Other than the actual morbidity of the disease, respiratory viral infections increase a patient’s susceptibility to other respiratory conditions like nasal allergies and asthma. One of the ill-effects of the recent mini-pandemics of viral flu on patients of pollen allergy will be that they may suffer more severely from nasal allergies and asthma in the forthcoming pollen allergy season.

These views were expressed by Dr. M. Osman Yusuf, national coordinator of the Joint National Task Force on Asthma, and an advisor to WHO’s respiratory diseases programme, while talking to ‘The News’ here on Monday.

The last two years have witnessed the emergence of several new strains of influenza viruses. “Commonly called ‘flu’ viruses, these viruses are grossly misunderstood, not only by the general public but the medical community as well. The interchangeable use of the terms ‘flu’ and ‘rhinitis’ (‘nazla’ and ‘zukaam’ respectively, in Urdu) has compounded the difficulty in differentiating between these two conditions,” Dr. Osman pointed out.

According to the allergy specialist, influenza or ‘flu’ is the infection of the mucous membranes of the nose, caused by a particular type of influenza virus. “In the preceding three years, we have seen the expected mutations of influenza viruses to give rise to infections like SARS, Avian Flu, Swine Flu, and many other types of hitherto unlabelled influenza viruses. The recent mini-pandemics of influenza viruses which affected almost all parts of Pakistan, were seen in the later half of Ramazan 2010, and again in December 2010, and February 2011,” he recollected.

Unfortunately, most of our physicians, Dr. Osman said, are unaware that being a high endemic area, Pakistanis would need to receive influenza vaccination not once a year, but twice or in some cases, three times in the season. He disclosed that all countries from where a large number of people go to perform Haj and Umra can be considered high danger areas as far as communicable respiratory illnesses are concerned, and as long as Hajj falls in the winter season.

Unlike preceding years when influenza viruses simply caused a runny nose, sneezing, fever, and at the most, a bad sinus headache, the viruses seen this year (2010-11) are far more pathogenic, causing severe coughing, asthma attacks and chest pain. And this is sometimes accompanied by pain in the upper abdomen and stomach disorders, and occasionally intractable skin rashes. “Whether or not this is caused by the conventional Swine Flu virus or not can only be determined by a laboratory test, but whatever the cause, the Pakistani population is certainly far more resilient to the long-term effects of such infections than the more susceptible and sensitive Western societies, where such infections would have made headline news for weeks,” Dr. Osman noted. Indeed, even the dreaded Swine Flu has caused much less mortality in Pakistan than other similar virus infections. It may be recalled that clinical cases of what was discovered and labelled as Swine Flu by the United States in 2009 was already reported in these columns in November 2008.

Referring to the possibility of aggravation of asthma symptoms, Dr. Osman clarified that not all pollen grains cause allergy, and not all persons are affected. Only those who have inherited a tendency to develop allergies or who are exposed to large quantities of pollens or other allergens, are usually affected more.

Severe respiratory allergy to pollens of paper mulberry trees is a well-known and feared phenomenon for allergy sufferers in Islamabad. Other cities affected by this form of allergy are the Hayatabad area of Peshawar, Sialkot, Attock and certain areas near Haripur.

The common signs and symptoms suffered by patients of respiratory allergies, including pollen allergy, include sneezing, itching and watering from the nose and eyes, and occasionally on the skin, as well. If the allergy affects the lower respiratory tract, it causes constriction of the breathing passages, causing a whistling sound (wheezing) from the chest, with a feeling of tightness in the chest and difficulty in breathing. If this condition becomes severe, it can cause a full-fledged asthmatic attack, which may even be life-threatening.

In order to prevent an allergy attack from becoming worse, Dr. Osman advised, it is essential to commence treatment as soon as the season starts, without waiting for the symptoms to develop. Patients are advised to seek medical advice before they start suffering.

Daily pollen counts can be monitored on the Pakistan Meteorological Department’s website (www.pakmet.com.pk) and precautions for pollen allergy in Urdu and English can be read at (www.allergypakistan.com). The pollen counts of paper mulberry are expected to be rather unpredictable this year because of the changed patterns of rainfall.