Spring seems to be arriving earlier than ever this year, and — along with it — allergy season. As seasons change and rains bring budding trees, green lawns, and fields of flowers, millions of Americans are plagued with spring allergies. More than 35 million people in the United States suffer from allergic rhinitis — and some may be surprised to learn it’s possible to develop allergies later in life as well. It is estimated that the work missed due to allergies amounts to $250 million annually. So, what’s an allergy sufferer to do?

Seasonal allergies often come in three forms: eye allergies (conjunctivitis), skin reactions (dermatitis), and the most common – allergic rhinitis. More than 35 million people in the United States suffer from allergic rhinitis, and it is estimated that the work missed due to allergies amounts to $250 million annually.

Pollen triggers

The first pollen triggers tend to come from tree pollen, especially in the northern parts of the country. Grass pollen tends to fill the air in late spring. Mold allergens emerge after the first thaw through the first frost, and peak in the late-summer throughout much of the United States.

If you are unsure of your allergy triggers, you can visit your primary care doctor or an allergist to have a skin test.  An allergy skin test is the quickest, cheapest, and most accurate way to determine what allergies you have.

Once you know your triggers, it is important to check the local pollen counts and to stay ahead of the triggers.  If you decide to treat your allergies with medication, you should ideally start your over-the-counter allergy regimen 1-2 weeks before the pollen season begins.

Allergy treatment: avoid pollen

There are many ways to treat allergies. One of the best ways is to avoid the pollen.

• Keep windows and doors shut at home and in the car – pollen makes its way through screens and open spaces and into your carpeting, seats, and bedding.
• Avoid peak pollen periods – try to avoid early- to mid-morning outdoor activity when pollen counts are highest.
• Minimize pollen contact – if spending a lot of time outside, remove and wash clothes upon returning inside, try to rinse the pollen off your body with a shower, and even consider wearing a dust mask if spending a lot of time in a pollen-rich environment.
• Be careful with pets who go outside – don’t let pets who play outside spend time on your couches or beds, as they will bring pollen with them.
• Don’t hang laundry outside to dry – pollen will stick to clothes that have been hanging outside.

Hot, dry or windy days result in higher pollen counts and often spread the pollen beyond the source; rain helps lower pollen counts by washing it away.

Allergy treatment: medications

Seasonal allergies can also be treated with medications, usually OTC medications. The first step in treating allergic rhinitis is to use over-the-counter, non-sedating antihistamines each morning. If you are still congested, try using a saline nasal rinse or an oral decongestant (talk to your doctor if you have high blood pressure).  Saline nasal rinses, when used 1-3 times daily, help reduce congestion and sinus drainage.

If you are unable to find relief through these treatments, talk to your doctor about other options, including corticosteroid nose spray.

You can also treat many allergy-related problems with simple over-the-counter remedies such as lozenges for sore throats and antihistamine drops for itchy, watery eyes.

Talk to your doctor

If you continue to feel badly, are unsure of your symptoms, or have questions about seasonal allergies, talk with your doctor or care team.

Recent reports show that up to 30 percent of pregnant women who are infected with the H1N1 flu virus require hospitalization. And of the H1N1-related deaths reported in the United States, 6 percent of them – a disproportionately high percentage – are pregnant women. According to the U.S. Centers for Disease Control, “Getting a flu shot is the single best way to protect against the flu.” Yet many pregnant women are either hesitant to get a flu shot or have been unable to get vaccinated due to limited supplies.

The National Consumers League wants to make sure that expectant moms have the best information available, so they can make good decisions about protecting their health—and the health of their babies—and know where to go to get the care they need. The following is a fact-filled discussion featuring NCL executive director Sally Greenberg and, providing the answers, Dr. Annelise Swigert, a board certified Ob/Gyn and fellow of the American College of Obstetricians and Gynecologists.

Sally: What is H1N1 flu, also known as swine flu? And what is a flu vaccine?

Dr. Swigert: Every year, the public is faced with a seasonal flu which usually arrives in late fall. This year, the U.S. and many other parts of the world must deal with an additional flu called H1N1 or swine flu. H1N1 is a relatively new virus that was first detected in April 2009. It is contagious, spreading from person-to-person worldwide. Illness with H1N1 has ranged from mild to severe, including hospitalizations, and some deaths. Flu vaccines, given as a shot or inhaled through the nose, protect against contracting the disease.

Sally: Why is it important for women to be vaccinated for the H1N1 “swine flu”?

Dr. Swigert: H1N1 can cause serious complications during pregnancy. Pregnant women who are infected by H1N1 are more likely to end up in the hospital. A recent report showed up to 30 percent of pregnant women with H1N1 required hospitalization. Even if they are otherwise healthy, pregnant women who get the H1N1 virus can develop severe pneumonia and respiratory failure, deliver their babies early, or possibly miscarry. Of all the deaths related to H1N1, six percent have been in pregnant women, an unusually high percentage.

Getting the H1N1 vaccine while pregnant will continue to protect the baby after he or she is born. Studies on previous influenza vaccine use in pregnancy have shown more than a 60 percent decrease in serious illness in infants born to mothers who received the vaccine when they were pregnant.

Sally: Is the vaccine for the H1N1 flu safe for pregnant women and their babies?

Dr. Swigert: Yes, the H1N1 flu vaccine is safe for

pregnant women and their babies, and has been approved by the Food and Drug Administration. The H1N1 vaccine is the same as the seasonal flu vaccine with a slightly different strain of influenza. If H1N1 had been identified a few months sooner, it would have been the seasonal flu vaccine for 2009-2010. The seasonal flu vaccine has been safely given to pregnant women for more than 40 years. The vaccine can be given during any trimester of pregnancy and also postpartum, while breastfeeding.

As with all medication use in pregnancy, your doctor will review risk versus benefit. For most women, the benefit of getting the vaccine and preventing active infection from H1N1 far outweighs the extremely small risk of serious side effects.

Sally: Where can a pregnant woman get the vaccine?

Dr. Swigert: Pregnant women should start by contacting their Ob/Gyn or other primary health care provider if they don’t have access to an Ob/Gyn. The vaccine is available at many Ob/Gyn clinics, and those that don’t have it may be able to help their patients find it elsewhere. Community centers are now holding flu shot clinics for high-risk populations, such as pregnant women or those with certain chronic conditions, like asthma. Some employers will have the vaccine, especially those in health care fields. Always let the doctor or clinic know you are pregnant, as you’re in a high-risk group and should receive priority.

Sally: Is there any way the H1N1 vaccine could have been made more quickly?

Dr. Swigert: This year was particularly challenging because vaccine manufacturers needed to produce many millions of doses of both the seasonal flu vaccine and the H1N1 vaccine – simultaneously. As a result, production of the H1N1 vaccine is being completed in about half the time it usually takes. For the most part, pregnant women and other high-risk groups have been able to get vaccinated, and health officials believe enough vaccine will be available by the end of the year to safely vaccinate all those who wish to receive it.

In Europe, government regulators have approved the use of what are called “adjuvants,” additives that can be added to the vaccine supply to greatly increase its yield

or number of doses available. U.S. officials have not yet approved adjuvants, although many in the medical community believe they are a safe and effective way to expand the vaccine supply.

Sally: How is the vaccine delivered?

Dr. Swigert: The vaccine is available in two ways: an injection and an inhaled version. The injection contains a part of the virus that causes the immune system to make antibodies to protect the body from actual infection. The inhaled vaccine has the live virus that also causes the immune system to make antibodies. Both vaccines are safe and effective.

Pregnant women should receive the shot, and not the inhaled vaccine. Women who are postpartum or breastfeeding can receive either the shot or the inhaled vaccine. Only one injection is necessary to fully protect pregnant women from infection with H1N1.

Sally: Are there side effects?

Dr. Swigert: Some women have mild side effects such as soreness at the injection site or mild headache or body aches 2-3 days after the shot. These are not signs of infection or an allergic reaction, but signs that the immune system is responding as it should to the vaccine.

Women who have an allergy to eggs could have an allergic reaction to the shot and should not receive the vaccine. Serious reac­tions to the vaccine are very rare and occur in only one in every million women.

Sally: Have any unborn babies been harmed by the vaccine?

Dr. Swigert: The only danger to unborn babies is if their mothers get sick with the H1N1 virus. The vaccine is not dangerous, but getting the H1N1 virus is. Studies of pregnant women and their children who received the seasonal flu shot have shown no bad outcomes.

Sally: Will pregnant women who don’t get the vaccine risk getting sick?

Dr. Swigert: Pregnant women who do not get vaccinated risk becoming acutely ill with the H1N1 virus. Many of these women will have mild to moderate illness, but they risk possible complications such as pneumonia and respi­ratory failure. These complications cannot be predicted or prevented, even once the illness is diagnosed. Risks to unborn babies can include premature delivery and respiratory distress.

Sally: Does the H1N1 flu vaccine contain any additives that could interfere with a child’s development?

Dr. Swigert: Thimerosal, a preservative, is used in flu vaccines, including the H1N1 vaccine. Although thimerosal has never been scientifically proven to be harmful to children or pregnant women, due to public perception, vaccine manufacturers have produced preservative-free, single-dose syringes for use in pregnant women. These vaccines are more costly and time con­suming to produce than vaccines with thimerosal, and may not be available in all communities. Your clinic will be able to give you information on the vaccines they have available.

Also remember that because thimerosal has never been scientifically proven to be harmful to pregnant women or the fetus, injections using this preservative should be safe for use in pregnant women.

Sally: My friend gave birth a month ago. Should she get the vaccine now?

Dr. Swigert: Yes. Infants under 6 months of age are at extremely high-risk for complications from H1N1. By getting vaccinated not only will you decrease the risk of getting sick and giving it to your baby, but if you are breastfeeding, the baby will get protection from the illness through antibodies in the breast milk.

Sally: Is the vaccine safe for women who are breastfeeding?

Dr. Swigert: Yes. It is safe to receive either the shot or the inhaled vaccine while breastfeeding.

Sally: What if your family already had the flu this fall? Should expectant mothers still need to get vaccinated?

Dr. Swigert: Yes. Even if members of your family or you have had an influenza-like illness, it is still impor­tant to get vaccinated to protect you and your baby.

Sally: How can we avoid getting the flu?

Dr. Swigert: The best way to prevent the flu is to be vaccinated. Like many viruses, it is transmitted from person to person most commonly through coughing or sneezing. Other important ways to reduce the risk include: washing your hands often and thoroughly with soap, using alcohol-based hand sanitizers, and not touching your nose, eyes, and mouth.

Sally: What are the symptoms of the H1N1 flu?

Dr. Swigert: The two main symptoms of H1N1 are a fever of 100 degrees or higher, and cough and/or sore throat. Other symptoms may include headache, body aches, chills, runny nose, fatigue, diarrhea, and vomiting. Pregnant women should contact their doctor or clinic immediately if they experience any of these symptoms, as they will need to start anti-viral medication.

Sally: What should a pregnant woman do if she thinks she has H1N1? Should she take an anti-viral medication?

Dr. Swigert: H1N1 can be dangerous for a pregnant woman and her baby. Contact your doctor or clinic immediately if you have any symptoms. Treat any initial fever with acetaminophen (Tylenol), which is safe in pregnancy. Anti-viral prescription medications, such as Tamiflu, are recommended for pregnant women and safe to use.

Medication should be started within 48 hours of the onset of symptoms. Confirmation that the illness is the H1N1 virus is not necessary to begin treatment. A pregnant woman should follow her physician’s instruc­tions and should not delay seeking treatment under any circumstances.

Emergency care is necessary if a pregnant woman experiences difficulty breathing, chest pain or pressure, vomiting, dehydration, dizziness, confusion or loss of alertness. It is also important to contact your doctor if your symptoms have improved and then get worse again.

Sally: If a pregnant woman’s child or family member becomes sick with H1N1, should she avoid contact with the sick family member?

Dr. Swigert: If a family member becomes sick, a pregnant woman should contact her doctor immediately to be treated with anti-viral medication. In addition, families should have a plan to care for each other that protects pregnant mothers from the risk of infection. If others aren’t available to help care for a sick child, pregnant mothers should try to limit exposure by washing their hands often, throwing away dirty tissues, and avoiding touching their nose, mouth, or eyes as much as possible. Pregnant mothers may also wear surgical-quality face­masks if they must care for sick family members.

Sally: If a pregnant woman gets the H1N1 flu vaccine, does she need to get the seasonal flu vaccine too?

Dr. Swigert: Yes. The H1N1 flu vaccine will not protect against the seasonal flu. The seasonal flu is also a threat to a pregnant woman’s health – and the health of her baby. The seasonal flu should be treated with the same caution, care, and preventative measures as H1N1 flu.

According to the Centers for Disease Control and Prevention, an estimated 66 percent of U.S. adults are overweight (33 percent) or obese (33 percent) but, according to a new National Consumers League study conducted by Harris Interactive®, only 12 percent of U.S. adults say they have ever been told by a doctor, nurse, or other health care professional that they are obese. 

Following the recent announcement by RAND Corporation, which notes that the prevalence of American adults who are classified with severe or morbid obesity is increasing at a much faster rate than the prevalence of moderate obesity, the National Consumers League today is releasing troubling new survey data about consumers’ misconceptions about their weight and knowledge of weight-loss options. NCL is also announcing new Web resources for consumers who may need to lose weight but don’t know where to begin the daunting process.The survey of 1,978 adult Americans, was conducted online by Harris Interactive from March 6th to 12th, 2007. NCL has launched a new consumer education campaign, “Choose to Lose”. The new materials available at www.nclnet.org/obesity aim to help consumers overcome the overwhelming task of honestly evaluating their individual weight and work with their doctor to do something about it.

‘Obesity’: Not Admitted by Most

NCL’s new survey found a startling disconnect between the way people perceive their weight, and their actual weight category based on the body mass index (BMI), the most common measurement for obesity. U.S. adults were much more likely to refer to themselves as “overweight” rather than “obese”, and consistently identified themselves as being in less severely overweight groups.  In fact, 52 percent of respondents referred to themselves as overweight, and only 12 percent as obese, severely obese, or morbidly obese. But, based on actual BMI calculations using self-reported height and weight information, among the 96 percent of respondents who reported height and weight, 35 percent are actually “overweight,” whereas 34 percent are actually obese, severely obese, or morbidly obese. Among respondents who are obese according to BMI, 82 percent consider themselves to be simply “overweight.” Alarmingly, only a minority of all respondents (20 percent) claimed to know their BMI number.

“This discrepancy between perceived and actual weight categories suggests that the stigma associated with being obese is a powerful one; many consumers would benefit from a more realistic picture of their own weight,” said NCL President Linda Golodner. “We wanted to find out how consumers feel about their weight, their health, their need to lose pounds, and the stigma surrounding treatment options. We found that while many consumers view obesity as a legitimate disease, they don’t want to identify themselves as ‘obese.’ Weight is a highly personalized, complicated issue, and many overweight and obese consumers are in need of help.”

Perceptions about Obesity: Real Disease, Real Treatment, Real Stigma

Despite the commonly held view that obesity is a serious disease, significant levels of cultural bias persist. Most respondents (78 percent) say that obesity is a serious, chronic disease and that it requires medical treatment (54 percent). Most U.S. adults (61 percent) report, however, that obesity is considered taboo in society today, and half (50 percent) attribute the condition to a “lack of will power.” More than a third of U.S. adults (37 percent) agree that obese people should pay more for health insurance, and more than a quarter (27 percent) say that it is still acceptable to make fun of obesity. And, although many U.S. adults were accepting of many different types of treatment (more below), ranging from diet and exercise to acupuncture, there are still some negatives associated with certain options. For example, although 79 percent of respondents say weight-loss surgery can be a life-saving treatment, half (49 percent) agree that there is a stigma associated with using surgery as a weight-loss option. Moreover, forty-seven percent held a very negative or somewhat negative view of weight-loss surgery.

“There is a serious disconnect between an individual’s perception of both what it means to be overweight and the health risks of carrying extra pounds. While many consumers know that weight loss can improve the illnesses associated with excess weight, they do not have the information to separate unsubstantiated weight-loss claims from evidence-based strategies to support their weight-loss efforts,” said Madelyn H. Fernstrom, PhD, CNS, Associate Professor and founding Director of the Weight Management Center at the University of Pittsburgh Medical Center. “Consumers need accurate information about the lifestyle changes they need to make to not only lose weight, but keep it off. Lifestyle change is the foundation of successful weight loss, but other treatment options, including prescription medications and surgery, can be added to help support—not replace—the lifestyle effort. When it comes to losing weight, one size does not fit all, and obesity treatment should be individually tailored, with careful consideration to both biological and behavioral factors.”

Personal Reflections on Weight & Weight Loss

According to findings, 64 percent of respondents are not happy with their current weight, and many say that more time to exercise (59 percent), better access to healthful foods (31 percent, and more time to cook and eat at home (31 percent) would help them achieve and maintain a healthier weight. More than three quarters (77 percent) of respondents have tried to lose weight at some point, and among these, 60 percent agree that it is one of the hardest things they have ever tried to do. Despite the attempts, many are unsuccessful at either losing weight or keeping it off. Less than a third (29 percent) of those who have ever tried to lose weight report being successful, and about a third (34 percent) have only been able to keep off the weight they lost for less than one year.

“I was fortunate to have a doctor tell me that I seriously needed to lose weight. But not all consumers who need that push from their healthcare professional get it,” said Peggy Kindler, a 51-year-old Pittsburgh, PA resident who has battled weight issues all her life. In the year since gastric banding surgery, Kindler has lost 53 pounds but continues to struggle with the challenges of weight-loss. “As someone who has experienced the very real benefits of losing a significant amount of weight, and being able to keep it off, I truly hope that these new materials for consumers at www.nclnet.org will help people recognize their weight problem, understand the weight-loss options available and motivate them to get help.”

Getting on Track for Weight Loss

About half (52 percent) of people say that they have talked about losing weight with their doctor, although respondents who are obese are more likely to have done so. Among those who have discussed weight loss with their doctor, nearly three in five (59 percent) report that their doctors recommended a diet change (47 percent) and/or exercise regimen (35 percent). However, only one third discussed the health risks associated with their weight, and only ten percent said their doctor helped them develop a plan to lose weight.

Of the weight-loss options other than regular diet and exercise discussed in the survey, respondents reported being most familiar with: organized weight loss programs (56 percent); over-the-counter medications (42 percent); weight-loss surgery (41 percent); and prescription medications (39 percent). Organized weight-loss plans also were perceived very or somewhat positively by most (69 percent) respondents, followed by counseling/psychiatry (55 percent), and intensive weight loss “camp” (45 percent). More than a third (38 percent) held a very positive or somewhat positive view of weight-loss surgery, while a third thought positively of prescription weight-loss medications (35 percent), acupuncture (34 percent), and hypnosis (33 percent).

About the Survey

The survey was conducted online within the United States from March 6 to 12, 2007 by Harris Interactive® on behalf of the National Consumers League among 1,978 adults aged 18+. According to BMI calculations out of this sample of 1,978, 25 are underweight, 528 are normal weight, 679 are overweight, 351 are obese, 164 are severely obese, 138 are morbidly obese. According to self-assessment 58 are underweight, 590 are normal weight, 1,032 are overweight, 180 are obese, 60 are severely obese, and 48 are morbidly obese. Figures for age, gender, race/ethnicity, education, region and household income were weighted where necessary to bring them into line with their respective total populations. Propensity score weighting was also used to adjust for respondents’ propensity to be online.

With a pure probability sample of 1,978 adults one could say with a 95 percent probability that the overall results would have a sampling error of +/-5 percentage points would have a sampling error of +/-3 percentage points.  Sampling error for data from sub-samples may be higher and vary.  However, that does not take other sources of error into account. The online survey is not based on a probability sample and therefore no theoretical sampling error can be calculated.

NCL thanks Allergan, Inc. for an unrestricted educational grant that made this survey and educational effort possible.