What are the other Names of this Condition? (Also known as/Synonyms)

• Mildew Allergy
• Mold and Mildew Allergy

What is Mold Allergy? (Definition/Background Information)

• Mold Allergy (including Mildew Allergy) is a common condition that manifests as an abnormal immune reaction/response to inhaled fungal spores. The condition may occur in both indoor and outdoor spaces
• Mold and mildew are types of fungi that grow on damp surfaces of the walls and floors. It can result in black smelly stains on hard surfaces of the walls, floors, and ceilings. The growth can further release fungal spores in air (that are normally invisible to the eye) causing a risk for allergies. There are thousands of species of mold, but not all cause allergic reaction in individuals
• Common indoor spaces involved include wet areas like kitchens, bathrooms, and basements. Outdoors, mold is also present in gardens, rotting logs, fallen tree twigs and leaves, compost mounds, etc. The condition may occur all-round the year (especially indoor Mold Allergy). Freezing temperatures are known to make them inactive, but not completely destroy the fungi
• The respiratory system is typically affected, since mold particulate matter are inhaled/breathed in. The signs and symptoms of the allergic reaction may include runny nose, sneezing, and breathing difficulties. In some rare cases, Mold Allergy may lead to an anaphylactic shock, which is a medical emergency
• Mold Allergies are generally diagnosed by conducting a physical examination, assessing the symptoms, and via an antibody blood test or a skin-prick test
• Anti-allergic medications form the first line of treatment for mild Mold Allergies. However, in the case of a severe allergic reaction (anaphylaxis), epinephrine or adrenaline injections are recommended
• The prognosis of Mold Allergy is generally good with adequate treatment, although the condition is incurable. Awareness of such allergies and taking steps to eliminate them from indoor spaces is the best form of prevention practiced

Who gets Mold Allergy? (Age and Sex Distribution)

• Mold Allergies can occur in both children and adults. Individuals of any age may be affected
• No gender preference is noted and both males and females are affected
• All racial and ethnic groups are equally vulnerable to the condition

What are the Risk Factors for Mold Allergy? (Predisposing Factors)

The risk factors for Mold Allergy include:

• Wet and poorly-ventilated spaces
• Poorly maintained gardens and backyards
• Dripping plumbing lines and fixtures
• Clogged rainwater and water drains
• After natural disasters, such as earthquakes, hurricanes, cyclones, and tornadoes, water damage to the homes promote the growth of molds that may go undetected for months and years
• Family history of an associated allergy
• Having one form of allergy puts one at risk for other forms too

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Mold Allergy? (Etiology)

An allergic reaction occurs in an individual with Mold Allergy, because the immune system recognizes the fungal spores as being dangerous and harmful to the body.

• Exposure to mold and mildew results in the production of antibodies, specifically immunoglobulin E (IgE). The next time the individual is exposed to the substance, the antibodies that are circulating in blood causes an antibody-antigen reaction
• This results in the production of histamine and other chemical messengers, which cause the symptoms seen during an allergic reaction
• The extent of exposure that triggers an allergy may not be significantly large. Sometimes, mild or minor contact with the allergen is sufficient to trigger Mold Allergy

In some cases, a severe allergic reaction termed as anaphylaxis may occur, which is a medical emergency that requires immediate medical attention.

What are the Signs and Symptoms of Mold Allergy?

The signs and symptoms of Mold Allergy may start to appear within a few minutes, to a couple of hours, after the individual has been exposed to the fungi. Depending on the level of sensitivity and quantum of exposure, the symptoms may be mild or severe. A severe allergic reaction is a medical emergency.

The signs and symptoms of Mold Allergy may include:

• Coughing, sneezing
• Runny or stuffy nose
• Shortness of breath (trouble breathing), wheezing
• Asthma-like symptoms; in individuals with asthma or other lung conditions, Mold Allergy can make it worse
• Watery eyes, redness, and irritation; conjunctivitis like symptoms
• Irritation of the throat

Generally, not all episodes of allergy will be of the same severity. In some individuals, the most severe symptom caused by Mold Allergy is anaphylaxis. However, this is very rare.

• Anaphylaxis (sometimes called an anaphylactic shock) is a life-threatening, whole-body allergic reaction
• During anaphylaxis, tissues in various body parts release histamine and other messenger chemicals, which causes swelling of the throat and other symptoms
• Swelling of the throat is especially dangerous as this can cause shortness of breath. If the swelling is not reduced soon, then there is a possibility that the individual could die from a lack of sufficient oxygen
• It can also result in a bluish skin, weak pulse, and decreased blood pressure (hypotension)

How is Mold Allergy Diagnosed?

The diagnosis of Mold Allergy may involve the following:

• Physical examination, assessment of symptoms, and medical history evaluation (history of allergies in the family)
• Radioallergosorbent (RAS) test; to determine the specific allergy-causing substance
• Skin-prick (allergy) test:
  • For this test, tiny amounts of certain substances are injected right underneath the skin (forearm, upper arm, or back)
  • After 15-20 minutes, if the spot where the chemical was injected swells, or if there is redness noticed, then this indicates that the individual may be allergic to the substance
• Blood test to detect antibodies (IgE antibody test)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Mold Allergy?

The complication of Mold Allergy is associated with the allergic reaction itself and it depends on the severity of the reaction. It may include:

• Anaphylactic shock/reaction that may be life-threatening
• Development of chronic conditions including asthma, when the lungs are affected due to continued exposure
• Having one form of allergy can make the individual prone to other allergy types
• In severe reactions, a tracheostomy may have to be performed during an emergency situation 

In some individuals, consuming fermented foods (breads, wine, etc.) are known to worsen the condition.

How is Mold Allergy Treated?

The treatment of Mold Allergy may be undertaken in the following manner:

• Anti-allergic medication for mild reactions; antihistamine therapy, that is prescribed by the allergy physician
• Symptomatic treatment; use of decongestants, especially for nose block including steroid sprays
• In the case of anaphylaxis (severe allergic reaction), epinephrine or adrenaline is immediately administered
• Breathing support as necessary, control asthma symptoms and low blood pressure
• Undertaking appropriate treatment for any underlying lung infections or illnesses
• Immunotherapy, in case of severe allergies, for long-term tolerance development

It has been reported that in some individuals, minimizing the intake of fermented food stuffs can prevent worsening of the condition.

How can Mold Allergy be Prevented?

Currently, it may not be possible to prevent Mold Allergy, but the growth of fungus, both indoors and outdoors, may be minimized by the following steps:

• Using suitable dust masks, particularly during peak periods of exposure
• After garden work or after being outdoors, wash and clean face (including nose) thoroughly and take a shower
• Wash hands thoroughly with soap and water, in case of contact with an allergen, especially before eating
• Reduce exposure to mold: Avoid indoor wetness, keep spaces dry and well-ventilated
• Use exhaust fans and dehumidifiers, when necessary
• Do not keep windows and ventilators shut during all times of the day
• Take out garbage regularly
• Clean refrigerator and air-conditioning drip pans regularly
• Clean drainage system, gutters, storm drains regularly
• Do not let puddles collect on roof tops, above sunshades, or on roof projections
• Do not let rainwater accumulate around the house
• Repair leaking taps, pipes, and plumbing fixtures
• Use better A/C filters (such as HEPA filters)
• Keep outdoor garden backyard spaces properly cleaned and well-maintained; mow lawns regularly, cut tall and wild grass

Additionally, the following may be considered:

• Studies have shown that breastfeeding children for 4-6 months or over, can help build their body immunity and make them less prone to allergies
• Appropriate maternal diet during pregnancy can help build stronger resistance (against allergies) in children
• Generating public awareness on various allergies

In case the child or adult is susceptible to an anaphylactic shock (high-risk individuals) from Mold Allergy, the following should be considered:

• Being watchful of triggers and avoiding them
• Wearing medical alert information bracelets or suitable devices
• Carry auto-injector epinephrine or adrenaline medications such as EpiPen, Anapen, or Twinject. Since the condition may recur, it is advised to carry 2 doses (2 pens)
• Supervise children on how to self-administer the injection, if required
• If child is prone to anaphylactic reaction, then information (preferably written instructions) should be given to day care, school authorities accordingly
• Adults should inform their spouses, colleagues, and friends, about the condition, in case of a future emergency

What is the Prognosis of Mold Allergy? (Outcomes/Resolutions)

• The prognosis of Mold Allergy depends on the severity of the signs and symptoms, but it is generally good with appropriate treatment. However, the condition can recur if the buildup of mold in indoor and outdoor spaces is not minimized
• In some cases, the allergic reaction may be severe, causing anaphylaxis. This is a medical emergency that can lead to a respiratory failure. It requires an immediate treatment of the condition. In such cases, the prognosis is guarded and it depends on whether immediate medical assistance is provided

Additional and Relevant Useful Information for Mold Allergy:

Please visit our Allergy Health Center for more physician-approved health information:

http://www.dovemed.com/health-topics/allergy-center/