Unlike pneumoconiosis in coal miners, avian lung is still largely unknown as a disease. It owes its name to the fact that people who regularly come into contact with birds often suffer from it.
What is avian lung?
Bird breeder’s lung is sometimes referred to as pigeon breeder’s disease or bird breeder’s lung. In medical terminology, it is called exogenous allergic alveolitis or one of several forms of it. In bird breeder’s lung, the alveoli, or air sacs, are inflamed as a result of an allergic reaction. The allergic reaction is generally caused by inhalation of fine dust, such as chemical substances or organic dusts. In the specific case of avian lung, however, the allergic reaction and associated inflammation is caused by inhalation of animal proteins found in dust stirred up by the droppings and feathers of birds. This distinguishes it from similar diseases such as chemical worker’s lung, farmer’s lung, and humidifier lung, which are also categorized as exogenous allergic alveolitis but have different causes. Avian lung can occur either acutely or insidiously and can sometimes be chronic.
Causes
The actual cause of avian lung is an immune reaction in the lungs. This is caused by the inhalation of certain allergens found in the dust created by the droppings as well as feathers of birds. When this dust is then inhaled, it enters the lungs and with it certain animal proteins. These proteins trigger a so-called type III immune complex reaction, which in turn causes an inflammatory reaction of the lung tissue. The type III immune complex reaction falsely activates the so-called complement system, which, as part of the human immune system, serves to eliminate cellular antigens such as bacteria. In this way, the organism is told that there is a danger to the lungs and reacts with an inflammation of the tissue, which in turn brings further symptoms.
Symptoms, complaints and signs
In the acute form of avian lung, the first symptoms usually appear 4 to 8 hours after the first contact with the allergens. Symptoms are similar to those of pneumonia and range from cough, accompanied in some cases by sputum, to fever, difficulty breathing, and an elevated pulse. Symptoms usually resolve within a few days after contact has ceased. The insidious chronic form of avian lung, on the other hand, is noticeable through more flu-like symptoms. In addition to aching limbs and fatigue, weight loss and a general feeling of weakness and lassitude may occur. In contrast to the acute illness, the symptoms then occur in a weakened form and in episodes. Continued contact with the allergen can lead to fibrosis, a permanent change in the lung tissue, which in turn can result in chronic cough, shortness of breath even during normal exertion, and heart discomfort.
Diagnosis and course of the disease
The diagnosis of avian lung is usually made by ruling out other possible medical conditions as well as various examinations. The information alone that the affected person has frequent contact with birds usually puts the treating physician on the right track. Listening to the lungs, x-raying the thorax, and detecting specific antibodies against the inhaled animal protein in the body then usually make the diagnosis clear.
Complications
Avian lung leads to serious symptoms and must always be treated. In many cases, however, affected individuals suffer a significantly reduced and limited life expectancy as a result. The symptoms can vary and depend on the severity of the disease. However, they are very similar to the symptoms of pneumonia, so that patients suffer from coughing or sputum. Fever or severe breathing difficulties also occur due to avian lung and have a very negative effect on the daily life of the affected person. As a rule, the symptoms are further aggravated by contact with the allergen. If the contact is avoided, the symptoms usually disappear after a few days.If avian lung is not treated, it can cause significant breathing problems even under ordinary exertion. It comes to a strong tiredness and exhaustion of the affected person. Since a direct and causal treatment of avian lung is not possible, only the individual symptoms can be treated. This usually does not lead to any particular complications. However, a completely positive course of the disease is not achieved.
When should one go to the doctor?
In the case of avian lung, a visit to a doctor is always necessary. The earlier the doctor is visited, the better is usually the further course with this disease. If it should not come to a treatment, it can come in the worst case to the death of the concerning. A doctor should be contacted in case of this disease if the affected person suffers from inflammation of the lungs very often. In most cases, there is also very frequent severe coughing and permanent breathing difficulties. The patient’s daily life and ability to cope with stress is also considerably limited by bird’s nest lung. It is not uncommon for patients to experience permanent fatigue and suffer from the symptoms of flu, and further, weight loss. If these symptoms occur without any particular reason and also do not disappear on their own, a doctor must be consulted in any case. As a rule, avian lung can be diagnosed by a general practitioner or an ENT specialist. However, further treatment depends strongly on the severity of the symptoms, so that no general prediction about success can be made. In many cases, however, the patient’s life expectancy is reduced by this disease.
Treatment and therapy
The absolute most important thing in the treatment of avian lung is the immediate and permanent avoidance of contact with the allergen, that is, the dust from the feces and feathers of birds. People who are professionally involved in keeping birds may then have to give up or change their profession. Without renouncing contact with the allergen, successful treatment is almost impossible. In the case of a chronic course, the administration of glucocorticoids is the remedy of choice. These steroid hormones, which are produced in the adrenal cortex, inhibit the inflammatory reactions in the lungs and thus also the symptoms that occur. Severe forms of chronic avian lung can be treated with immunosuppressants. These inhibit the normal function of the immune system and thus can also prevent the type III immune complex reaction responsible for avian lung and its inflammatory reactions. They may also slow the development of an irreparable change in lung tissue that is already in the process of developing.
Prevention
The development of avian lung can only be prevented to the extent that contact with birds is avoided entirely. However, since it is impossible to know with any certainty that the disease will break out at all before the first contact with birds or before the first symptoms appear, such a safety measure is richly exaggerated. Another possible prevention tactic would be to avoid inhaling the bird dust, but this could prove extremely difficult in practice. Avian lung is common in people who deal with birds for a living. Because of its potentially serious health consequences, it is a reportable occupational disease. However, hobby breeders can also contract it and should take even the first symptoms seriously, as long-term contact can have dire consequences for the lungs and heart.
Aftercare
This disease was challenging for the immune system, especially if the patient had intensive contact with birds and/or was diagnosed late. Even if the birds have been surrendered and the bedding replaced, it is possible that traces of the allergens may still be found in the household. Therefore, at least during the first year of follow-up care for avian lung, special attention should be paid to hygiene and cleanliness in the affected person’s environment. If possible, professional cleaning is recommended. To support the immune system and prevent chronic lung damage, it helps patients if they pay attention to a healthy lifestyle and do not smoke, but spend a lot of time in nature and fresh air.It is also recommended to abstain from alcohol and sports activities, as far as the general physical condition allows. Of course, a healthy lifestyle also includes a vitamin-rich diet, sufficient sleep and as little stress as possible. Excretory and detoxifying measures are also helpful in the aftercare of avian lung. Naturopathic physicians or alternative practitioners can recommend appropriate remedies here. Even saunas, steam baths or sweaty work or sports detoxify the organism. Water-rich fruit and vegetables also have a detoxifying effect. Such discharge processes should be supported by the patient by drinking one and a half to two liters of water daily.
What you can do yourself
If bird owner lung has been diagnosed, allergen contact must be completely avoided. Bird owners and breeders may need to surrender their birds to prevent progression of the disease. In addition, feather beds and feather pillows should be removed from the home. Potted plants, aquariums, and food that is susceptible to mold must also be disposed of to prevent mold. Avian lung is reportable. Affected individuals should contact the appropriate authorities quickly, as well as people who may also have been in contact with the animals. The allergy can be treated well, provided the patient complies with the above measures and informs the doctor of any unusual symptoms. Typical symptoms are respiratory problems and skin changes, which must be treated by a doctor. Suitable self-help measures are sports and plenty of exercise in the fresh air. After diagnosis, patients should take it easy until the symptoms have subsided. This can take several weeks to months. If cardiovascular complaints occur in connection with the disease, the relevant internist or allergist must be consulted. The administration of glucocorticoids can be supported by regular fluid intake and the creation of a medication diary in which any side effects and interactions are noted.
