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It's March and the weather is finally starting to get warmer. A patient visits the doctor complaining of sneezing, itchy eyes, a runny nose, and a sore throat. What's the diagnosis? It's most likely seasonal allergic rhinitis, also known as hay fever.

Seasonal allergic rhinitis is an allergy-related inflammation of the nasal passages, throat and eye membrane (conjunctiva) caused by exposure to pollen, dust or dander. Although hay fever in Japan is mainly caused by pollen from Japanese cedar and cypress trees, there are more than 40 kinds of plants throughout the country that produce pollen that causes hay fever. Usually Japan's hay fever season begins in mid-February, peaks in March, decreases at the end of April, and ends by mid-May. Hay fever affects Japanese people of all ages throughout the country. According to Kafun Joho Kyokai, a non-profit organization that monitors hay fever in Japan, one in five people in the Tokyo metropolitan area is affected by the pollen that causes hay fever.

Hay fever, like all allergies, is caused by an oversensitive immune system. It occurs when the immune system reacts to allergens (substances such as pollen, dust and dander) that are usually harmless. When pollen is inhaled by a person allergic to pollen, his or her immune system responds by producing antibodies, leading to the release of histamine. This causes itchy eyes, sneezing and mucus production. In severe cases it can also cause hives or rashes.

A variety of treatments for hay fever are available, including: antihistamines (short-acting and long-acting), corticosteroid nasal sprays, topical decongestants, comolyn sodium and hyposensibilization ('allergy shots'). The treatments have various side effects, therefore it is important to choose the appropriate medication based on each individual patient and the type and severity of the symptoms. The best treatment is prevention - on days when the outdoor pollen count is very high stay inside or wear a mask and goggles to avoid the allergens that cause hay fever.

Discussion questions

1. Please summarize the article. What is the main point of the article?
2. What is seasonal allergic rhinitis?
3. What causes seasonal allergic rhinitis?
4. When is hay fever season in Japan?
5. What are the symptoms of seasonal allergic rhinitis?
6. What treatments for hay fever are available?
7. Can hay fever be prevented? If so, how?

References:

• Sakaya Yakushiji. Invisible enemy: For sufferers in misery, hay fever is nothing to sneeze at. Asahi.com. 03 March 2005.
• Hay fever. Wikipedia.