Hypersensitive Pneumonia due to Pigeon Droppings on the Rise, Officials Warn People Against Feeding the Birds
The Municipal Corporation officials in Maharashtra’s Thane district have warned against feeding pigeons near the living spaces as cases of hypersensitive pneumonia, a lung disease, are on the rise. The ailment, which spreads through bird droppings, and feathers can completely damage the lungs. The authorities have pasted posters all over warning a fine of Rs 500 will be levied on those found feeding pigeons.
New Delhi: Municipal Corporation officials in Maharashtra’s Thane have warned against feeding pigeons as cases of hypersensitive pneumonia, a lung disease, are on the rise.
The Thane Municipal Corporation or TMC had put up several posters in the city recently to spread public awareness about the disease which spreads due to pigeon droppings, as bacteria, and mold causes inflammation in the lungs, completely destroying them.
Health experts say that the numbers shoot up in people who live in the vicinity of droppings and feathers accumulating nearby. The breathable antigen arising from the bird droppings and feathers goes into the lung and leads to an immunological reaction, which damages the lung.
Signs and symptoms
The symptoms of hypersensitivity pneumonitis can be acute or chronic.
Acute symptoms come on within a few hours of being around an allergen and last a few hours or days. Chronic symptoms on the other hand can develop slowly and get worse over time.
A few common signs of the ailment are:
- Breathlessness
- Dry cough
- Tightness in the chest
- Chills
- Fatigue
- High fever
- Muscle pains
- Chronic cough
- Unexpected weight loss
How can hypersensitive pneumonia be diagnosed?
Diagnoses for hypersensitivity pneumonitis can be done based on your symptoms and personal history, physical exam, and a few other tests.
A few of these tests include:
Allergy tests
This is done through blood samples that check if you have signs of a reaction to the allergens.
Imaging
Chest x-rays and CT scans can look for the damage.
Pulmonary function tests
Most lung function tests involve breathing into a tube attached to a machine to measure how well your lungs are working.
Bronchoscopy
A small, flexible tube that passes through your nose or mouth can view the inside of your lungs and collect samples.
Ways to prevent Hypersensitive Pneumonia
According to health experts, hypersensitive pneumonia is not reversible, and so it is best to prevent the damage caused by the ailment.
Avoiding exposure to allergens that cause lung inflammation to reduce your risk include:
- Wearing masks and personal protection gear if your workplace has a lot of birds and animals around, or there is heavy usage of animals, lumber, paper, grain, etc.
- Keep humidifiers, hot tubs, and heating and cooling systems clean and in good condition
- Avoid feather-filled bedding
- Keep your pets’ living spaces clean
Beware of pigeon droppings! It can permanently damage your lungs; here’s how
Lung transplantation remains the last treatment option if the disease progresses despite medical management leading to very poor quality of life, doctors revealed
It is still important to take precautions and avoid unnecessary exposure to large accumulations of pigeon droppings.
We have often come across people in our neighbourhood who feed pigeons assuming it to be a harmless noble act. However, the act of feeding them isn’t just harmful to the bird as it destroys their hunting instincts, it can also lead to some dangerous diseases in humans.
According to health experts, pigeon droppings and feathers are associated with respiratory diseases. Fibrotic lung disease, for example, hypersensitivity pneumonitis or bird breeder’s, lung disease is caused by pigeon droppings.
A single pigeon is capable of producing around 12 Kg of excreta annually. According to experts, the excreta of pigeons are acidic in nature and it can cause damage buildings and monuments. It also spreads salmonella germs.
“It has been found to be increased in India in 2017, the study was published with the name of a registry which showed that in India, the main cause of Influeza-like Illness is hypersensitivity pneumonitis, followed by other causes like connective tissue disorders and other diseases. And this is what we have found, that there has been increase in the number of patients with hypertensive pneumonitis in Delhi as well, and this has been well documented in many studies also,” Dr Vikas Murya – Director & HOD – Pulmonology – Fortis Hospital Shalimar Bagh told Financial Express.com.
Dr. Maurya also revealed that they are seeing many patients with hypersensitive pneumonitis and it has increased in the past year.
“…obviously it has increased in past year and in many in year, I would say in a few years. And this obviously, this requires that, first of all, you know, we should avoid, you know, breeding of pigeons predominantly because most of this hypersensitive pneumonitis is caused by, you know, the bird breeders, for example, pigeons. So this is very, very important. And even I have, you know, I have kept a photo in my OPD. We say that say no to pigeons because obviously, it can cause very severe, debilitating disease like hypertension and pneumonitis, which can cause interstitial lung disease or fibrotic lung disease.,” he added.
‘Pigeons have become the dominant bird species’
Dr Arjun Khanna, Head, Department of Pulmonary Medicine, Amrita Hospital, Faridabad pointed out that if you look around in the Delhi-NCR region, you will notice that pigeons have become the dominant bird species.
“Other birds, such as sparrows, are difficult to spot due to the exponential growth in the pigeon population, which has replaced many other birds in the ecosystem. However, the proliferation of pigeons poses a significant health hazard. The fur, feathers, and excreta of pigeons can cause lung diseases that exacerbate airway allergies,” Dr. Khanna told Financial Express.com.
Dr. Khanna also revealed that hypersensitivity pneumonitis is one of the most severe diseases caused by pigeon exposure. It is a variant of interstitial lung disease (ILD), which can cause lung fibrosis or shrinkage. This condition is a significant issue in clinical practice, as several papers from India have highlighted that pigeon exposure and droppings are a significant cause of ILD in our country, he revealed.
“If you have pigeons in your home, it is essential to remove any nests on your balcony or terrace immediately. It would be best to install pigeon-resistant nets, which are readily available in the market, to avoid pigeon exposure. This is crucial because pigeon exposure is associated with numerous lung diseases, the most severe of which is lung fibrosis,” he added.
Pigeon droppings can potentially carry harmful microorganisms
Dr. Shuchin Bajaj, Founder & Director Ujala Cygnus group of Hospitals told Financial Express.com that the excreta of pigeons carry microbes like bacteria, fungi, and viruses.
“When these droppings dry out and turn into dust, they can become airborne and be inhaled. The potential damage to the lungs primarily arises from the presence of a fungus called Histoplasma capsulatum, which is commonly found in pigeon droppings. Histoplasma capsulatum is responsible for causing a lung infection known as histoplasmosis. When the spores of this fungus are inhaled, they can reach the lungs and cause an inflammatory reaction. In most cases, histoplasmosis causes mild flu-like symptoms or even no symptoms at all. However, in some individuals with weakened immune systems or those exposed to a large number of spores, the infection can become severe and spread throughout the body,” Dr. Baja revealed.
According to Dr. Bajaj, if the lungs are repeatedly exposed to large amounts of pigeon droppings or if an individual’s immune system is compromised, the risk of developing chronic lung damage increases.
“Chronic histoplasmosis can lead to progressive lung disease, which may manifest as chronic cough, chest pain, shortness of breath, and eventually permanent lung scarring (fibrosis). In severe cases, it can result in respiratory failure or even death,” he added.
It is worth noting that the risk of developing significant lung damage from pigeon droppings is relatively low for healthy individuals with intact immune systems, especially if the exposure is minimal.
“However, it is still important to take precautions and avoid unnecessary exposure to large accumulations of pigeon droppings, particularly in enclosed or poorly ventilated areas. If you suspect you have been exposed to a significant amount of pigeon droppings and are experiencing respiratory symptoms, it is advisable to seek medical attention,” he revealed.
According to Dr. Arunesh Kumar, Head & Senior Consultant – Pulmonology & Respiratory Medicine, Paras Health, Gurugram, constant exposure leads to this condition.
“If presented in early condition it is completely curable. People need to immediately stop exposure to pigeon dropping. If left untreated it can convert into chronic Hypersensitivity pneumonitis which can not be cured. The symptoms of this condition are dry cough, shortness of breath which progressively gets worse. Early Pulmonology review is vital,” Dr. Kumar told Financial Express.com.
Symptoms of Hypersensitivity Pneumonitis
According to Dr. Chetan Rao Vaddepally, Consultant Interventional and Transplant Pulmonologist, Yashoda Hospitals Hyderabad, repeated inhalation of pigeon antigen either from bird feathers or droppings can lead to the lung disease and it can emerge from both domestic exposure and the global poultry handling industry.
“Susceptibility to the disease following exposure varies and differs in each individual as only a small proportion of the individuals exposed develop the disease. It an under-diagnosed cause of severe debilitating breathlessness and needs a high clinical suspicion. Studies document 6000–21,000 cases per 100,000 persons per year for pigeon breeders in U.S but the incidence in India is unknown,” Dr. Vaddepally told Financial Express.com.
He revealed that Hypersensitivity Pneumonitis (HP) presents as acute, sub-acute or chronic forms based on the exposure to antigens and host response.
Acute form presents after high level of exposure and the symptoms develop within 4 to 8 hours in the form of high grade fever with chills, muscle pains, fatigue and dry cough. Sub acute form is due to a relatively low level of exposure and the symptoms are more insidious. Chronic HP results from prolonged low level exposure to the antigens which lead to irreversible pulmonary damage of the lungs.
Meanwhile, symptoms of chronic HP include fatigue, persistent cough, worsening dyspnea, anorexia, and weight loss.
“PFT typically reveals a restrictive pattern and a decrease in DLCO. Acute and sub acute form of disease may resolve by the avoidance of exposure. Chronic HP is a potentially severe disease which may be progressive, irreversible, and result in debilitating fibrotic lung disease. Chronic HP may lead to respiratory failure and poor prognosis,” he added.
Dr. Vaddepally also pointed out that diagnosis is based on detailed clinical history including environmental exposure to pigeons along with investigations like CT chest, PFT and some immunologic tests.
“Early diagnosis is important as it may reverse the disease and if untreated can lead to irreversible lung damage, respiratory insufficiency and even death. Treatment primarily includes avoidance of the antigen/exposure to pigeons and steroids in acute and sub-acute forms. Chronic HP with irreversible lung damage will not respond to medical management and the treatment is mainly palliative,” he added.
Patients with HP might require long-term oxygen therapy, and cardiopulmonary rehabilitation. Lung transplantation remains the last treatment option if the disease progresses despite medical management leading to very poor quality of life, he said.
Meanwhile, Dr. Sachin Kumar, Senior Consultant Pulmonary & Critical Care Medicine at Sakra World Hospital pointed out that progressive types of lung damage cause symptoms like breathing trouble, cough, tiredness, chest tightening and wheezing. It is often confused with diseases like asthma and Bronchitis.
“These symptoms may last for weeks or months and weight loss gets progressively worse. Over time, some people with chronic hypersensitivity pneumonitis develop clubbing in the fingers and toes and irreversible pulmonary fibrosis. The proteins in the bird droppings and feathers cause inflammation of the alveoli in the lungs. The lungs become inflamed. It can take many years of exposure to cause progressive lung fibrosis to the honeycombing stage,” Dr. Kumar added.
‘Pigeon population has surpassed that of other local birds such as sparrows’
Dr. Shilpa Bhatte, MBBS, MD Chief Program Officer, CureBay told Financial Express.com that earlier there used to be areas within a city to feed pigeons designated as “Kabutar-khanas”. Some of these are now heritage sites.
“However, with growing human population and some communities feeding pigeons as a part of their religious practices, the pigeon population has surpassed that of other local birds such as sparrows. This has led to the pigeons seeking shelter in apartment buildings and hence the new trend of having a net to protect your balconies from the pigeon nuisance has emerged in the cities.Feeding animals and birds is a part of being a human being – however it is important to remember that non domesticated animals carry infections and can pass them to humans, called “Zoonosis,” Dr. Bhatte said.
According to Dr. Bhatte, some of the infections caused by pigeon feathers/droppings are those that affect the lungs – cryptococcosis, histoplasmosis and psittacosis, but they can affect other systems as well.
“Children and the elderly or anyone who is prone to get respiratory infections, are especially at risk. Immuno-compromised people, like Diabetics are also at risk to get these infections which can be fatal in the long run. In children, pigeon feathers and droppings can lead to allergies affecting respiratory system (nose, lungs), skin and the eyes. This can cause severe complications if left untreated. We have very well seen how human interference with bats led to the COVID-19 pandemic. Hence it is about time that we realise that as humans – we should not disturb the natural ecological cycle by indiscriminate feeding of a certain species that leads to an imbalance in bird populations,” she added.
“…The main thing is that not all people exposed to pigeon droppings will get the disease but only some people will. Once lungs are infected the cycle inflammation may lead to scarring of fibrosis, the condition is knowns as pulmonary fibrosis,” Dr. Ravindra Mehta, Senior Pulmonologist, Apollo Hospitals, Bangalore told Financial Express.com.
There are large movements to ban feeding pigeons in public places. For people who have longer exposure to pigeon droppings, it is important to take precautions.
“Also, awareness on the same has increased so that people who experience shortness of breath, or persistent cough, should consult a doctor for early intervention and treatment,” he added.
Source-https://www.timesnownews.com/health
SOURCE- https://www.financialexpress.com/healthcare
