Maddie Swanner, a nurse at Mississippi Valley Allergy & Asthma Associates, applied 30 dermapiks of various allergens to Jacob Cantrell's back to see what he is allergic to. The allergens range from pollens to animal hair.

It's spring. Trees are budding out, flowers are blooming, the sun is shining.

And allergy sufferers are sneezing, wheezing and itching.

Anyone stricken this time of year -- and any of the medical professionals doling out antihistamines and advice -- can tell you: Spring allergies are nothing to sneeze at.

Southeast Missouri is prime territory for allergens, say Drs. Michael Critchlow and Robert Sacha, Cape Girardeau allergists.

"You can find just about any of the major allergens right here in a fair abundance," Critchlow said.

"Everything is warming up. Nature is just bursting with beauty, and it's bursting with pollen, too," Sacha said.

The varied number of plants, grasses and trees, the abundance of agriculture and the remnants of swampland in the Bootheel all add to the allergen mix, he said.

"We export great allergens," Sacha said.

All of the ingredients are in place for creating a congested, itchy hell in what should be a springtime paradise, Sacha said. It's warm, it's breezy and all the pretty flowers, trees and grasses are greening up or budding out, pumping pollen into the air.

"It makes you feel good, 'cause it's warm and sunny, but for the people that have allergies, it's miserable," he said.

Not one but two allergy plains -- the Eastern farming plain and Southern coastal plain -- converge on the region, creating a double-whammy for allergy sufferers.

People moving to Southeast Missouri from other areas notice a difference.

"Southeast Missouri is amazing," Sacha said. "I've got people who come here from St. Louis, two hours north, and say this is much worse."

Sacha grew up in Chicago, traveled while in the military and then moved to Southeast Missouri.

"And I've had recurrent sinus problems since I got here," he said.

The Mississippi River and its wetlands also produce a lot of mold, which adds to the misery, Critchlow said.

The allergy season started a little early this year, Critchlow said, with an unusually warm winter followed by a mild, damp spring.

"We seen about three different species (of trees) pollinate in February because it's been so warm, so we can expect a pretty long season," he said.

It's one more thing to blame on El Nino.

"Everyone wants to know if this is going to be a bad year," Sacha said. "If the number of calls I'm getting is any indication, it's a bad year."

Allergies are caused by glitches in the immune system, and are usually genetic. People with allergy problems produce too many antibodies to whatever allergen -- pollen, mold or any other stimulus -- is present, and symptoms result.

Luckily, medications have come a long way, Sacha and Critchlow said.

Non-sedating antihistamines are now available for those prone to snoozing while they're sneezing. And steroid-based nasal sprays are new options.

A number of new eyedrops also are available for what Sacha says is probably the most irritating allergy symptom: itchy, swollen, irritated eyes.

Immunotherapy -- allergy shots -- is also an option for people with chronic allergies, Critchlow said.

"Allergy shots are a regular, weekly therapy which actually change the way the patient's immune system responds, so it responds in a non-harmful way," he said.

And in addition to medications, people with allergies need to take steps to avoid whatever it is they're allergic to. That usually means staying indoors and keeping the windows closed to avoid contact with pollen or mold.

There's nothing funny about allergies, Sacha said.

"It's something we don't think about as a major problem, like when you think about heart disease and cancer. But it causes a lot of missed school and a lot of missed work, so it really is a major problem," he said.