The Allergist

• A Clear-Eyed Look at the Red-Eye Culprit

  “Don't just rely on the textbook definition of when the pollen seasons are. You need to have reliable data to know when the pollen seasons are starting, when they're ending, and when they're peaking.”  Dawn JurgensAllergy season may be winding down, but for allergists, the work never really stops. This is the moment between ragweed and winter — a brief respite before the cycle begins again. On this episode, Dr. Mariam Hanna is joined by Dawn Jurgens, Director of Operations and Quality Management at Aerobiology Research Laboratories. She breaks down the science behind pollen and spore counts, why forecasts matter, and how shifting seasons are changing the game for patients and clinicians alike.Timothy grass is the most common and potent trigger globally, while birch remains the most clinically relevant pollen in Canada. Pine releases large amounts of pollen but isn’t highly allergenic.Pollution and thunderstorms can make pollen more potent by breaking it apart and exposing allergenic epitopes, intensifying symptoms.Cross-reactivity stems from conserved epitopes, meaning patients sensitized to one pollen may react to related species — or even certain foods.Mold spores, especially Alternaria, Cladosporium, and Basidiospores, can mimic ragweed season and are major fall culprits.Canada’s pollen seasons are starting earlier than they did 30 years ago, though the fall season hasn’t yet extended.Simple strategies — like showering before bed, keeping windows closed, using filters, brushing pets outside, and checking reliable forecasts — can meaningfully reduce exposure.Pollen season may be taking a break, but planning for the next wave starts now.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions

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• Standard Vaccines And Special Cases

  “Vaccine counseling is really a team sport. — Dr. Anne Pham-HuyVaccines can stir anxiety for patients and confusion for clinicians, especially when biologics enter the mix. Dr. Mariam Hanna is joined by Dr. Anne Pham-Huy, clinical immunologist at CHEO, member of the Special Immunization Clinic Network, NACI member, and chair of Immunize Canada. Together, they break down the science of vaccine responses and tackle some of the trickiest questions allergists face in daily practice.On this episode:The major types of vaccines — from live attenuated to mRNA — and what sets them apart.Why live vaccines often produce strong, durable protection, but may require caution in certain patients.How adult immunization is still underutilized, with gaps in boosters, pneumococcal, HPV, and influenza coverage.Which “special populations” need tailored vaccine strategies, including patients on immunosuppressants, transplant recipients, and those with chronic disease.Practical guidance on timing vaccines around biologic use and which precautions truly matter.When to check titers and antibody responses — and why it’s only relevant for select patient groups.Strategies for counselling vaccine-hesitant patients with empathy, focusing on disease risk and building trust.What’s next: combination mRNA vaccines and nirsevimab for RSV prevention in infants.The questions are simple — are they vaccinated, special, or special enough — but the answers matter.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions

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• No to Olive Oil, Yes to What Works in Eczema Care

  “Atopic dermatitis is not just about what you see on the skin. It's about what the patient's experiencing.” Dr. Melinda GooderhamEczema care has become a world of creams, cleansers, oils, and myths — but what actually works? Dr. Mariam Hanna is joined by Dr. Melinda Gooderham, assistant professor at Queen’s University and consultant physician at the Peterborough Regional Health Centre. As principal investigator for more than 250 clinical trials, Dr. Gooderham brings both evidence and practical wisdom to the table.On this episode, they explore:Why barrier repair remains the cornerstone of therapy, and how humectants, emollients, and occlusives play distinct rolesThe evidence behind natural oils (and why olive oil is out while coconut, sunflower seed oil, and shea butter may have a place)Bathing basics: frequency, water temperature, and whether bleach baths still matterHow to choose topical steroid potency and when to pivot toward non-steroidal optionsThe promise of newer agents: calcineurin inhibitors, PDE-4 inhibitors like roflumilast, and topical JAK inhibitorsWhen to escalate to systemic therapy, with itch and quality of life as key markersEczema may be complex and misunderstood, but Dr. Gooderham reminds us that consistent barrier care, adequate product use, and asking the right questions about itch can simplify management and improve patient outcomes.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions

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• Solving the Mystery of Mastocytosis — Tests, Treatments and Triggers

  “You will think it is mastocytosis much more often than you'll actually diagnose mastocytosis.” — Dr. Matthieu PicardMastocytosis is rare, complex, and often confused with other mast cell disorders. To help clinicians cut through the confusion, Dr. Mariam Hanna welcomes Dr. Mathieu Picard, allergist and clinical immunologist, who has built a dedicated practice caring for patients with mast cell diseases. Together, they explore what physicians need to know about diagnosis, monitoring, and management.On this episode:Adults: Around 80% of adults with skin lesions have systemic mastocytosis, and the disease typically persists.Children: Pediatric cases are almost always cutaneous and often resolve by puberty.When to order a tryptase — and why a normal result doesn’t rule out systemic diseaseThe role of KIT D816V mutation testing and why biopsy technique mattersKey risks to monitor in indolent systemic mastocytosis: anaphylaxis, osteoporosis, and rare progression to advanced diseasePractical tips for patient care, including venom immunotherapy considerations, osteoporosis screening, and symptom control strategiesMastocytosis may be rare, but it doesn’t take uncommon skill to spot — just the right tools, a sharp eye, and maybe a tongue depressor scratched five times.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions

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• Finding the Fix for Chronic Cough

  “At least 60% don't respond to anything or who have been to somebody else before and they've come to me and they've tried everything and failed” — Dr. Imran SatiaDr. Imran Satia, Respirologist and Associate Professor at McMaster University and Canada Research Chair in Chronic Cough, joins Dr. Mariam Hanna to walk clinicians through a practical, evidence-based approach to diagnosing and managing chronic cough. With decades of research and clinical experience, Dr. Satia explains how to define chronic cough and its subtypes, recognize red flags, and navigate the common — and less common — causes that keep patients coughing for years.On this episode, you’ll hear:The difference between chronic cough, refractory chronic cough, and unexplained chronic cough — and why the terminology matters for treatment.The key investigations every patient with chronic cough should have, and how to interpret results in the context of cough hypersensitivity.The role and real-world value of methacholine challenge, FeNO, induced sputum, and sputum culture in refining diagnosis and guiding therapy.Why empiric ICS–LABA and PPI trials aren’t always the right move — and when they are.Management strategies for patients who don’t respond to initial treatment, starting with a low-dose morphine trial, followed by neuromodulators, speech therapy, and clinical trial options.By the end of the episode, you’ll have a clear, step-by-step framework for assessing chronic cough, avoiding unnecessary treatments, and helping even the most refractory patients find relief.Visit the Canadian Society of Allergy and Clinical ImmunologyFind an allergist using our helpful toolFind Dr. Hanna on X, previously Twitter, @PedsAllergyDoc or CSACI @CSACI_caThe Allergist is produced for CSACI by PodCraft Productions

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