Pigeon droppings

Further Reading

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Code: e7
Latin name: Columba livia
Source material: Droppings
Family: Columbidae
Common names: Pigeon, Feral Pigeon, Town Pigeon, City Pigeon
Direct or indirect contact with Pigeon allergens frequently causes sensitisation.
Pigeon allergens may be major components in house dust. Pigeon breeder's disease (PBD) has been found in 6-21% of breeders, the figure differing from country to country.

Allergen Exposure

Geographical distribution
The number of domestic birds is currently estimated at 25 million in the USA and more than 8 million in German households. In Germany, an additional 11 million Pigeons are kept by more than 140 000 registered breeders of fancy Pigeons. (The Homing/Racing Pigeon is a specifically bred variety of Pigeon. These Pigeons are capable of returning home within the day after being released several hundred miles from their loft.) This number does not include the breeding of fattened Pigeons for the table.
There are over 300 species of Pigeons and Doves around the world. Feral, Town or City Pigeons are believed to have descended from domesticated strains of the Rock Dove. In the wild they then interbred (and continue to interbreed) with racing Pigeons and Pigeons from bird fanciers' lofts. The Feral Pigeon is found worldwide. It is closely associated with humans and is a common sight in urban environments.
Feral Pigeons are seen as a pest, due to the noise they create from cooing and scratching; damage to cars, domestic premises, monuments and commercial properties due to droppings, the resultant smell, and of course the potential slip hazard. (Gutters and drainpipes may become blocked, leading to flooding and associated problems.) Extensive damage to air conditioning units and other rooftop machinery is commonplace.
Feral Pigeons build their nests in or on buildings and other structures, where they are usually found on ledges or in hollows - often under eaves or on girders. They may, however, be found in more rural situations, e.g., farmland, parks, golf courses, moorland and woodland.
Pigeon droppings contain excreted serum protein antigens which may have been degraded, making identification difficult. But it is clear that IgA and intestinal mucin are major antigen components. Droppings may also include bacterial endotoxin and other non-specific biological substances.
In one study of patients with Pigeon Breeder's Lung, a 21-kDa protein was shown, by immunoblotting tests,  to be the only protein that identifiedindividuals exposed to Pigeons (1). Antigens identified by indirect immunofluorescence staining, and specific for sera from patients with Pigeon Breeders' Lung or healthy Pigeon breeders, have been isolated from Pigeon intestinal mucus. Two antigenic peaks, one being Pigeon intestinal mucin and the other IgA, were isolated. These studies demonstrate that antibodies to two quite different antigens are associated specifically with sera from Pigeon breeders (2). Pigeon intestinal mucin is a complex high-molecular-weight glycoprotein shown to be a key antigen in the development of Pigeon Breeder's Lung. Different IgG subclasses appear to recognise different epitopes on mucin (3).

Potential Cross-Reactivity

Positive IgE antibody reactions to sera and feathers from five bird species (Pigeon, Budgerigar, Parrot, Canary and Hen), and to Pigeon droppings, have been found in subjects with Bird Fancier's Asthma (4). Since antibodies of each of the patients also recognised antigens of birds with which they were not in contact, immunological cross-reactivity between different avian species was suggested.
Pigeon allergens also appear to cross-react with Dove droppings (5).

Clinical Experience

IgE-mediated reactions
Diseases associated with exposure to Pigeon include Extrinsic Allergic Alveolitis/hypersensitivity pneumonitis, asthma, allergic rhinitis, ornithosis (microbial infections transmitted to man) and lung inflammation caused by irritant dusts (6).
Extrinsic allergic alveolitis, also known as hypersensitivity pneumonitis, Bird Fancier's Lung and Farmer's Lung, is a disease of inflammation of the lung parenchyma in the terminal bronchioles and alveoli. Symptoms may start soon after exposure to bird allergens or after many years, and may include breathlessness, cough, occasional chills, and fever. Death may also result.
The disease is also known as Pigeon Breeder's Disease, a type of hypersensitivity lung disease due to the inhalation of Pigeon-derived antigens, such as antigens from dried Pigeon droppings (6-8). In Mexico, the most frequent form is due to the inhalation of avian antigens, mainly Pigeon proteins (9). A nasal form of Pigeon Breeder's Disease also exists (10).
It occurs after exposure to organic dust and may occur after close contact with Pigeons or other birds such as Budgerigars, Parrots, Canaries, Parakeets, Cockatiels, and Doves. Exposure results in the development of various immunoglobulins including IgE (4), IgM (11), IgA and various IgG subclasses (12-14). Th e antibodies may be found in the sera and saliva of patients (15) as well as in the sera of asymptomatic but exposed subjects (16).
The allergenic proteins are found in bird serum, droppings, skin scales, feathers and Pigeon bloom (a waxy fine dust which coats the feathers of Pigeons). "Fancy" birds produce copious bloom; poultry (Duck, Chicken, Turkey) produces very little bloom. Contact may result from handling birds, cleaning the loft, or from exposure to the organic dust drifting down from a ceiling where birds nest.
Diagnosis is based on a characteristic clinical picture and a typical x-ray pattern, accompanied by the presence of specific IgG antibodies (17).
The measurement of specific IgG using IgG tracer technology has been shown to be a sensitive and specific assay for the routine diagnostic testing of Extrinsic Allergic Alveolitis caused by bird antigens (18).
Extrinsic Allergic Alveolitis may also occur in families, as reported in a study where the cause was wild city Pigeons (19).
Extrinsic Allergic Alveolitis is not common in childhood (20-22). A study from Malta reports on 5 cases in the pediatric population. All were males, and were initially diagnosed as having other respiratory illnesses or mental disturbances. A final correct diagnosis was made based on a history of exposure to birds, clinical findings, positive avian precipitins, a restrictive defect shown on pulmonary function tests, and a suggestive chest X-ray appearance (23).
A typical clinical presentation would be a male Pigeon breeder who develops a sudden fever, cough and dyspnea, with diffuse nodular shadows on the chest X-ray film (24). In a study conducted in the Canary Islands, of 343 Pigeon breeders, 29 (8%) fulfilled the classic Pigeon Breeder's Disease criteria. One hundred and six (31%) had rhinitis, 62 (19%) had immediate bronchial symptoms, and 51 (15%) suffered from chronic bronchitis. A significant level of specific IgG was detected in 139 (40%) cases. A statistical relationship between the intensity of exposure and specific IgG response was also found (17).
The presence of IgG, IgA, IgM and IgE antibodies against Pigeon serum and Pigeon droppings has been demonstrated in serum from symptomatic breeders (6) (25) (26) (27). Positive IgE antibody reactions to sera and feathers from five bird species (Pigeon, Budgerigar, Parrot, Canary and Hen), and to Pigeon droppings, have been found in subjects with Bird Fancier's Asthma (4). Pigeon Breeder's Disease has been found in 6-21% of breeders (6), with the figure differing from country to country. Rhinitis in bird fanciers can be associated with an IgE-mediated allergy to bird antigens.
A 61-year-old woman was diagnosed with chronic hypersensitivity pneumonitis due to Wild Pigeons. The patient was not a Pigeon breeder, but she could have been exposed to Pigeons at her workplace. She had specific antibodies against Pigeon serum and droppings, and her peripheral lymphocytes showed proliferation in response to Pigeon serum. A positive provocation test involving inhalation of Pigeon serum confirmed that she had chronic hypersensitivity pneumonitis caused by allergy to Pigeons. This is a rare case of chronic hypersensitivity pneumonitis, associated with Wild Pigeons, that progressed to pulmonary fibrosis (28).
Other reactions
Acute urticaria may be caused by Pigeon Ticks, which, according to a report, had dropped from wooden ceiling beams. The patient was living in the centre of Milan in a very old house, where numerous Pigeons had built their nests under the rooftop (29).
The House Dust Mite Dermatophagoides farinae has been found in samples from a Pigeon loft. Besides Mites of the family Pyroglyphidae, Mites of the Tyroglyphidae family and/or mucedine were found. House Dust Mites should be considered in patients with apparent allergic disease to Pigeon (30).
Compiled by Dr Harris Steinman, harris@zingsolutions.com


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  2. Todd A, Coan RM, Allen A. Pigeon breeders' lung: pigeon intestinal mucin, an antigen distinct from pigeon IgA. Clin Exp Immunol 1991;85(3):453-8
  3. Baldwin CI, Todd A, Bourke SJ, Allen A, Calvert JE. Pigeon fanciers' lung: identification of disease-associated carbohydrate epitopes on pigeon intestinal mucin. Clin Exp Immunol 1999;117(2):230-6
  4. Tauer-Reich I, Fruhmann G, Czuppon AB, Baur X. Allergens causing bird fancier’s asthma. Allergy 1994;49:448-53.
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  14. Baldwin CI, Todd A, Bourke SJ, Allen A, Calvert JE. IgG subclass responses to pigeon intestinal mucin are related to development of pigeon fancier’s lung. Clin Exp Allergy 1998;28(3):349-57
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As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.