Pet Allergy

Dear Lisa,

My son has Asthma and he wants a dog really bad. I’m afraid that if we get a dog it will make his Asthma worse. What is your opinion about getting a pet if a child has Asthma?

“Want a dog but my son has Asthma”

Dear “Want a dog but my son has Asthma”,

Having a pet in the home and caring for it teaches children a lot of valuable life lessons. It teaches children about caring, compassion and responsibility. Once a pet enters the home, many families consider it a part of the family. Therefore purchasing a pet is a big decision, especially if your son has Asthma.

Asthma and Allergies many times come hand and hand and many children with Asthma also have Allergies. Some sources report that up to 90% of patients with Asthma have Allergies. (1) In particular, sensitivity to dog and cat allergens occurs in up to 70% of children with Asthma. (2) Pet exposure is one of the common triggers for the exacerbation of Asthma symptoms. Exposure to any pet with fur or hair, such as cats, gerbils, mice, rabbits, guinea pigs may also be a trigger for Asthma. Therefore there is a good chance that your son’s Asthma may worsen if a pet enters the home.

In my practice I found that many parents were under the impression that if they purchased a “non-allergic” dog, a dog with hair instead of fur, or a dog that doesn’t shed that their child would not be allergic. This is not true because children can be allergic to not only the dog’s fur, but to the dog’s saliva and dander too. Even if a dog doesn’t shed or if it has hair instead of fur, it still has dander.

Dander is microscopic pieces of stool that stick to the skin and hair of the dog. As the dog walks around the house and sits on the furniture, dander is spread onto carpeting, bedding and sofas where children live and play. It is the exposure to this dander that you can not see that causes a lot of allergy symptoms. Even once a pet is removed from the house, dander can remain on these household objects for a length of time, in some cases months. (3) Therefore if your child has a problem with a pet and you remove the pet from the house, you may not see resolution in his symptoms for some time after the animal is removed.

Once a pet is in the home, it will be very hard to remove it because family members tend to become emotionally attached to animals. Some families see their pets as a "part of a family" and would never remove it from the home. (4) Since it is much harder to remove an animal once its in the home, it’s a good idea to make sure your child is not allergic before you get a pet.

To see if your child has a sensitivity to dogs you can bring him to a home with a dog and let him spend time there. Let him play with the dog, let the dog lick him and if possible let him spend a few hours there. If your child develops a rash on his skin where the dog licks him, his eyes become red, itchy or swollen, he develops nasal symptoms or if he starts to cough, wheeze or have shortness of breath, there is a good chance that he is allergic. This should give you the information that you need in order to make your decision.

If your child doesn’t have any reaction at all, it would be a good idea to discuss allergy testing with your doctor before purchasing a dog in case the exposure was not long or intense enough to cause symptoms. If the allergy testing is negative and your doctor gives you the green light to purchase a dog you should know that just because your child is not allergic to dogs at that point in his life, that doesn’t mean that he never will be allergic. Unfortunately, people can develop allergies at any time.

You may want to discuss with your son the option of getting a different kind of pet. Any pet with fur can potentially cause an allergic reaction. In particular children tend to be allergic to the urine from rodents such as mice, gerbils, guinea pigs and rabbits. Therefore, exposure to these animals also has the potential to trigger your son’s Asthma. Choosing an animal without fur or hair is a good idea. Pets such as iguanas, lizards, hermit crabs or fish make great pets and are a good choice for children with Asthma.

I wish you luck in choosing a pet.

References:
(1)Grossman J. One airway, one disease. Chest. 1997;111:11S-16S.
(2) Ingram J, Sporik, R. Rose G, Honsinger R, Chapman M, Platts-Mills T. Quantitative assessment of exposure to dog (Can f 1) and cat (Fel d 1) allergens: relation to sensitization and asthma among children living in Los Alamos, New Mexico. J Allergy Clin Immunol. 1995;96:449-456.
(3)Wood R ,Chapman M, Adkinson N, Eggleston P. The effect of cat removal on
allergen content in house-hold dust samples. J Allerg Clin Immunol. 1989;83:730-734.
(4)Phipatanakul, W. Environmental Indoor Allergens. Pediatric Annals. 2003;32(1):44-45.


Lisa Kelly R.N., P.N.P., C.
Certified Pediatric Nurse Practitioner

Pediatric Advice Website

Chicken Pox Immunity

Dear Lisa,

I am a mother with a 14 year old daughter. When I was 4 yrs old, I had a moderate case of chickenpox. When I became pregnant with my daughter, my 8 yr old son contracted a very mild case of the chickenpox. So mild, the doctor said he would likely catch them again. He is 23 now and never did. I was about 20 weeks pregnant when this happened. My daughter is now 14 and has never contracted chickenpox even after repeated exposure. Is it possible she is immune, because I was immune at the time of the exposure in my pregnancy? State law does not require her to get the varicella vaccine, which would be 2 doses. Should she be vaccinated anyway?

“Is she Immune?”

Dear “Is she Immune”,

Children who were exposed to the varicella-zoster virus in utero or before they were born can develop Varicella (Chicken Pox) without knowing it. This could be the case with your daughter. Another possibility is that your daughter may have had Chicken Pox as a young child but did not develop the classic symptoms. Many people report never having Chicken Pox, when they actually did, but never knew it. (1)

Since your daughter has had repeated exposure to Chicken Pox and never seemed to develop the disease there is a chance that she is immune. The only way to be sure is to have her tested. Your daughter’s Pediatrician can order serology testing for Varicella titers. This involves giving a blood sample which will tell if she is immune or not.

If your daughter is not immune, there is a concern that she may develop the disease when she is older. This is not a desirable situation. Chicken Pox is a contagious viral infection that causes mild symptoms in young children, and potentially serious consequences for someone older. The symptoms of Chicken Pox in a young child include a sore throat, and skin lesions which are pruritic or itchy. The symptoms become more severe and the risk of complications is greater as a child gets older. These complications may include encephalitis, ataxia, thrombocytopenia, seizures, arthritis, hepatitis, meningitis, and glomerulonephritis.

There is an additional concern if the non-immune child is a female. If a female doesn’t contract Chicken Pox before her child-bearing years there is a concern that she may develop the disease when she is pregnant. If a pregnant woman develops Chicken Pox her newborn has the risk of developing Fetal Varicella Syndrome which results in limb deformities and scarring of the skin. (1) If a pregnant woman develops chicken pox five days before or 2 days after delivery the newborn infant is at the risk of developing severe Varicella with fatality rates as high as 30%.(2)

If the serology testing reports that your daughter is not immune, it would be a good idea to have her vaccinated now. There are many parents who wish to wait for their child to develop Chicken Pox naturally instead of getting vaccinated. This is not a viable option for your daughter because at this point in her life, there is not a good chance that she will contract Chicken Pox naturally. The reason for this is because the incidence of live Chicken Pox in the community is low. Most children are vaccinated against the disease and there is less opportunity to catch it naturally.

There have been reports of a 79% decrease in cases of Chicken Pox disease since the introduction of the Varicella vaccine in 1995. (3) In addition, Varicella occurs in 90% of U.S. children before age 10 years. (4) Since your daughter’s 14, there is a very low chance that she will be exposed to other children with the Chicken Pox. By vaccinating her now you will protect her and her future children from potential complications.

References:
(1)Brunell, P. Varicella. Changing Epidemiology and Parents’ Perceptions. In Infectious Disease in Children. 2002. April; S (3-14).
(2)Committee on Infectious Diseases. Varicella-Zoster Infections. In: Peter G, ed. 1997 Red Book: Report of the Committee on Infectious Diseases. 24th ed. Elk Grove Village, IL: American Academy of Pediatrics1997:573-574.
(3)Stephenson M. Varicella zoster virus vaccine making a big dent in case rates. Infectious Diseases in Children. 2006;June: 31.
(4)Pang, M. Spot the Rash. Infecious Diseases in Children. 2006;March:90.

Lisa Kelly R.N., P.N.P., C.
Certified Pediatric Nurse Practitioner

Pediatric Advice about Disease Prevention