As COVID-19 deaths surged in January, Christy Berger worried she had all the symptoms of a coronavirus infection.
She started to feel her lungs when she breathed — a strange sensation that wasn’t painful or uncomfortable, but more like a tickle or an itch.
Then, the 52-year-old began having such severe shortness of breath that she couldn't walk across the street without feeling winded. Her doctor ordered a COVID-19 test, but before Berger received the results, she panicked and bought a pulse oximeter in the middle of the night to measure the oxygen level in her blood. One time, it dropped to 75% — a dangerously low reading.
“I was really scared. When you're not able to breathe, that's one of the scariest things you can feel and it affects everything,” Berger, who lives in Citrus Heights, California, told TODAY.
“I knew something was really wrong.”
The COVID-19 test was negative, but a CT scan finally provided an answer. Berger had a rare but potentially life-threatening reaction to an allergen in her home: bird feathers. For six years, she’d been a volunteer at a wildlife rescue, tending to injured birds. Berger brought some of them home to give them better care and some of those pigeons and doves became her pets. About 10 lived in the house. A couple of dozen more lived in an aviary outside.
Berger’s diagnosis: hypersensitivity pneumonitis, also known as bird fancier's lung when it’s caused by breathing in particles from bird feathers or droppings. Some people even react to feather pillows or down comforters.
'Birds and hot tubs are the two biggest culprits'
The condition is an inflammatory reaction of the lung when it’s exposed to antigens — different types of proteins that can be found in the environment, said Dr. MeiLan Han, a spokesperson for the American Lung Association and professor of medicine in the division of pulmonary and critical care at the University of Michigan.
“Birds and hot tubs are the two biggest culprits that I see in my practice for potential issues in the home,” said Han, who was not treating Berger.
“(The inflammation) will lead to shortness of breath and oxygen levels dropping. During a pandemic, if you see a funny shadow on an X-ray or CT scan, plus oxygen levels dropping, it makes a lot of sense that people jump immediately to the thing that's on everyone brain right now, which is COVID-19.”
Doctors recognize hypersensitivity pneumonitis by a certain pattern they see on a CT scan, but it can take a long time to figure out which antigen is causing the problem, she noted. More than 300 substances can trigger hypersensitivity pneumonitis, according to the American Lung Association.
Besides bird fancier's lung, there’s hot tub lung, which develops when people breathe in bacteria found in the water vapor coming from indoor spas; humidifier lung, triggered by breathing in fungus growing in humidifiers, air conditioners and heating systems; and farmer's lung, caused by breathing in mold found in hay, straw and grain.
Treatment starts by removing the patient from the antigen exposure so the lungs can heal. But if the affected person is repeatedly exposed over long periods of time, the inflammation becomes a scar, Han said. She had a patient with bird fancier's lung die because the woman refused to give up her parrot.
“Often, it's very difficult to part people from their birds, and parrots live a really, really long time,” Han noted.
Staying away from birds
Berger called having to give up her birds “devastating.” She’s been able to find new homes for many of them, so she’s now down to about 20 birds living in the aviary outside her house. They'll have to be adopted, too, so she's seeking help through her Facebook page. She also can’t volunteer inside at the wildlife rescue anymore.
“Probably the first month, I cried every day,” Berger said.
“I love animals, but there's something special about birds for me… they're so smart and beautiful and there's something about them that I really connect with. So it just breaks my heart. It's really hard.”
Berger also had to have her house deep cleaned to get rid of bird dander. The antigens can get into the ventilation system and be farther into the home than people realize, Han said.
Berger’s CT scan showed her condition may be reversible since there was no lung scarring present. She was prescribed the corticosteroid prednisone for a while to suppress the inflammation and said she feels much better.
Most bird owners won’t get bird fancier's lung. Doctors don't fully understand why some people are affected, but it’s thought they may have a genetic predisposition for the condition, Han noted. If you have a bird in your home, she recommended keeping it in a well-ventilated space and keeping things as clean as possible.
See a doctor if you develop a new cough or become short of breath, and don’t ignore those symptoms, warned Han, author of the upcoming book "Breathing Lessons: A Doctor's Guide to Lung Health."
“One of the problems with lung diseases in general is that we tend to talk it up to something else, like ‘I'm getting over a cold’ or ‘I smoke’ or ‘I'm overweight,’” she said.
“Shortness of breath is never normal… the quicker you identify (the problem), then the quicker you can be on the road to recovery.”