Eight-year-old Justus Brown has had allergy problems before, but nothing like he experienced Sunday on the way to church in Towson - an attack that his parents blame on last week's record pollen counts.
"He told me on Sunday morning he made a 'funny noise' when he breathed," recalled his mother, Kenya Brown, 37, of Owings Mills.
Justus was wheezing, and he knew something was wrong. "I thought I was going to die," he said. "It felt horrible every time I walked. Every second I had to bend down and catch my breath."
Justus spoke by phone yesterday from St. Joseph Medical Center, where he was admitted Sunday for an asthma attack during some of the worst spring pollen conditions that allergists have ever seen.
"It's been a horrendous allergy season," said Dr. John R. Bacon, an allergist and immunologist on the staff at St. Joseph. "Thankfully, we've had some rain to cleanse the atmosphere. I was supremely happy [about the rain] because it was difficult keeping up with the phone calls."
But there's more misery ahead for allergy sufferers, thanks to an unlucky combination of weather patterns that first amplified, and then synchronized, the spring peaks of both the tree and grass pollen seasons.
"We're in the peak of oak season, and the grasses are going to continue all though May and June," said Dr. Peter S. Creticos, clinical director of the Johns Hopkins Division of Allergy and Clinical Immunology.
As bad as it has been for people whose allergy problems peak in the spring, he said, "It's just getting started for them."
Pollen-induced allergy and asthma symptoms are suspected of triggering a rash of complaints by school children across Baltimore County, school officials said.
When Parkville Middle School students first complained of breathing problems Friday, worried administrators called in the county Fire Department's medics and a hazmat team. They evacuated the school while they swept it for contaminants and hazardous materials. They found none.
Fire Department spokeswoman Elise Armacost said 15 students were evaluated for "mild respiratory symptoms." Five were taken to Franklin Square Hospital, where they were treated and released.
Allergy sufferers, meanwhile, are descending on their doctors.
"Over these past several weeks, we have seen people coming in with significant nasal, occular and chest problems," said Hopkins' Creticos. "Many people are saying this is the worst spring season they've encountered."
At St. Joseph, patients have been showing up with "general cold-like symptoms - sneezing, runny nose, coughing. Those with asthma are wheezing, with a tightness, or shortness of breath," said Dr. Robert A. L. Blake, a pediatric hospitalist.
"I can't put a firm number on it, but just from what we're seeing it seems the season is worse than it has been in prior years," he said. "Some [patients] actually required quite a bit of intervention."
People with allergies suffer almost every spring, of course. But this season is different. Drs. Jonathan Matz and David Golden have been recording pollen counts in Owings Mills since 1996. Until last week, the highest tree pollen numbers they had ever seen were in the range of 1,500 grains per cubic meter of air.
"Starting last week, in mid-week, we had our first [count of ] 2,200," Matz said. "Friday's count was [almost] 4,000."
Grass counts also soared to 161 on Friday. "Grass at 100 gives you more bang for the buck than a tree count of a thousand. And we're still in the midst of the highest point of the season. It's still going to be high for the next three to four weeks. There's no relief in sight," he said.
Creticos blames unlucky weather: "When the winter is mild, we tend to have a more robust tree and grass pollen season, because the plants thrive through the winter. They begin to pollinate earlier and the counts are higher."
But cool weather in March delayed the early tree species. Milder weather in April then sped everything up again and accelerated grass pollination.
"As a result, everything is hitting at once," Creticos said. "Now we're seeing a preponderance of trees continuing to pollinate. Oak is peaking now. And grass is starting earlier than usual - in April rather than May. That's why people are having so many problems right now."
Baltimore County schools have seen a difference, too.
"We're certainly seeing a higher than average number of ... children going to visit the nurse because of asthma and allergy-related symptoms," school spokesman Charles Herndon said. "We expect that in spring, but we really have seen quite an increase this spring."
It has not caused a spike in absenteeism, he said. But the students are turning up in the nurse's office with complaints that range from itchy, watery eyes to wheezing, coughing and "respiratory distress of a mild nature."
"The nurses have been able to handle it," he said.
The absence of classroom air conditioning may have contributed to the students' distress at Parkville Middle School.
"Air conditioning ... filters out 90 percent of the pollen," said Dr. Mary Beth Bollinger, interim chief of pediatric pulmonology and allergy at the University of Maryland Hospital. Opening windows on a warm day like Friday would have admitted plenty of accumulated pollen.
Kenya Brown said her son's allergies had always been kept in check with medication. But in hindsight, she said, last Friday's high pollen counts - on the same day he was outdoors helping his parents work in the yard - may have overwhelmed him.
Two days of medication and breathing treatments at St. Joseph brought improvement. And Justus said yesterday that he was wheezing "only a little bit."
But he was in no rush to leave, his mother said. "He's just chillin', playing games with Mommy all day. ... He feels fine."
For daily pollen counts, visit: aaaai.org/nab/index.cfm
How to minimize the pollen blues
Wear a pollen mask while gardening
Wash, shower, shampoo after being outdoors
Keep grass cut short
Avoid touching your eyes, nose while gardening
Plan outdoor time for wet, cloudy or windless days
Leave your outdoor clothes outside your bedroom. Wipe shoes and rinse glasses
Remove pollen-producing trees from your yard
Avoid allergy-producing plants [Source: American Academy of Allergy, Asthma and Immunology