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The Allergist
A newsletter from the Oklahoma Allergy & Asthma Clinic Fall 2021
Ragweed Pollen Allergy Strikes Start of Flu Season
Amid Rising Covid-19
in Late Summer, Fall Cases Causing Concern
Just when you thought summer al- of a “Twindemic”
lergies were, hopefully, beginning to
wane, a weed that LOVES to grow in
Oklahoma starts showing up in our
counts. With 17 species of ragweed
in the U.S., this pollen usually starts
reaching peak levels near the end of
August through October. Ragweed
pollen can cause seasonal allergic
rhinitis – commonly known as hay
fever – which affects as many as 23
million people. weeks before the beginning of rag-
Ragweed allergy symptoms include weed season.
sneezing, runny nose, nasal conges- Laura Chong, M.D.
To avoid pollen, know which pollens
tion, headaches, irritated eyes and you are sensitive to and then check Last year ended up being the mildest
itchy throat. Ragweed pollen can pollen counts. In spring and summer, influenza season on record. Howev-
also aggravate asthma symptoms, during tree and grass pollen season, er, health experts are warning about
leading to increased coughing and levels are highest in the evening. In a possible ‘twindemic’ where flu and
wheezing. late summer and early fall, during COVID-19 cases rise and overwhelm
How can you avoid exposure to ragweed pollen season, levels are hospitals, may be possible this fall.
ragweed pollen? Avoidance is the highest in the morning. “We urge everyone to get their year-
easiest way but not so easy for those Keep your windows closed at all ly flu shot and a COVID-19 vaccina-
who like to spend time outdoors or times, both at home and in the car. tion,” said OAAC Allergist Dr. Laura
work outside. Chong.
Remember that pollen can be
Medication options include oral tracked into your home via your As students return to in person learn-
antihistamines, intranasal antihis- clothes, your hair or your pet — so ing and mask and social distancing
tamines, or nasal corticosteroids. change your clothes after being out- rules have been relaxed, disease ex-
Other options available are over- side for long periods of time, shower perts from Johns Hopkins and the
the-counter supplements that con- before going to bed and wash your CDC are concerned about the rise in
tain antihistamine properties. hands after petting an animal that flu and COVID-19 patients.
Immunotherapy (allergy shots) is has been outside. In one week in August, the U.S. re-
another option. Traditional immu- Oral Allergy Syndrome ported more than 1.05 million cases
notherapy desensitizes patients to of COVID-19 – amounting to 104
Sometimes when people suffering
ragweed allergens and so they can cases every minute, according to
from hay fever eat raw fruits, vegeta-
be exposed to it without symptoms John Hopkins data. Nationwide, ICU
bles or certain tree nuts, they devel-
and can live a normal life. An FDA- beds are filling and threatening hos-
op an itchy mouth, a scratchy throat
approved tablet known as Ragwitk pital capacities.
or swelling in their lips, mouth,
is also available that dissolves under
tongue or throat. This can be a sign
the tongue and desensitize ragweed
allergens. Pills must be started 12 (continued on page 6) (continued on page 6)
Yummy yet Nutritious Lunches for Food Allergic Children
Let’s be honest – packing school
lunches every day can be hard. As a
parent of a kid with food allergies, Using cookie cutters to
you want it to be: cut shapes is another
• Nutritious way to make lunch
more fun.
• Tasty
• Portable
• Kid-friendly
• Free of your child’s food aller-
gens
But these types of lunches take time
to prepare. Busy days make it easy
to fall into a rut where you find your-
self sending the same lunch with
your child every day. to using pepitas (pumpkin seeds), into fun shapes. Fill them with your
Kids With Food Allergies (KFA) is parsley or sorrel leaves, basil, garlic, child’s favorite taco fillings, such as
here to help make packing lunches olive or grapeseed oil, lemon juice, refried beans, taco meat, chorizo,
a little easier with some creative tips and nutritional yeast (optional). and regular or milk-free cheese. Or
and recipes from our staff and food Sundried tomato spread – There are make pizza-dillas filled with pizza
allergy community members. Check a lot of different ways to use sun- toppings like sausage, pepperoni,
out these allergy-friendly lunch box dried tomatoes. You can do a “tap- pizza sauce, and regular or milk-free
hacks! enade” or even mix it with a safe cheese. Use cookie cutters to cut
cream cheese. them into fun shapes. Add toppings
Sandwiches and Wraps like olives, bell peppers, mushrooms,
Let’s start with sandwiches – the go- “Cream cheese” and jam sand- and more to add faces or decoration
to for kids’ lunches. They are simple wiches – If your child has a milk al- to cutouts.
and customizable. If you’re look- lergy, pair a safe jam with a milk-free
“cream cheese.” But don’t stop there. Cut fruit slices,
ing for some ideas outside of lunch pancakes, flatbreads, homemade
meat or nut- or seed-free butters, You can turn just about any sand- brownies, and Rice-Only Crispy Ce-
try these sandwich spreads free of wich into a wrap by using a safe tor- real Treats into fun shapes.
milk, soy, egg, gluten, peanut, tree tilla or flatbread. To add some fun,
nuts, and sesame from Melanie send salsa, guacamole, or a home- Bento Boxes
Carver, chief mission officer of the made sauce with it for dipping. Nothing gives you endless options
Asthma and Allergy Foundation of Crazy Cutouts like a bento box. A bento box is a
America (AAFA): type of lunch box that holds a single-
Since we’re talking about sand- serving meal. They are a great way
Chickpea-free and sesame-free wiches, let’s talk about presenta-
hummus – Use great Northern white to give your child a varied, nutritious
tion. Sometimes adding a little fun lunch.
beans instead and blend with lemon is enough to make a common lunch
juice, olive oil, garlic, and salt. more entertaining for little ones. You can buy bento boxes that come
Olive tapenade – Blend up olives, ca- Use cookie cutters to turn any lunch with separate food compartments.
pers, olive oil, and add herbs and/or into a themed lunch. You can cut If you don’t have a bento-style box,
garlic as well. sandwiches into shapes to go along you can make your own with a large,
with holidays, seasons, or your kid’s reusable food container. Use cup-
Artichoke tapenade – Blend ar- cake liners or smaller food contain-
tichoke hearts with lemon juice, favorite animals.
ers to hold individual food items.
herbs, and olive oil. Quesadillas are also a versatile op-
tion that can be customized accord- The internet is full of bento box ideas
Pesto – You can make your own pes-
ing to your child’s allergies and cut (continued on page 4)
2
Well-Controlled Asthma Patients See Less Severe COVID-19
Outcomes than those with Uncontrolled Asthma in New Study
New research published in The Jour- group. Patients in the inactive asth-
nal of Allergy and Clinical Immunol- ma group saw no increased risk for
ogy in Practice (JACI: In Practice), any of the four COVID-19 outcomes.
the official journal of the American According to the study author, Anny
Academy of Allergy, Asthma & Im- Xiang, PhD, the study found that
munology, found that those with even in patients with active asth-
asthma who needed clinical care for ma – if using asthma medications
their asthma within 12 months prior – their odds of worsened COVID-19
to their COVID-19 diagnosis had an outcomes decreased, which dem-
increased risk for severe COVID-19 onstrates just how important these
outcomes. The study results rein- medications are.
forced how important it was for any-
one with asthma to work with their ers separated more data with the Patients in the active asthma group
healthcare provider to ensure their active group accounting for any who were using asthma medica-
asthma is well controlled, especially patients who had a clinical visit for tions were more than 25 percent
during the ongoing pandemic. asthma in the last 12 months and an less likely to have several COVID-19
inactive group accounting for those outcomes compared with those
Researchers collected data on COV- not taking asthma medications. The
ID-19 patients using electronic med- who had not.
odds for hospitalization were still
ical records from Kaiser Permanente The studied group consisted of higher for those with IRS and ICU
Southern California from March 2,751 in the inactive asthma group admission than those in the inac-
1-Aug. 31, 2020. Medical codes and 2,775 in the active asthma tive group. The study demonstrated
were used to see if these patients group. Additionally, 820 patients how important asthma medications
had asthma or chronic obstructive had a history of COPD. Those with are for improving asthma control
pulmonary disease (COPD) prior to active asthma had higher odds of and therefore COVID-19 outcomes.
their COVID-19 diagnosis. Research- being hospitalized, a need for inten- Future research is needed to take a
sive respiratory support (IRS) and closer look at asthma care, including
“The Allergist” is published quarterly by the
Oklahoma Allergy & Asthma Clinic. Contents
ICU admission within 30 days of CO- medications and how those factors
are not intended to provide personal medical VID-19 diagnosis compared to those impact COVID-19 severity.
advice, which should be obtained directly from with no history of asthma or COPD.
a physician.
A history of COPD was associated Those with asthma should continue
“The Allergist” welcomes your letters, with a higher risk of hospitalization, to work with their healthcare pro-
comments or suggestions for future issues. IRS and mortality within 60 days vider to ensure they are getting the
Send to:
from COVID-19. Researchers didn’t best treatment for their asthma,
The Allergist
750 NE 13th Street see a higher likelihood of mortality which leads to better control and
Oklahoma City, OK 73104-5051
within 60 days for the active asthma decreases the likelihood of severe
Phone: 405-235-0040 COVID-19 outcomes.
www.oklahomaallergy.com
Oklahoma Allergy & Asthma Clinic
Editorial Advisory Board
Happy 30th
Dean A. Atkinson, M.D.
Laura K. Chong, M.D. OAAC Work
Scott B. Dennis, MHA
Maya N. Gharfeh, M.D.
Richard T. Hatch, M.D.
Anniversary
Bret R. Haymore, M.D.
Gregory M. Metz, M.D. to Dr. Patricia
Patricia I. Overhulser, M.D.
Shahan A. Stutes, M.D.
Karen L. Gregory, DNP
Overhulser!
Chelsea E. Robinson, APRN-CNP
Stefanie E. Rollins, APRN-CNP, AE-C
Elisa C. Thompson, APRN-CNP
3
FAQs about the Covid-19 Vaccine
Why should I receive a vaccine second dose of the Pfizer vaccine is severe allergic reaction) after getting
against COVID-19? administered 18-23 days after vacci- a COVID-19 vaccine. These are rare,
Protection. A COVID-19 vaccination nation. The Moderna vaccine is ad- occurring less than once for every
will help keep you from getting CO- ministered 28 days after the vaccina- 200,000 injections. Please visit with
VID-19 or keep you from becoming tion. The Johnson & Johnson vaccine your OAAC allergist before you get
seriously ill if you get it. Having ev- uses an adenoviral vector that can’t the vaccine if you have a history of
eryone getting the COVID-19 vacci- replicate and contains DNA for the anaphylaxis or have any concerns
nation is the pathway towards stop- spike protein. The muscles cells pro- about receiving the vaccine.
ping the pandemic. For most people, duce the spike protein which stimu- Should I take my allergy and asthma
the benefits far outweigh the risks. lates the immune system to make medicine the same day as I receive
protective antibodies. The vaccine my COVID vaccine?
Can I get the COVID-19 vaccine? only requires a single dose.
Currently the only contraindication Yes, take your routine medicines on
What if I don’t get the second vac- the same day as getting the vaccine.
(medical issue) is a history of a se- cination within the window of time
vere allergic reaction to any of the Questions? Visit with your physician.
that is recommended?
vaccine components, including a If I have a food allergy or a stinging
sensitivity to PEG (polyethylene gly- According to the CDC, the second insect or allergy injected caused a
col) and/or polysorbate, which cross dose should be administered as reaction, should I be vaccinated?
reacts with PEG. Children under age close to the recommended interval
as possible. However, if not possi- Allergic reactions to foods, medi-
12 are not currently approved yet cines, or bee stings are not reason
for the COVID-19 vaccines. Safety ble, the second dose of the Pfizer or
Moderna vaccines can be scheduled to avoid the vaccine. If you have a
and efficacy studies in children and history of anaphylaxis, it is recom-
adolescents are underway. for up to 6 weeks or 42 days after
the first dose. mended your vaccination take place
Is the COVID-19 vaccine safe? in a facility that can treat allergic re-
Do both doses need to be the same? actions and that you are observed
More than 110,000 people partici-
pated in U.S. clinical trials prior to the Yes, if possible. The CDC says every for 30 minutes after receiving the
approval of the current COVID-19 effort should be made to determine vaccine.
vaccines. More than 434 million which vaccine product was received Should I still get a seasonal influen-
people have received the COVID-19 as the first dose. In exceptional situ- za vaccine annually?
vaccine and more than 172 million ations in which the Pfizer is not avail-
able, any available Moderna vaccine Yes, it is very important to get the
have received both doses. Safety has influenza vaccine since flu can cause
been demonstrated across a broad may be administered at a minimum
of 28 days. symptoms similar to COVID. Reduc-
range of the population across dif- ing the number of people who get
ferent ages, races and those with When can I get a COVID-19 vaccine severe influenza and require hospi-
different medical conditions. booster? talization will also help ensure the
Is the vaccine free and where can I Currently, immunocompromised pa- health care system, hospitals and
get it? tients are eligible for a booster. It is intensive care units will not be over-
There is no cost to get the vaccine recommended 8 months after the whelmed should the number of CO-
and many options are available at 2nd dose of Pfizer or Moderna vac- VID cases increase during flu season.
local hospitals, pharmacies and the cine. People who have received the The CDC says now that COVID-19
Oklahoma County Health Depart- Johnson and Johnson vaccine likely vaccines and other vaccines can be
ment. need a booster, but the CDC does administered without regard to tim-
not have specific recommendations ing.
The Pfizer and Moderna vaccines are
very similar and are equally safe and What about an allergic reaction to For the compete article - https://
effective. They have both met the the vaccine? acaai.org/news/frequently-asked-
rigorous safety standards set by the There have been reports of a few patient-questions-about-covid-19-
FDA. The only difference is that the patients experiencing anaphylaxis (a vaccine
4
School Lunchbox Ideas...
(continued from page 2)
to inspire you. AAFA Content Man-
ager and Editor, Tanya Bumgardner,
recommends keeping it simple by
giving a purpose to each section in
the box.
“I like to have one section for the
main protein or entrée, one for a
vegetable, one for a fruit, one for a
carb, and one for a dip,” Tanya says.
It takes away the guesswork by mak-
you heat up the food. Then empty Use small food containers from the
ing it easy for me to choose one item
the food jar and fill. camping department to hold sea-
in each category each day.”
Allergy-Friendly Foods and Recipes sonings and spices. Kathy notes that
Lunchables® are similar to bento putting salt on vegetables ahead of
boxes and a popular lunch for many When you’re planning lunches, time draws out the water and can
kids. Create homemade versions by check out KFA’s Allergy-Friendly make them soggy come lunchtime.
putting safe crackers, lunch meats, Food Finds for lunch foods you can
buy. You can search for foods free Try breakfast for lunch. For a change,
regular or milk-free cheese, and
from the allergens you are avoiding. send breakfast foods for lunch.
cookies into bento box.
Our collection includes lunch-friend- Breakfast burritos, breakfast muf-
Hot Foods fins, and overnight oatmeal make
ly foods like granola and snack bars,
An insulated food jar, like a wide- protein bites, chips, trail mix, torti- easy lunches you can customize ac-
mouth Thermos, can be used for llas, cookies, and more. cording to your child’s allergens.
much more than soup. Pack it with Involve your child. If your child is
You can also find almost 1,500 reci-
preheated leftovers, such as last old enough to help pack their lunch-
pes in our Safe Eats® Allergy-Friendly
night’s stew, chili, or leftover pasta es, have them help. Let them pick
Foods collection. It includes recipes
and sauce. cookie cutters and cut their own
submitted by our KFA community
Many of our community members members free of many of the most sandwiches the night before. Store
like to use a food jar to keep foods common allergens. You can search a variety of single-serving snacks in
like hot dogs, chicken nuggets, and for recipes based on the allergens the pantry or refrigerator and let
fish sticks warm. Heat them, and your child needs to avoid, or you can them choose their snack each day.
then wrap them in aluminum foil browse by category. Also ask your child if they have any
before placing in the food jar. creative ideas for making lunches
Other Lunch Prep Tips and Tricks fun. Kids can be so creative and may
Some of our members recommend
Plan lunches like you plan other have ideas you haven’t thought of.
filling it with jambalaya or Asian
meals. One community member Involving your child in the process
dishes. You could even try a layered
finds it easiest to “plan lunches the helps them learn beneficial self-
Chipotle-style burrito bowl.
same way I do dinner – protein, management skills.
Kathy Przywara, AAFA’s Senior Com- carb, fruit/veggie, nutritious drink,
munity Director, recommends that KFA is the food allergy division of
and maybe a dessert or chips as a AAFA
you get a quality food jar that will be treat.”
sure to hold heat well so your child’s Looking for more school lunch
Consider your child’s preferences, ideas? Join their online community
food doesn’t dip into an unsafe tem-
lunch time, and eating style. For ex- where you can share tips and tricks
perature range before lunchtime.
ample, a “build your own” pizza or with other parents of kids with food
Be sure to preheat your food jar be- taco lunch may seem fun, but your
fore you put food in it. It will help allergies. You’ll also get educational
child’s eating time may be limited. information, food allergy news, and
the food stay warmer longer. Put hot They may not have time to both put
or boiling water in the food jar and food recalls. www.aafa.org
their lunch together and eat.
let it sit for about 10 minutes while
5
Ragweed Allergy...
(continued from page 1)
Twindemic... “We would like to strongly encour-
age the health measures from the
(continued on page 3) pandemic continue on this fall,” said
tongue or throat. This can be a sign Dr. Chong. “Wearing masks, washing
of oral allergy syndrome — when While flu cases have not quite your hands and staying home when
proteins in these raw foods are simi- shown up yet, doctors are seeing an feeling ill will help protect people
lar enough to pollen that they cause increase in respiratory viruses that from getting sick and possibly infect-
an allergic response by the immune indicate conditions may be ripe for ing those who are most vulnerable
system. Peeling, cooking or canning spreading fall and winter flu viruses. health wise.”
the fruit or vegetable may prevent Physicians are seeing a rise in Re-
symptoms for those with oral allergy spiratory syncytial virus (RSV) cases
syndrome. among children in Oklahoma which
Birch, grass and ragweed pollens are is also causing concern.
common triggers of oral allergy syn- RSV causes mild, cold-like symptoms
drome. primarily in children according to the Remember to Follow OAAC on
If you suspect you are allergic to rag- CDC. It is the most common cause of Facebook, Twitter & Instagram
weed, make an appointment to be pneumonia in children younger than In addition to posting pollen and mold
1 year old in the U.S. Some children counts each day, OAAC also uses social
tested. Your OAAC allergist can help
hospitalized with COVID also have media to post announcements or
you manage and treat your allergies
a co-infection of RSV. While RSV educational allergy news updates.
and come up with the best treat- Follow us on Facebook
ment that fits your needs and pref- doesn’t predict flu transmission in
at www.facebook.com/
erences. the fall and winter, children, who are
oklahomaallergyasthmaclinic/
efficient transmitters of the flu, are
Twitter @ okallergyasthma
interacting more in social settings. Instagram @
Immediate appointments oklahomaallergyasthmaclinic
are available!
Board Certified
Allergist Dr.
Maya Gharfeh
is now seeing
patients at our
Midwest City
and Norman
Clinics
Stefani Rollins,
APRN-CNP,
AE-C, is now
seeing patients
on Mondays,
Tuesdays and
Wednesdays in
Norman
Elisa Thompson,
APRN-CNP,
has added
every other
Wednesday
to her current
schedule in
Edmond
6
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