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Mumbai doctors blame pigeons for rise in lung diseases | News from Radio-Canada

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At his clinic in Mumbai’s northern suburbs, Dr. Pralhad Prabhudesai looked at an X-ray, flipped through a chart and quickly fired a series of questions at the patient standing before him.

“Are you often around pigeons?” What else are you exposed to?

The pulmonologist is part of a group of doctors working in India’s most populous city who are increasingly alarmed by what they have observed over the past seven years: a five-fold increase in cases of inflammation severe lung disease called hypersensitivity pneumonitis.

This is a sharp rise that experts directly link to the explosion in the pigeon population in Mumbai. Bird droppings contain fungi which, if inhaled for a prolonged period, can cause immune system disorders.

“It’s a terrible, progressive disease,” Dr. Prabhudesai said in an interview with CBC News, adding that in chronic cases, hypersensitivity pneumonitis causes irreversible scarring of the lungs, which can force the patient to constantly receiving oxygen, or even leading to a lung transplant.

“There are more than 300 reasons for getting this hypersensitivity pneumonia and (exposure to) pigeons is one of them,” Prabhudesai said. “More importantly, it is the most common cause of illness in our country.”

A doctor talks to his colleague about a patient's lung disease diagnosis at a clinic in Mumbai, India.
Pulmonologist Dr. Prahlad Prabhudesai, who is seeing more and more cases of pulmonary hypersensitivity pneumonitis caused by exposure to pigeon droppings, often tells his patients not to feed the birds. (Salimah Shivji/CBC)

Other causes are allergens found in grains, feathers, and air conditioning units that are not properly maintained, but several recent studies of newly diagnosed patients in India have identified exposure to birds as the main link to the chronic disease.

Experts are calling for more data to be collected and the Indian Council of Medical Research has now developed a registry to track cases of lung disease, as well as identified causes.

Problem with pigeon feeding

The problem is acute in Mumbai, India’s most densely populated city, which has millions of apartment buildings with flat surfaces where pigeons love to roost. The city also has a strong cultural tradition of feeding birds for religious reasons, such as a deeply held belief that caring for pigeons brings blessings and helps wash away a person’s sins.

Mumbai is known for its kabutarkhanas, designated feeding grounds, often located near temples and other places of worship where thousands of pigeons gather and are fed. It is not uncommon to see people dragging large bags of grain to pour them in front of the birds.

“In Mumbai, they give a lot of food near your house, near the temple… wherever you go,” Prabhudesai said.

He often fields questions from patients asking if there is a pigeon repellent or other technology being developed to drive birds out of homes.

A group of pigeons in central Mumbai, India.
Pigeon droppings contain fungi that can cause serious lung inflammation after prolonged exposure. (Glen Kugelstadt/CBC)

‘I had no idea’

“Patients (of the danger posed by pigeons) have started to become aware in the last five years,” he said, but many of them feel helpless “because they are very stubborn birds.”

A diagnosis of hypersensitivity pneumonitis came out of nowhere for Namrata Trivedi, who just returned to work last year after more than a decade battling the disease.

She started having breathing problems and a persistent dry cough in 2011 and a series of doctors failed to figure out what she had.

“When I saw the X-rays from my CT scan, I could see a black layer on my lungs,” she told CBC News in an interview in Gujarati.

“The doctor looked at my husband and my mother and told me I only had three years to live.”

Namrata Trivedi was in disbelief when doctors told her she had contracted a lung disease caused by pigeon droppings.  “I had no idea,” she told CBC.
Namrata Trivedi, who has been battling severe symptoms of hypersensitivity pneumonitis for years, was incredulous when doctors told her she had contracted lung disease from pigeon droppings. “I had no idea,” she told CBC. (Salimah Shivji/CBC)

Trivedi, 57, frequently fed the pigeons, and in one of his former homes there were large bird nests tucked into a windowsill. Yet she was stunned when she was told that the cause of her lung disorder was pigeon poop.

“I had no idea, I was completely unaware,” she said. “I remember thinking how could pigeons cause such a huge problem! That’s not possible.”

Trivedi has defied doctors’ predictions and her condition is now under control, although she still suffers occasional lung pain and has to take precautions to avoid large crowds when she goes out.

The hairdresser wants more people in Mumbai to know how deadly pigeon droppings can be.

A crowd of pigeons converges on a square in central Mumbai, in front of a large apartment building.
Experts believe that Mumbai’s many apartment buildings, as well as the tradition of bird feeding, have contributed to the city’s booming pigeon population. (Glen Kugelstadt/CBC)

“People don’t understand, they keep saying that feeding pigeons is ‘Jeev Daya” said Trivedi, using the Hindi and Gujarati term meaning to help or show compassion towards all living beings, including animals.

“But humans deserve to be helped too,” she added, saying it breaks her heart to see children suffering from this disease because the people around them insist on feeding the birds.

Difficult to avoid pigeons

Prakash Punjabi, 68, who discovered he had chronic lung disease due to exposure to pigeon droppings last year, is trying to deal with the same physical and emotional pain.

He spends at least four days a week exercising at a rehabilitation center adjacent to Prabhudesai’s clinic in north Mumbai, often connected to an oxygen machine.

Prakash Punjabi, 68, who suffers from chronic hypersensitivity pneumonitis, feels grateful to have access to a rehabilitation center to control the symptoms.
Prakash Punjabi, 68, who suffers from chronic hypersensitivity pneumonitis, feels grateful to have access to a rehabilitation center to control the symptoms. (Salimah Shivji/CBC News)

“It’s very difficult,” he said, panting from his oxygen intake while on the treadmill. “I have trouble breathing through my nose and feel tired all day.”

Punjabi was not used to feeding the pigeons, but he and his doctors suspect he contracted the disease after spending so much time at home during the COVID-19 lockdown.

“Where I live, there are a lot of pigeons,” he explains. “We have grids and aluminum siding where all the pigeons dance all day.”

These days, Punjabi doesn’t leave his house without wearing a mask to protect him from dust and pigeon droppings, but he says that’s often hard to avoid with Mumbai locals. kabutarkhanas.

A man throws food towards a crowd of pigeons in Mumbai, India.
Pigeon feeding, seen as a way of helping birds and accumulating religious blessings, is a common practice in Mumbai. (Glen Kugelstadt/CBC)

“People believe religiously that if you feed them you get the blessing of the pigeon. You can’t ban it, you can’t do anything,” he continued. “But people need to be very careful when dealing with (pigeons).”

Technically, the city of Mumbai imposes fines of 500 rupees ($8 Canadian) for feeding pigeons in undesignated areas, but residents say the regulation is rarely enforced.

It is up to thoracic surgeons like Prabhudesai to sound the alarm and repeat the same advice over and over again:

“We always try to tell people, ‘Number one, don’t feed the pigeons.’

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