Hay fever usually refers to a seasonal form of respiratory allergy causing symptoms from August onwards, that is when ragweed pollen counts increase and as such would represent a ragweed allergy. For others, hay fever relates rather to hay and grasses known to cause more symptoms from the end of June to early August in Quebec. Hay fever may yet be used by some as a way of talking about seasonal allergies more generally, this including even tree pollens associated with springtime allergies.
Hay fever is one type of seasonal allergy which, like other respiratory allergies commonly cause rhinitis (inflammation of the lining of the nose) with sneezing (sneezing fits), nasal congestion, discharge and itchiness. This explains the notion of fever or cold without a virus as a culprit. At the level of the eyes, allergens relating to hay fever (grass allergy, ragweed and/or weed allergy) may cause conjunctivitis with itchiness, watery eyes and swelling of the eyelids.
The symptoms of hay fever may be most uncomfortable and indeed interfere with productivity at work (a notion more recently referred to as « presenteeism »)or with academic performance in children. Sneezing fits are not really a laughing matter as fatigue, nasal blockage and even asthma contribute to gradual deterioration of sleep and health. As with other respiratory allergies, merely treating the symptoms of hay fever leaves the allergic disease to progress, increasing the odds of development of further allergies or sensitization of the lungs, leading eventually to allergic asthma with wheezing, coughing, shortness of breath and chest tightness. There is even a pollen-food syndrome and thus a particular form of food allergy related to grass and ragweed pollens.
Allergy tests are required to confirm a respiratory allergy such as hay fever and from there to allow the consideration of appropriate treatment. These tests may be carried out on the skin (skin prick tests) or as a blood test (serology) in certain circumstances. In some situations, often when many positive results are noted on those tests, molecular allergy, a specialized set of blood tests, may be relied upon to confirm grass or ragweed pollen allergy among other seasonal allergies.
While the symptoms of a seasonal allergy such as hay fever can generally be controlled by antihistamines and topical nasal steroids, these medications do not address the risk of this respiratory allergy progressing to further allergies or allergic asthma. Started a few months before the pollen’s allergy season, sublingual immunotherapy represents an appealing alternative to treat effectively hay fever symptoms and indeed aim to change the course of grass and/or ragweed pollen allergy.