC, Northern Virgina, and Maryland metro area.  They are known as Dermatophagoides fariniae (i.e., American dust mite) and Dermatophagoides pteronyssinus (i.e., European dust mite).  Both species are highly allergenic and tend to live indoors in places like carpeting, upholstered furniture, pillows, mattresses, box springs, and bedding.  It is technically the fecal particles and exoskeleton that are the allergenic components of the dust mites.  The dust mites are microscopic and look similar to a cockroach, however, they cannot be seen with the naked eye.  They are about 0.25 mm. in length.  They survive by eating dead skin that regularly sloughs off of humans each night.  The dust mites thrive in warm moist climates and when the humidity is high.  They do not survive if the temperature is over 130° F or when the altitude is greater than 1 mile (5,280 feet).  Dust mites are known to be a cause of allergic rhinitis and asthma in many individuals.  There are products that can be put on carpeting that act to kill dust mites, but these products have been shown not to very effective.  Encasing one’s pillows, mattresses, and box springs in allergy-proof encasings are a fairly effective way to minimize exposure to dust mites.

When the home is “closed up,” pet allergens from the dander and saliva tend to be worse.  Usually, however, pet allergy tends to be very similar for most individuals despite the time off the year.  Likewise cockroach allergy is common particularly in major cities such as Washington, DC.  Many homes, apartments, condos, restaurants, and public buildings in urban settings are infested with cockroaches, even though they may not be visible during the day to most people.  It is important to make sure that traces of food are not left on counters, floors, etc., as this attracts cockroaches.  There is a common strong association between cockroach allergy and childhood asthma in inner city populations.  Cockroaches are potent allergens allergy sufferers of all ages and cause both allergic rhinitis and asthma symptoms.

Other than avoidance, which is always preferable, there are numerous medications that can be used by allergists to treat dust mite, mold, pet, and cockroach allergies.  Allergy shots (i.e., allergy injections, allergy immunotherapy, allergy desensitization) are a very effective tool that board certified allergists use to treat individuals with these allergies, as well as pollen allergies.  They work in 80-85% of people and allergy injections have been used in the U.S. for over 100 years.  The average length of treatment is 3-5 years.

The board certified allergists at Black & Kletz Allergy have been diagnosing and treating allergies and asthma for more than 50 years in the Washington, DC, Northern Virginia, and Maryland metropolitan area.  We have convenient locations in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  Each office has on-site parking.  The Washington, DC and McLean, VA offices are Metro accessible and there is a free shuttle that runs between our McLean, VA office and the Spring Hill metro station on the silver line.  Please call for an appointment if you would like a consultation with one of our allergists, or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day.  Black & Kletz Allergy prides itself in providing quality allergy and asthma care to the Washington, DC, Northern Virginia, and Maryland metropolitan area community.

Aspirin-Exacerbated Respiratory Disease (AERD) is an acquired condition in which the sensitivity to aspirin and/or related drugs (e.g., nonsteroidal anti-inflammatory drugs or NSAID’s) is associated with long term inflammation of the upper and lower airways.

How common is AERD? Approximately 8% of the adults in the U.S. are asthmatics and 9% of those individuals have AERD. About 13% of U.S. adults have chronic nasal and/or sinus disease and 15% of those have AERD.

AERD is a clinical syndrome consisting of: 1. Growth of polyps inside the nose 2. Chronic sinus inflammation and/or recurrent sinus infections 3. Persistent asthma, which is often difficult to control 4. Allergic sensitization to aspirin and/or other nonsteroidal anti-inflammatory drugs (NSAID’s)

What causes AERD? Although the exact cause remains unknown, a disorder in the metabolism or breakdown of a chemical called arachidonic acid is at the root of the condition. Aspirin is not the cause of the disorder, but in sensitive individuals, ingestion of aspirin will aggravate the underlying respiratory symptoms, probably by increasing the levels of inflammatory chemical mediators called leukotrienes. This process also leads to the accumulation of excessive numbers of eosinophils (i.e., “the allergy white blood cell”) in the respiratory tract.

Clinical Features: 1. Severe nasal congestion 2. Overgrowth of polyps in the nose, which typically recur after surgical removal 3. Decreased sense of taste and/or smell 4. Facial pressure and pain 5. Frequent headaches 6. Moderate to severe asthma causing wheezing, coughing, chest tightness and/or shortness of breath 7. Fatigue caused by sleep deprivation 8. Significant opacification of the sinuses seen in X-rays and CT scans of the sinuses

Diagnosis: The diagnosis is suspected when there is a history of an exacerbation of one’s asthma following ingestion of aspirin and/or NSAID’s. The diagnosis is confirmed if the symptoms are induced or aggravated during an oral aspirin challenge, where incremental doses of aspirin are administered by mouth under the close monitoring by a board certified allergist.

Treatment Options: Complete avoidance of aspirin and other salicylates (e.g.,diflunisal (Dolobid); salsalate (Disalcid), as well as other related NSAID medications called COX-1 inhibitors (e.g., all NSAID’s except celecoxib) will help some patients attain better control of their symptoms. For some individuals, however, these medications can be substituted for other similar NSAID pain relievers called COX-2 inhibitors without adverse effects. Note that Celebrex (celecoxib) is currently the only approved COX-2 inhibitor NSAID in the U.S. Some, but not all, of the common available NSAID’s which are COX-1 inhibitors include . Avoidance of aspirin is not always possible due to the need for aspirin in the management of heart, blood vessel, and joint diseases. In addition, even with the avoidance of aspirin and NSAID’s, AERD patients usually experience progressive airways disease, despite aggressive surgical intervention and/or topical or systemic anti-inflammatory treatment with corticosteroids and leukotriene antagonists like montelukast (Singulair), zafirlukast (Accolate), and zileutin (Zyflo).

For these individuals that need to be treated with aspirin, aspirin desensitization followed by regular long term intake of aspirin is an alternative option. Multiple studies have shown that desensitization and daily treatment with aspirin can significantly improve overall symptoms and quality of life, decrease formation of nasal polyps and sinus infections, reduce the need for oral corticosteroids and sinus surgery, and improve nasal and asthma scores in patient with AERD. Significant clinical improvement is seen in as little as 4 weeks after treatment.

The procedure for aspirin desensitization involves administering aspirin by mouth in gradually increasing doses at regular intervals, while closely monitoring for adverse effects in a controlled setting such as an allergy office. The process can take 1 to 2 days. There is a potential for adverse reactions during the procedure like nasal congestion, generalized itching (pruritus), hives (urticaria), swelling of the soft tissues (angioedema), wheezing, breathing difficulty, drop of blood pressure, and/or anaphylaxis. In case of a minor adverse reaction, they may be treated with medications. After observation for about 3 hours, the last dose can be repeated. Many individuals will be able to successfully finish the procedure in spite of some untoward reactions. Pre-treatment with leukotriene antagonists (e.g., montelukast) play a role in minimizing the risk of reactions during the desensitization procedure.

Aspirin desensitization reduces nasal congestion and nasal polyp formation, improves respiratory symptoms, reduces the need for surgery, and decreases the need for ongoing medications. The board certified allergists at Black & Kletz Allergy have had over 50 years of experience with patients who have aspirin sensitivity. Desensitization in patients who are sensitive to aspirin can be done in any of our 3 office locations in the Washington, DC, Northern Virginia, and Maryland metropolitan area. Black & Kletz Allergy has offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. We offer on-site parking at all of our offices and the Washington, DC and McLean, VA offices are Metro accessible. There is a free shuttle that transports patients between our McLean, VA office and the Spring Hill metro station on the silver line. For an appointment, please call us or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day. Black & Kletz Allergy treats both adults and children suffering from all types of allergies (i.e., hay fever, food, medication, insect stings), asthma, sinus problems, hives, swelling episodes, eczema, and immunologic disorders. We strive to provide exceptional quality allergy and asthma care to the Washington, DC metro community in a friendly and professional setting.

The Allergists Tysons Corner VA Trust Explain the Effects of Climate Change on Your Allergies The climate in places like Tysons Corner, VA, Falls Church, VA, and Gainesville, VA, as well as the rest of the Washington, DC metropolitan area, plays a significant role in producing allergens that annoy sensitized individuals.  The DC metro area was built on a swamp and there tends to be high counts of mold spores throughout the year, particularly from the Spring through the Fall.  Our humid Summers also account for excessive mold growth.  Pollen production is also a major problem in the Washington, DC metro area, mostly in the Spring and Fall.

Though there are still some unresolved controversies, the preponderance of evidence indicates that our climate has steadily changed over the past several decades and it is likely to continue to change in the near future.  This climate change has the potential to alter the incidence and severity of allergic and respiratory diseases in humans in the following ways:

More energy efficient and tighter homes will lead to an increase in indoor air pollution.  Accumulation of volatile organic compounds, radon gas, smoke, particulates, and protein allergens will increase the risk of respiratory illnesses.  In addition, higher water vapor and moisture levels will increase dust mite populations and cause an escalation of mold growth.

“Green practices” like composting facilities may cause increased respiratory diseases through the increased fungal burden that they put into the air.  Burning wood produces harmful chemicals including carbon dioxide, carbon monoxide, unburned hydrocarbons, and formaldehyde.  Inhaling particles coated with these chemicals contribute to asthma and chronic obstructive pulmonary disease (i.e., bronchitis, emphysema).

Ragweed flowers earlier and produces more pollen in urban locations where carbon dioxide concentrations and temperatures are higher.  The same effect can be seen with other allergenic species including poison ivy.

Whatever the coming changes may bring, a few proven environmental control measures such as keeping the indoor humidity lower to limit dust mite and mold growth, as well as decreasing outdoor activities on high pollen days, can help minimize allergic symptoms and reduce the need for medications. Contact a Top Allergist Tysons Corner VA Relies On The board certified allergists Tysons Corner VA trusts at Black & Kletz Allergy see patients from Tysons Corner, VA, Falls Church, VA, and Gainesville, VA as well as many other cities and towns in the Washington, DC, Northern Virginia, and Maryland metropolitan area. They are ready to work with you in teaching you how to improve your environment which subsequently will help relieve your allergic and asthmatic symptoms.  The allergy doctors at Black & Kletz Allergy treat both adults and children.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  All of our offices offer on-site parking and the Washington, DC and McLean, VA locations are Metro accessible.  There is a free shuttle that runs between our McLean, VA office and the Springhill metro station on the silver line.  Please call one of our convenient offices to make an appointment or if you prefer, you can click Request an Appointment and we will respond within 24 hours.  Black & Kletz Allergy has been providing excellent allergy and asthma care to the general population of the greater DC area for more than 50 years in a caring and professional setting.

From Allergy Doctors Vienna VA Patients Trust Now that the weather in Tysons Corner, VA, Gainesville, VA, and Falls Church, VA and the rest of the Washington, DC metropolitan area has warmed up, as it is now Summer, the risk of an insect sting has increased.  The most common stinging insects in the Washington, DC metro area are honey bees, yellow jackets, white-faced hornets, yellow-faced hornets, and wasps.  They all introduce their venom into their subjects when they sting their prey.  In some cases, people have toxic (i.e., non-allergic) reactions to the insect stings, particularly if stung by several insects at the same time.  The body, in this case, generally reacts to the venom as if it was a poison.  This can occur because the victim is exposed to an over-abundance of venom at one time.  A toxic reaction can cause symptoms similar to those of an allergic reaction, but also may include symptoms such as nausea, fever, and seizures.  This can be life-threatening and depends on the amount of venom injected into the individual.  On the other hand, about 3% of individuals experience true allergic reactions, which is usually not dependent on the amount of venom, but to the allergic response to the venom by the individual.  These allergic reactions can also be life-threatening.

When stung, most individuals have no reaction or a small local reaction.  People with this type of response are at no increased risk for a systemic (anaphylactic) reaction than that of the general population.  Other people will develop a large local reaction, where the area that was stung gets red and very swollen.  This large local reaction can reach the size of a baseball in some cases.  Still, however, there is no increased risk in these individuals of a systemic or anaphylactic reaction from the insect sting.  On the other hand, a small percentage of individuals will develop a systemic reaction to an insect sting which may include some or all of the following:  generalized itching (i.e., pruritus), hives (i.e., urticaria), swelling (i.e., angioedema) of another area of the body where the sting did not take place, abdominal cramping and pain, wheezing, shortness of breath, chest tightness, coughing, feeling faint, and drop in blood pressure.

If a person has had a large local reaction or a systemic reaction to an insect sting, they should definitely seek a consultation with a board certified allergist like the allergy specialists of Black & Kletz Allergy.  The allergists that Tysons Corner, VA, Falls Church, VA, Gainesville, VA, and Washington, DC residents have trusted for years have had over 50 years’ experience diagnosing and treating insect sting allergies.  A comprehensive history and physical examination is taken and then a decision is made whether to test that individual for allergies to honey bees, yellow jackets, white-faced hornets, yellow-faced hornets, and wasps.  Allergy testing can be done via blood or by skin tests.  The allergist will then decide the preferred method of testing for each specific individual, depending on the history of the reaction that is ascertained at the visit.

Measures in order to help prevent insect stings are discussed with patients, as well as what things should be done, if a future sting occurs.  For example, if stung by a honey bee, a stinger is left in the skin of the victim.  One should never pull out the stinger, as this actually increases the amount of venom that is introduced into the individual by causing contractions of the venom sac which is hidden under the skin of the person.  Instead, one should scrape off the stinger with a finger nail, credit card, etc. in order to prevent the introduction of more venom into the body of the individual.

If a patient has a positive allergy test to any of the stinging insect venoms, it is imperative that he/she go on a course of venom allergy immunotherapy (i.e., allergy shots, allergy injections, allergy desensitization) as it is extremely successful in preventing further anaphylactic reactions from insect stings.  The procedure entails giving progressively larger doses and volumes of insect venom to the individual weekly over a period of 10 weeks, then every 2 weeks for 1 dose, then every 3 weeks for 1 dose, then a maintenance dose every 4 weeks for 1 year, and then the maintenance dose can be decreased to every 6 weeks for several years.  The maintenance dose is roughly equivalent to the amount of venom in an actual sting.  Therefore, if someone gets stung while they are on a maintenance dose of venom immunotherapy, they are essentially getting the same dose of venom as they normally get every 6 weeks.  For this reason, they usually do not have a systemic reaction to the stinging insect, because they are protected due to the allergy shots.

All patients with allergic reactions to stinging insects are prescribed a self-injectable epinephrine device (e.g., EpiPen, Auvi-Q, Adrenaclick).  At Black & Kletz Allergy, individuals are taught the correct method on how to use, when to use, and what to do, after using these devices.  We have training devices that we use to show patients the proper way to use them.  As a general rule, if someone is stung by a stinging insect and experiences any systemic sign or symptom, they should use the self-injectable epinephrine device and go immediately to the closest emergency room.

Reach Out To The Allergy Doctors Vienna VA Patients Call For Relief Insect sting allergies in cities such as Tysons Corner, VA, Falls Church, VA, and Gainesville, VA as well as others in the Washington, DC, Northern Virginia, and Maryland metropolitan area are not uncommon.  During the Summer and early Fall, there are more insect stings taking place and it is very important to take precautions to reduce the likelihood of getting stung.  The allergy doctors of Black & Kletz Allergy see both adults and children with insect sting allergies, in addition to other allergic disorders such as allergic rhinitis (i.e., hay fever), asthma, hives, swelling episodes, eczema, sinus disease, food allergies, medication allergies, and immune disorders.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA, all of which offer on-site parking.  The Washington, DC and McLean offices are Metro accessible and the McLean office offers a free shuttle that runs between the office and the Spring Hill metro station on the silver line.  Please call one of our offices to make an appointment or you can click Request an Appointment and we will respond to you within 24 hours by the next business day. Black & Kletz Allergy takes pride in providing excellent quality allergy, asthma, and immunology care to the Washington, DC metro area community in a friendly, convenient, and professional setting.

Explained By Allergists McLean VA Patients Trust There has been an increase in the incidence of allergic diseases over the past 20-30 years and this phenomenon is more pronounced in industrialized countries compared to developing countries.  Many researchers believe that environmental and dietary changes play major roles in the development of allergies.  This is true in areas such as Falls Church, VA, Gainesville, VA, and Tysons Corner, VA as well as the rest of the Washington, DC metro area.

The primary role of our immune system is to defend and protect us from infections caused by germs like viruses, bacteria, and parasites.  Exposure of the immune system to infections with germs in early life stimulates the maturation of the immune system in a normal balanced way.  The absence of this stimulation can trigger the immune system to mistake innocuous substances such as dust mites, molds, pollens, and certain foods as potentially harmful and mount a defensive attack on them causing allergic disease.  This “hygiene hypothesis” aims to explain why more people suffer from allergic disorders in the developed, overly hygienic Western world.  An alternative interpretation of the evidence supporting the hygiene hypothesis forms the basis for the “microflora hypothesis,” which says that rather than specifically limiting infection, even the decreased exposure to microbes changes the colonization of bacteria of the infant gut, which has a negative effect in the development of the normal immune system which ultimately leads to allergic disease.

An adult human harbors about 100 billion bacteria in the intestines alone.  These gut bacteria account for 90% of the cells in the human body!  Human cells contain about 21,000 different genes, but the microbes living in the human comprise about 3 million genes.  The composition and function of the bacteria in the gut varies from person to person (i.e., biodiversity) and evolve during the first years of life and stabilize within the first 3 years of life.

The development of the gut microbiome (i.e., all the microorganisms that live in the gut) is influenced by interactions between diet, environment, and host-associated factors.  There is increasing evidence that these bacteria play many helpful roles in the modulation of our immune responses, especially in maintaining a balance between 2 different types of white blood cells called Th1 lymphocytes and Th2 lymphocytes.  The Th1 lymphocytes help protect us from infections, whereas the Th2 lymphocytes help mediate allergic disease.

The emerging hypothesis infers that environment or lifestyle-driven aberrancies in the early-life gut microbial composition and function represent a key mediator of childhood allergies and asthma.  Significant perturbations in the gut bacterial composition, especially reduced diversity, in the Western societies due to frequent antibiotic usage, environmental and lifestyle changes, etc. have disrupted the mechanisms of mucosal tolerance leading to more allergic disease.

Epidemiologic and clinical data supporting this interpretation include:

A recent meta-analysis of 25 studies revealed that the administration of probiotics reduces allergy-causing IgE antibody levels and the risk of atopic sensitization.  An example of dietary factors influencing allergies is the landmark LEAP study which demonstrated that early introduction of peanut products to high risk infants significantly decreased the subsequent development of peanut allergy.

There are a number of ongoing studies which will improve our understanding of the mechanisms underlying allergic disorders and hopefully offer new and exciting options in the management of these conditions in near future.

The board certified allergists of Black & Kletz Allergy always strive to keep abreast of new developments in the field of Allergy, Asthma, and Immunology in order to offer new and emerging diagnostic and therapeutic modalities, as soon as they are available.  Black & Kletz Allergy has 3 offices in the Washington, DC, Northern Virginia, and Maryland metropolitan area.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA and offer on-site parking at each location.  In addition, the Washington, DC and McLean offices are Metro accessible.  There is a free shuttle that runs between the McLean office and the Spring Hill metro station on the silver line.  The allergy specialists of Black & Kletz Allergy see both adults and children in the Tysons Corner, VA, Falls Church, VA, and Gainesville, VA areas and we have been serving the greater Washington metro area for over 50 years.  Please call one of our convenient offices to make an appointment or alternatively, you can click Request an Appointment and we will reply within 24 hours by the next business day.