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HYPERSENSITIVITY PNEUMONITIS
Every Breathe I Take
JOIN US.  A support group for sufferers of hypersensitivity pneumonitis has been formed.  Link at the bottom of this page.
Extrinsic Allergic Alveolitis
Hypersensitivity pneumonitis, or extrinsic allergic alveolitis, is a group of related inflammatory lung diseases that result from hypersensitive immune responses to repeated inhalation or ingestion of a variety of agents from fungal, bacterial, animal protein or chemical sources.
These agents can come from a variety of sources such as diary and grain products, animal dander and protein, wood bark and water-reservoir vapors.  The most common disease is "farmer's lung" and was first described in the 1790's and identified moldy barn hay as the causative agent.  But, the agent most common to the community of aviculturists are the various proteins from bird feathers, feather dust and dried droppings. 

When the disease strikes a fancier of avian culture, it is called "pigeon breeder's lung," "bird breeder's lung," or "bird fancier's lung," just to name a few.  I will try to limit the discussion to the avian variety of this disease process since that is the one closest to my heart.  I was diagosed with this condition in August 1999.  Fortunately I have a doctor that understands my sincere interest in keeping my birds and we are working together to make that a reality.
SYMPTOMS
There are two phases of this disease process.
One is ACUTE and the other is CHRONIC.
In the
acute phase, symptoms develop 4-6 hours after exposure to the avian protein.  Most common are shortness of breath, cough, chills, fevers, headache, muscle aches and a general "not feeling good" feeling.  These symptoms may last up to 12 hours, but usually subside spontaneously once away from the allergens.  However, these symtoms can occur with increasing severity with each repeated exposure.  The actue phase is often mistaken, initially, for the "flu" or a "cold.
In the
chronic phase, the symptoms are becoming more severe, more frequent and usually require medical intervention for relief.  The shortness of breath, fatigue, low-grade fever, chronic non-productive cough and often weight loss progress to a "permanent" condition.  At this time, definite changes are noted within the lungs and these changes are irreversible.  It is referred to as pulmonary fibrosis.  This conditon is very serious and in extreme cases  may be fatal. 
DIAGNOSIS
If you think you have been affected, seek medical advice.  There are a number of tests your doctor can order to determine what the problem is.  Remember, this condition can often mask itself and resemble the flu or a cold and you need to have a firm diagnosis so treatment can begin.  And, above all, do not be afraid to seek a "second opinion."

Any or all of the following test may be ordered so that your doctor can confirm the presence of the condition.

Chest X-ray
Pulmonary function tests
Complete Blood Count
Antibody panels
Bronchoscopy with or without biopsy

As abnormal findings occur, your doctor may request further, more intense, diagnostic studies.  About 1 in 10,000 people have some form of hypersensitivity pneumonitis so the medical profession is familiar with this disease process.  It is, however, important, that you have your medical record adequately marked stating that you are a bird fancier so this medical condition is not overlooked.
TREATMENT
The primary objective of treatment is to identify the allergen and avoid further exposure to the protein once it is identified.  Does this mean you will have to give up your birds.  Not necessarily -- however, that is a decision you will have to make with your doctor once all of the test results are in.
Initially, steriod medication may be given.  Other oral and inhalation medications are also available to ease the symptoms.  But, remember, the damage to the lungs is permanent and progressive with repeated exposures.
For those that have continued exposure to the identified proteins,commercial respirators can reduce the amount of the targeted agent inhaled.
The best form of treatment is obviously going to be avoidance of the causative agent and continued medical follow-up.
RISK MANAGEMENT
Not every birdkeeper is susceptible to avian protein allergies.  Why some are and some aren't is not easily answered.  Why are some allegic to poison ivy and others can work with it without difficulty?  Why  do some react severely to bee stings and other keep bees as a hobby?  Why aren't all Texans allergic to cedar?  We are all individuals and what we develop reactions to is as indivdual as we are.  It is known, however, that with proper husbandry and management, your risks are decreased.  

CLEANING:  Do not allow seed dust or hulls, pellet dust ,or droppings to accumulate in the cage or play area.  Remember that it is the particles you CANNOT see that are the most dangerous.  The best way to remove the dust is with the vacuum cleaner; however, if you do not have adequate filtration on the cleaner, you may just be blowing the particles back into the air.  A simple filter over the vacuum exhaust portal  is beneficial.  Prior to cleaning, spray with a fine mist to help settle the seed/pellet dust and the feather powder/dust.  Even the feather sheaths contain the suspect proteins.

HANDLING: Be alert to dust, dander, feather sheath particles when handling your birds.  This material is easily transferred from your hands and clothing to your respiratory tract.  The more you cuddle and "fluff" or "preen" your bird, the more you are subjecting yourself to the proteins.  When you are finished cuddling and playing with your companion, wash your hands and arms, if possible change your clothing.  It is also beneficial to have a specific smock or other "over garment" to wear just when handling your birds.  Men, be particular aware of sideburns, beards and moustaches.  They are traps, conveniently close to your nose, for feather dust.
WEAR A MASK:  For cleaning and continuous handling such as wing trimming and nail trimming days, wear a mask.  They are readily available at your local pharmacy.
VENTILATE; VENTILATE; VENTILATE:  There are many varieties of air cleaners and purifiers.  Some of these can be quite costly.  There is also an on-going controversy regarding the use of ionization around the birds that I will not go into here.  Something as simple as a standard window "box" fan with a standard furnace filter attached to the intake side of the fan will trap a considerable amount of seed/pellet/bird dust.  Weather permitting, open the windows and place a small fan in the window to blow the dust out of the room.  Keep your furnace and air conditioner filters clean.  Replace frequently, more frequently than recommended by the manuafacturer.  They were probably not tested in "bird homes."
BATHING & MISTING:  Make frequent baths and mistings part of you birds routine.  Most birds will welcome a nice bath or misting if you  add it to their "play time."

COMMON SENSE: Remember, when working or playing with you birds to use common sense.  If you notice your nose starting to run, your eyes starting to itch and water, a little difficulty taking a deep breathe -- get out of the room.  These are the early symptoms of an allergic reaction.  If you feel you have developed any type of allergic response to your feathered companions, notify you doctor.  Like any disease process, early detection and treatment is the key to a long happy life with your birds.

Hypersensitivity pneumonitis DOES NOT have to be fatal; it can be controlled with proper technique and treatment. 
Will it get worse -- yes it can if you ignore what your body is trying to tell you. 
Can your family get it -- yes, but not from you, it is not contagious.  They will need to have the allergic response to the avian proteins.
JOIN US  A new e-mail list has been formed as a support group for those of us diagnosed with hypersensitivity pneumonitis. The causative agent doesn't have to be birds.  If you would like to join our list on e-groups, please click on JOIN US and visit the mailing lists home page.
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