I have circulated you question to a number of experts in bird fanciers lung and attach their responses. We believe that any flying or show bird is likely to pose a risk for lung disease. The risks are small and early detection is possible.
1. The hazard probably lies with bloom from feathers, not droppings or dander, so cleaning out the droppings is not likely to be effective, and I would be very sceptical that any bird species is truly free from the risk of allergy.
2. If the first priority is to avoid bird allergy, then the best bet is to avoid birds.
3. If the first priority is to enjoy the company of birds, then it is a matter of balancing risk against benefit. When I investigated the risk of bird fancier's lung from keeping budgerigars, I found that among 109 folk currently keeping one or more budgerigars, 3 had budgerigar fancier's lung - ie about 3%. The 95% confidence limits were 0.5-7.5%.
4. The risk of getting the disease is not, consequently, high.
5. When the disease occurs, it is rarely life threatening or rapidly progressive. Furthermore, if it is recognised promptly and bird contact is then abandonned, the disease usually clears up. The risk would therefore be minimised if there is awareness of it and if relevant symptoms are promptly reported and investigated.
6. Monitoring the blood for avian precipitins may additionally provide advanced warning if hypersensitivity is developing. I suspect that developing an aversion to ingested egg may have the same significance.
7. Thousands of folk keep pigeons for racing or showing, and the pigeon keeping associations provide useful advice about the risk of allergy, and the optimal means of allergy surveillance/prevention.
8. It sounds to me as if the questioner might be reassured.
Although the risk is low the person is clearly very anxious so it's a balance whether this is a bigger problem.
Also, my impression is that parakeets are particularly problematic, there are relatively few who keep these compared to other birds yet I have heard of several very serious cases of EAA, so these perhaps should be avoided.
As for antigens, most of the fancy bird allergens share similar antigens such that their serology almost completely cross-reacts.
As for oil instead of bloom, this aspect of their tegument is beyond me but their droppings will be sufficient to cause a problem in someone clinically s
I have some nice EM photos of pigeon bloom that I published in Occ Lung Diseases some years ago. It seems to be the IgA in bloom that people become sensitised to and it is unrelated to IgE mediated allergy of course. The bloom is in the 5-10micron size range and thus causes a bronchiolo-alveolar reaction, allergic alveolitis. It is probably dose related. Bloom is what makes pigeons fly faster and show birds showier, hence the two common manifestations in pigeon fanciers and people who keep showy birds. I was once asked by a paediatric colleague see a 12year old child who had a mystery lung disease - when he came to the clinic he had a badge on his lapel with a pigeon on it! His dad was the fancier.
Reduction of risk in the domestic situation really only means keeping the room well ventilated if you have a fancy bird, and wearing a mask is unrealistic, apart from care in cleaning the cage etc. Risks are pretty low generally but the person should be aware of early symptoms - a persistent cough, exertional breathlessness. Of course if symptoms develop, treatment is easy and effective but includes removal of the birds.
Smoking is protective but not recommended!
I agree that the main point here is that there is no reason whatever to assume that there will be any health problem at all from these birds unless she is unlucky enough to be allergic to them - and from the sound of it there is the prospect of a definite deterioration of health status without them, if she loves them so much. I don't personally find precipitins all that helpful for clinical management, but if keeping the birds doesn't make her unwell there's nothing to worry about. Better a boid in the hand than a void in the heart
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