Dr. Joel Depper sneezed seven times in a row last Wednesday morning and then, he said, he knew.

Juniper season, and its associated allergies, had arrived.

”It’s here. It was here Monday, yesterday and today,” Depper, a Bend allergist, said last week. ”From now on until the first week of May there will be juniper in the air on sunny, warm days. Every single one of them. When it rains or it snows, there won’t be.”

Juniper trees are the first plants to pollinate in abundance in Central Oregon, and every year by the beginning of March, allergy sufferers start to complain of symptoms, local allergists said. The pollen from junipers is potent and prolific, hitting people harder than most other seasonal allergies.

”Juniper is the worst,” said Scott Aycock, a Bend resident and allergy sufferer. ”I’ve lived in North Carolina, British Columbia and here. The juniper here is the worst of my allergies.”

Aycock said he takes an oral allergy medication and a nasal steroid, he’s had surgery on his sinuses, does a nasal rinse once or twice a day and uses eyedrops. Yet still he is plagued by juniper.

”This time of year it’s awful,” he said.

Unpredictable pollen

Juniper is a High Desert plant that tends to grow mostly in eastern Oregon and Washington and in parts of the Southwest including New Mexico. Because the areas where juniper is prevalent tend to have lower populations, Depper said, not much research has been conducted on juniper allergies.

The pollen from juniper and the symptoms it creates in allergy sufferers falls into the category of allergies commonly known as hay fever. The term applies to all allergies caused by a seasonal pollen. In Central Oregon, juniper tends to be the first tree to pollinate, usually in March and April. It is followed by deciduous trees, pines, grasses and finally weeds in the late summer and early fall which can all cause allergy symptoms, said Dr. Kevin Kral, a Bend allergist.

”It’s just that we have a lot of (juniper.) If we lived anywhere else, it could be grass pollen. In California it could be oak or olive,” Kral said. ”If you ever fly into the Redmond Airport, look down right before you land and everywhere you look you see juniper trees. They are everywhere.”

Typically, juniper season starts after the first three or four days of warm weather where the temperature does not drop below freezing at night, said Dr. David Coutin, a Bend allergist.

But in the 14 years he has lived here, Coutin said, he has given up trying to predict what kind of juniper season it will be.

”Generally speaking we find that the high juniper counts are cyclical. Maybe every five to seven years you get a high season,” Coutin said. ”Every time I try to predict, we get a cold spell.”

And juniper is very dependent on weather, Depper said. As soon as the temperature drops or precipitation hits, the amount of juniper pollen in the air is dramatically reduced.

Both Depper’s and Coutin’s medical practices do pollen counts regularly during juniper season. As of Monday, Depper said the pollen count was at 1,600 pollen grains per meter square of air, which is fairly high on the scale.

”We know when we see up to 300-count that that is very modest and that 1,000 is very high,” Depper explained. ”Sometimes we see as high as 20,000 in very bad years.”

Yet knowing what causes a bad year is difficult. Depper said the worst year he has experienced in Bend was in 1996, but he can’t explain what made that year different than the rest.

That may have been the year that Carol Ranstad was first hit with symptoms of ”juniper sickness,” that changed her life.

”I had lived here about five years. It was one of those years where the counts are extremely high,” Ranstad, a Bend resident, said. ”I would suffer sleep deprivation. The eye itching would be so severe, if I touched my eyes they would be swollen shut.”

The pain and misery was so intense, Ranstad said, she considered moving.

”There were times when I thought, ‘How can I live here?’” Ranstad said. ”There is not much of a choice when you have three kids in school here and a husband in a job here.”

Airborne allergies afflict an estimated 35 million Americans, according to the National Institute of Allergy and Infectious Diseases, which is part of the National Institutes of Health.

And pollen allergies, according to the institute, are one of the most common forms, although people can also be allergic to dust mites, food, animals, mold and medicines. Allergy patients’ immune systems react to tiny pollen particles that are inhaled as if they were a virus that needed to be fought.

”People who have allergies don’t have an immune defect, their immune systems work fine,” Depper said. ”The problem is they work too well. They are trying to fight something they don’t need to fight at all.”

During that fight, the immune system issues an inflammatory response causing the sneezing, itchy eyes and throats symptomatic of allergies. To develop that response, Depper said, takes repeated exposures to allergens over time.

”Fifteen to 20 percent of the population is born with a genetic predisposition to have allergic reactions. If you are not in that 20 percent you can live here your whole life and not react to juniper,” Depper said. ”If you move here and you are allergic to other things from other places, it generally takes two to four years to develop an allergy to juniper.”

But there are some cases that are not easy to explain. Depper himself said he had never had allergies before moving to Bend and now his juniper allergies are so severe he requires shots to control the symptoms.

”Some people who didn’t know they had that genetic predisposition moved here and found out,” Depper said. ”Juniper is very potent. I have never lived anywhere where I have seen worse reactions than what I see to juniper here.”

Ranstad too said after trying multiple medications she has resorted to steroid shots to control the symptoms.

”I obviously am doing better than I used to,” she said. ”By this time most years, I would be in bad shape … My eyes sure hurt but they are not itching. My scalp itches. I’m not really bad at all compared to what I used to be.”

For most people, Coutin said, the good news is that the symptoms are easily treatable. He recommends daily use of a prescription anti-inflammatory nose spray starting two weeks before the juniper season hits and an over-the-counter antihistamine taken daily as needed to control symptoms.

Depper said he recommends the generic brand of Claritin, which is called Loratadine, over Benadryl because it does not cause drowsiness and can be taken just once a day.

For those who need further treatment, Depper and Coutin both said steroid shots tend to be effective at providing relief.

”When I first moved here, people used to go to the coast, stay indoors, put signs on their doors saying, ‘I will not open the front door because of the juniper season,’” Coutin said. ”That’s not really necessary if you do these other things. We don’t want anybody to treat themselves as a shut in.”

Juniper allergy signs, symptoms, treatments

* Juniper trees typically begin pollinating in March and continue through the beginning of May.

* Symptoms of juniper allergies include sneezing, itchy and watery eyes, itchy throat and nose, postnasal drip and coughing.

* Allergists recommend use of an anti-inflammatory nose spray and over-the-counter antihistamines to control symptoms. For those with severe allergies, steroid shots are sometimes necessary.