A rare but serious lung disease linked to exposure from pigeons is on the rise in Karachi, with weekly cases of Bird Fancier’s Lung (BFL) now reported between 15 and 25 — a sharp increase from the one or two weekly cases seen a decade ago.

The disease, a form of Hypersensitivity Pneumonitis (HP), is affecting women and elderly individuals at a concerning rate.

The condition is caused by repeated inhalation of microscopic particles—measuring just 1–3 microns—found in pigeon feathers and dried droppings. These particles often enter homes through open windows or unserviced air conditioners, settling deep into the lungs and triggering allergic reactions.

The symptoms usually begin mildly, with a persistent cough, fatigue, wheezing, or shortness of breath. However, if left unaddressed, BFL can develop into irreversible lung scarring known as Interstitial Lung Disease (ILD). In advanced cases, patients may require oxygen therapy or even a lung transplant.

Karachi’s pigeon culture under scrutiny

Pigeon feeding spots have multiplied across Karachi in recent years, increasing exposure risks for bird caretakers and nearby residents. As pigeons flap their wings and move about feeding areas, they release allergens into the air, which can drift far beyond the immediate surroundings.

While such public feeding spaces are considered part of urban culture, their health implications are drawing renewed attention. Many individuals affected are unaware of the risk they face, especially when exposure occurs inside homes or enclosed spaces.

Although BFL is treatable in its early stages, Pakistan currently lacks facilities for lung transplants. Patients with advanced conditions must seek medical care abroad — often in countries like India, China, or the UAE — adding further burden on families.

Health professionals stress that prevention remains the best approach. Simple steps such as wearing masks and gloves when handling birds, avoiding dry sweeping of cages, and installing filters or servicing air conditioning systems can greatly reduce risk.

Hospitals report spike but no formal classification

Officials at Civil Hospital Karachi confirmed a growing number of patients presenting with respiratory distress, but acknowledged the absence of a disease-specific classification system for BFL. This gap in medical coding has led to underreporting and an overall lack of structured data, making it difficult to gauge the full extent of the problem.

Internationally, several countries have taken strong measures in response to BFL and similar risks. Australia and Switzerland have banned pigeon feeding in urban areas due to public health concerns. Even in Makkah, the once-popular pigeon feeding site near the Holy Kaaba was dismantled during previous outbreaks of COVID-19 and MERS to curb airborne disease risks.

Public health advocates are calling on the government and municipal authorities to take immediate steps. Suggestions include launching public awareness campaigns, regulating or limiting urban bird-feeding sites, and incorporating BFL into national health registries to track and treat cases more effectively.