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.