Pigeon Breeders’ or Bird Fancier’s Disease or Avian Hypersensitivity Pneumonitis
Pigeons can carry a variety of diseases that can be harmful to humans. Most of these diseases, often cause mild symptoms such as a cold or stomach upset. However, some diseases carried by pigeons can cause more serious illness that infects the lungs.There are many lung diseases that pigeons can easily spread to humans, three of the most common being histoplasmosis, psittacosis, and cryptococcosis. Lung ailments such as Hypersensitivity Pneumonitis, Bronchial Asthma, and Chronic Bronchitis can also be contracted from pigeons.
What is bird breeder’s lung disease?
“Bird breeder’s lung or Bird Fancier’s disease, also known as Avian Hypersensitivity Pneumonitis, is a respiratory disease caused by exposure to bird droppings, feathers, and dust. The disease is commonly found among people who work in close proximity to birds such as bird owners, pet store employees, and poultry workers. Hypersensitivity Pneumonitis is a type of disease of the lung parenchyma (Interstitial Lung Disease- ILD) which causes scarring and fibrosis of the lungs due to repeated inhalation of an airborne antigen. Multiple environmental factors are associated with development of hypersensitivity pneumonitis, and one of them happens to be exposure to birds.
Love to feed birds in your balcony? You may be at risk of severe lung damage. All you want to know about bird breeder’s lung disease.
Your love for birds could be slowly damaging your lungs and putting you at risk of respiratory failure. The cases of bird breeder’s lung disease are on rise in the recent years and the disease is common in people who feed birds or pigeons, pet store employees and poultry workers, according to experts. Also known as Avian Hypersensitivity Pneumonitis, this condition can cause symptoms like shortness of breath, cough, fever, chest tightness and fatigue. Repeated and prolonged exposure to bird dropping, dust and feathers can cause irreversible damage to lungs over a course of many years and lead to chronic respiratory failure. The disease is difficult to diagnose but in recent years with more awareness it is getting better. “The site of people feeding birds and pigeons in their balconies or windows or terraces at home, at religious places like temples and mosques and at various traffic intersections is very common in India. However, what these individuals may not realize is that this seemingly harmless activity can have detrimental effects on their respiratory health,” says Dr Kamran Ali, Sr. Consultant, Lung Transplant & Thoracic Surgery, Marengo Asia Hospitals Faridabad
Although the prevalence of bird breeder’s lung disease is not well documented, but it is believed to be a growing concern. According to the ILD registry in India, exposure to bird droppings and feathers was the reason for HS in 21% cases. The odds of developing HP (Hypersensitivity Pneumonitis) as compared to other types of ILD (Interstitial lung disease) was the highest in patients exposed to birds, followed by moulds, air-conditioners and air-coolers.
Pigeon breeders disease (PBD) is caused by the exposure of a susceptible host to avian antigens. However, genetic factors determining individual predisposition are unknown.
This is the common term for “hypersensitivity pneumonitis” (or extrinsic allergic alveolitis) denoting nonatopic, non-asthmatic, allergic pulmonary disease.
Hypersensitivity pneumonitis is manifested mainly as occupational disease, in which exposure to inhaled organic agents leads to acute and eventually chronic pulmonary disease.
Description
Attacks of chills, fever, and cough with shortness of breath can occur in persons closely associated with birds such as pigeons and parakeets. In some patients, the onset is slow rather than acute. The symptoms are due to antigenic substances in the birds’ excreta. Symptoms usually subside when exposure to the birds ceases.
Associated forms of the disease include bird breeder disease, bathtub refinisher’s lung, mushroom picker disease, mushroom worker’s lung, laboratory technician’s lung, pituitary snuff-taker’s lung, plastic worker’s lung, epoxy resin lung, maltworker’s lung, maple bark stripper’s disease, bagassosis, wheat weevil disease, farmer’s lung, ventilation pneumonitis, and cheese-worker’s lung.
Antibodies directed against the inhaled agent can be identified in serum. Acute illness is characterized by sudden onset of malaise, chills, fever, cough, shortness of breath, and nausea 4 to 8 hours after exposure to the offending agent. This may occur after the patient has left work or even at night and thus may mimic paroxysmal nocturnal dyspnea.
A subacute hypersensitivity pneumonitis syndrome has been described that is characterized by the insidious onset of chronic cough and slowly progressive dyspnea, anorexia, and weight loss.
Chronic respiratory insufficiency and the appearance of pulmonary fibrosis on radiographs may or may not occur after repeated exposure to the offending agent.
Acute hypersensitivity pneumonitis is characterized by interstitial infiltrates of lymphocytes and plasma cells, with noncaseating granulomas in the interstitium and air spaces.
Diffuse fibrosis is the hallmark of the subacute and chronic phases.
Delhi sees rising number of bird breeder’s lung disease cases; doctors say no to pigeon breeding
Bird breeder’s lung disease is an immunologically mediated lung disease due to repetitive exposure of air-borne avian antigens. Bouts of cough, and lung conditions like fever, cough, and shortness of breath are some of the symptoms.
Symptoms
Symptoms generally include dyspnea, wheezing, and dry coughs that seem to shake the entire body. Additional symptoms may include chills, sweating, aching, and fatigue.
Most cases involve typical episodes that are mild and short and may be misdiagnosed. The chronic disease that develops with prolonged exposure to the irritant may be characterized by fever, rales, cyanosis, and, possibly, expectoration of blood.
Bibasilar crackles, tachypnea, tachycardia and occasionally cyanosis are present. Small nodular densities sparing the apexes (tips) and bases of the lungs are noted on chest x-ray.
Pulmonary function studies reveal restrictive dysfunction and reduced diffusing capacity. Laboratory studies reveal an increase in the white blood cell count with a shift to the left, hypoxemia, and the presence of precipitating antibodies to the offending agent in serum.
The symptoms of bird breeder’s lung disease include shortness of breath, cough, fever, chest tightness and fatigue, says Dr Ali.
“The symptoms usually develop over a period of several months to years and can be difficult to diagnose. Persistent, low-level exposure may lead to gradual damage to the lungs with symptoms becoming more pronounced after the lung damage is profound. The scarring and fibrosis of lungs eventually leads to failure of lungs to deliver oxygen to the blood stream leading to chronic respiratory failure. Such patients may become dependent on oxygen from external sources like a cylinder or concentrator to maintain normal oxygen levels in their blood,” adds Dr Ali.
Treatment
Prevention is the most effective approach to managing bird breeder’s lung disease. The most suitable way to prevent disease caused by bird droppings is to stop feeding and breeding birds. “Individuals who work with birds or own birds as pets should be aware of the risk of developing bird breeder’s lung disease. Proper precautions, such as wearing protective equipment and regularly cleaning bird cages and surrounding areas, can help prevent or minimize exposure to avian antigens,” says the expert.
“In the event of someone developing this disease, they should avoid further exposure to birds and their droppings. Early diagnosis and treatment are crucial for managing the disease and preventing further lung damage. In some cases, medication such as corticosteroids may be prescribed to reduce inflammation in the lungs,” he adds.
“Lung transplantation may be required in severe cases. Lung transplantation is a treatment option for end-stage lung disease, including bird breeder’s lung disease, where both the irreversibly damaged lungs are replaced by a pair of new and healthy donor lungs. Our team has performed lung transplants for several cases of bird breeder’s disease in India. However, it is a complex and risky procedure that requires careful consideration and evaluation by a multidisciplinary team,” concludes Dr Ali.
Identification and, if possible, avoidance of the irritant are the initial concerns of treatment. In an occupational setting, improved ventilation and air filtering masks are recommended for mild symptoms. If permanent lung changes have not occurred, corticosteroids and avoidance measures often reduces severity and may resolve acute symptoms. Corticosteroids also may be tried in persistent cases. A change of occupation may be necessary.
Treatment of hypersensitivity pneumonitis consists of identification of the offending agent, avoidance of further exposure, and, in severe cases, oral corticosteroids (prednisone, 0.5 mg/kg) daily as a single morning dose, tapered to nil over 4 to 6 weeks.
Compiled & Shared by- Team, LITD (Livestock Institute of Training & Development)
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Reference-On Request.
