Update on influenza vaccination of egg allergic patients.

allergen levels in the spring, consistent with findings seen in the classroom. Interestingly, the presence of a basement did not predict higher classroom allergen levels as would be expected andwas only associated with higher cafeteria airborne levels. Similar to previous studies, the reported presence of mice in homes was predictive of higher mouse allergen levels.5,6 However, home allergen levels were much lower than school levels. Housing type did not predict allergen levels, although detached 1-family homes seemed to have lower levels, consistent with other published findings.4,10 Although we found a significant association between visible classroom mouse droppings and higher mouse allergen levels, a substantial amount of allergen was present evenwhen droppings were not seen. Matsui et al3 reported more days of asthma symptoms, more rescue medication use, and a greater risk of asthmarelated health care use in inner-city Baltimore preschool children exposed tomore than 0.5 mg/g of Musm 1 in bedroom settled dust.3 Our settled mouse allergen levels exceeded this cutoff even in the groups that did not see mouse droppings. If a Mus m 1 level of greater than 0.5 mg/g is indeed associated with an increase in asthma symptoms and healthcare utilization, then actual measurement of allergen levels may be more informative for assessing asthma morbidity outcomes than relying on reported school characteristics as a surrogate for allergen exposure. This study demonstrated that childrenwith asthma are exposed to significant levels of mouse allergen in inner-city schools. We found that when mouse droppings are seen in the classroom there are much higher levels of settled mouse allergen than if there are no signs of mice. However, even if droppings are not seen, significant levels of mouse allergen, greater than 0.5 mg/g of Mus m 1, a level linked to an increase in asthma symptoms and healthcare utilization, are seen. Based on our findings, objective sampling in schools may be necessary to determine the extent of mouse exposure. Integrated pest management strategies may need to be more intensely applied in the spring, although year-long strategies are likely necessary to tackle this potential public health problem in the school environment.