Now that spring seems to have sprung, it is time to talk allergy. After such a long difficult sick winter allergy seems like a breeze but can be serious. Allergies affect 1 in 5 children, accounting for four million sick days and over eight billion in medical costs in the United States annually. This time of year is difficult for me as I must try and determine what is viral illness and what is allergy. One easy mechanism is that allergy does not cause fever. Fever especially at the onset of symptoms is always infectious. Now some bad asthmatics may develop fever later in the illness due to bacterial secondary infection or lung collapse (atelectasis), but allergy does not directly cause fever. I recommend Zyrtec/Claritin/Allegra for first line treatment of suspected allergy. The dose can be very due to weight, but I recommend 1.25ml for infants 6 months to 1 year, 2.5ml for toddlers 1 year to 2 years, 3.75ml for kids 3 year to 4 years and 5ml for those five and up. By age 10-12 you can increase to 10ml or 10mg tablets. Inhaled nasal steroids are extremely helpful for treatment of allergy but can take 2-4 days to work and need to be given daily or twice daily, throughout the season. Allergic eye drops can be helpful for ocular symptoms. I recommend Pataday one drop to both eyes daily, over the counter. Asthmatics can exacerbate and need steroids, make an appointment if you are needing your inhaler more than three times a day or more than 3 days in a row. Hopefully, this brief advice will help navigate the season until summer comes.
