Winter 2012-13
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Ask the Expert: Kids & Cedar Fever



What do you recommend for kids with Cedar Fever or other allergies?


By Poojay Varshney, MD, Pediatric Allergy, Asthma, and Immunology, 'Specially for Children and Dell Children's Medical Center

While people in many other parts of the country enjoy a respite from outdoor allergies, many Central Texans prepare to battle "Cedar Fever," a term used to describe the allergy symptoms caused by Juniperus ashei.

This evergreen shrub, more commonly known as Mountain Cedar, releases pollen from December to February. In susceptible (allergic) individuals, exposure to Mountain Cedar pollen can trigger eye, nose and lung symptoms. Eye symptoms include eye itching, redness and watery drainage. Nasal congestion, clear runny nose, sneezing, post-nasal drip, itchy throat and cough can cause significant impairment. Individuals with asthma may experience increased cough, wheeze, chest tightness or shortness of breath. However, despite its name, Cedar Fever does not cause fever.

Kids with Mountain Cedar allergy can experience other symptoms such as ear pain or discomfort, sleep disturbance and headache. Due to the way allergy develops, it generally takes several seasons of exposure to become sensitized to a particular allergen. Therefore, infants and young toddlers are unlikely to experience Mountain Cedar allergy. Similarly, individuals who recently moved to the area may initially escape the suffering.

Appropriate diagnosis is the first step. It is important to keep in mind that there are innumerable respiratory viruses (e.g., colds) that circulate during this time of year and that children are susceptible to these infections due to increased exposure and immature immune systems. Many of the symptoms of viral respiratory infections overlap with those of pollen allergy; fever, however, suggests infection.

If you have questions about your child's symptoms, ask your child's doctor or seek the input of a board-certified allergist. Based on your child's symptoms, an allergist may recommend aeroallergen skin testing, which is the preferred method to evaluate environmental allergy.

Once allergy has been established as the cause of symptoms, avoidance is key. Keeping windows closed at home and in the car is important, especially at nighttime, when trees release their pollen. Rinsing off after spending time outdoors might also help. Those with severe symptoms should limit time outdoors. Many allergy sufferers benefit from a nasal saline wash or Neti Pot to cleanse the nasal and sinus passages and flush out pollen and other airway irritants. Artificial tears can soothe eyes and remove pollen from the eye surface.

Medications proven to be effective for eye and nasal allergy include anti-histamines (oral formulations, nasal sprays and eye drops), intranasal steroids and allergy shots. Asthma treatment is individualized according to symptoms. Many forms of treatment are best started prior to the start of allergy season. Discuss with your doctor the best treatment plan for your child's allergy symptoms. Your doctor may recommend evaluation by an allergist to consider allergy shots, which can provide long-term relief by changing the body's response to allergens.

Ask the Expert: Kids & Cedar Fever

Good Health for Kids is produced by Dell Children's Medical Center of Central Texas.