When G.S. Srinivas took his mother, K. Sitakumari, to a pulmonologist for a recurring breathing problem, the doctor's line of questioning seemed bizarre.
“Do you live in close proximity to pigeons,” the doctor had asked. When the answer was in the affirmative, the doctor's prescription was even stranger — put up a fish net and keep the birds at bay. The remedy worked and Ms. Sitakumari recovered completely.
The pulmonologist, Dr. Vijay Kumar Chennamchetty, of Apollo Hospitals in Hyderabad, had diagnosed what most Indian pulmonologists will miss — Hypersensitive Pneumonitis (HP) or Bird Fancier's Lung — an inflammatory lung condition caused by bird droppings that are highly allergenic.
Since the symptoms are similar to lung infections, most doctors confuse it with atypical pneumonia, added Dr. Chennamchetty. “Many GPs may confuse this for viral or atypical pneumonia. But fever, cough, myalgia, joint pains and shortness of breath are a giveaway. I always keep a high index of suspicion to identify such cases. Pigeon droppings and AC ducts have become a dangerous combination in urban areas. People don’t open windows but airborne particles of pigeon droppings are a major causative factor of HP. And I am seeing one case every fortnight,” added Dr. Chennamchetty.
Not surprisingly, the only study conducted in India on the subject concluded last year that lack of awareness was resulting in a four-year diagnostic delay from the initial onset of symptoms.
The study was conducted at New Delhi’s Vallabhbhai Patel Chest Institute and an ‘incidental finding’ from the study was that the infection did not affect smokers. “We do not recommend people smoking tobacco but we believe that cigarette smoke has an immunosuppressive effect on alveolar macrophages or dust cells.” said Dr. Raj Kumar, Department of Respiratory Allergy and Applied Immunology, National Centre of Respiratory Allergy, a co-author of the paper.
Proximity to pigeons can damage lungs
“Since they smoke anyway, smokers’ lungs are not affected by the hypersensitivity that is caused among non smokers,” said Dr Raj Kumar, Department of Respiratory Allergy and Applied Immunology, National Centre of Respiratory Allergy, a co-author of the paper. Dr. Kumar said physicians must start questioning exposure to pigeon droppings to reduce wrong diagnosis when patients come in with lung infections.
Well-known victims
Amateur ornithologist Aasheesh Pittie has written a 1700-word blog linking the rise of pigeon population to HP. “Pigeons are one of the causes of this lung disease, which is one of the several forms of pulmonary fibrosis. Though there are 150 other known triggers for HP, feral pigeon population is one of the main suspects in urban areas and we keep feeding them due to pseudo-religious reasons,” says Aasheesh, and his blog lists famous victims to the disease, including Marlon Brando, Mansur Ali Khan Pataudi, James Doohan (Star Trek) and Peter Benchley (author of Jaws).
“First them and then us,” says K. Satyanarayana, a businessman, as his wife scatters grains of jowar on a disused stretch of road in Muslimjung bridge.
“Everyday I sell 300 kg of jowar and including other grains, it is in the region of 400 kg,” says Govind Raj who has a shop just outside the Kabootarkhana in Hyderabad.
Doctors advise that avoiding exposure to pigeon droppings is key to curing HP. Those exposed to the faecal matter should use N95 masks. In general, they recommend that pigeons are not fed.
