Mugwort (Artemisia vulgaris), also known as common mugwort, is one of the more important late-summer pollen allergens in North Macedonia. It stands in the shadow of ragweed, which flowers right after it and causes stronger reactions, but mugwort opens the late-summer season first and, in some allergy sufferers, is the main culprit for the trouble in July and August.

What mugwort is and where it grows

Mugwort is a perennial herbaceous plant from the daisy family (Asteraceae), one to two meters tall. It is recognized by its pinnately divided leaves, dark green on the upper side and silvery-white underneath — that is also the most reliable way to tell it from ragweed, which is green on both sides of the leaf. The stem is often reddish, and the inflorescences are small, yellowish to reddish panicles.

It grows as a ruderal species: along roads and railways, on embankments, building sites, dumps, along fences, and on neglected plots. In cities it is everywhere the ground is not managed.

Relationship to ragweed

Mugwort and ragweed belong to the same family, and their pollen allergens are strongly cross-reactive. The practical consequence for allergy sufferers in North Macedonia is an extended season: mugwort from July, ragweed from mid-August, so the trouble can run continuously from the start of July until the first frosts.

Season and distribution in North Macedonia

Mugwort flowers from July to September, peaking in late July and early August. Its season overlaps the end of the grass season, and its end overlaps the start of the ragweed season.

It is widespread across the whole country, but the burden is greatest in the basins and around the big cities — the belts along roads and railways, the embankments along the Vardar and Crna, and the neglected plots in Skopje, Kumanovo, and Tetovo are an ideal habitat. In the hilly and mountainous areas concentrations are as a rule lower.

The values we show for North Macedonian cities are modeled with the European CAMS model (via the Open-Meteo service), not measured at a local station — this service uses CAMS modeled data for its dynamic three-day forecast.

Symptoms

  • sneezing and a runny nose
  • a blocked nose
  • itchy, watering eyes
  • itching of the palate and throat
  • worsening asthma in sensitive people
  • in some patients, skin reactions on direct contact with the plant

Cross-reactivity with other pollen

Besides ragweed, mugwort cross-reacts with the pollen of other daisy-family plants — sunflower, chamomile, and dandelion — as well as, in some patients, with grass pollen at the end of its season.

Cross-reactions with food

Mugwort is known for several recognized patterns of cross-reactivity with food:

  • mugwort-celery-spice syndrome: celery, carrot, parsley, fennel, cumin, coriander, pepper
  • mugwort-peach syndrome
  • sunflower seeds, pumpkin seeds, chamomile (and chamomile tea)
  • in some patients, honey that contains daisy-family pollen

The symptoms are most often oral allergy syndrome — itching and mild swelling of the lips, tongue, and palate. Unlike the reactions linked to birch, part of the allergens from the daisy family is heat-stable, so cooking does not always remove the reaction; with celery and spices, more severe reactions have been recorded, so caution is warranted.

Treatment

Medication

  • Second-generation antihistamines for sneezing, itching, and discharge.
  • A nasal corticosteroid spray started in late June, before the season begins, works better than reacting to developed symptoms.
  • Eye drops for allergic conjunctivitis.
  • Asthmatics are advised to review their treatment before the late-summer season begins.

Immunotherapy

Immunotherapy for mugwort pollen is available and is prescribed by an allergist. In patients who also react to ragweed, the allergist assesses which allergen is leading and chooses the preparation accordingly.

Practical tips for allergy sufferers

  • Do not mow or pull mugwort without a mask and gloves; plan garden work before flowering begins.
  • Remove mugwort from your plot before July — after that, removing an already flowering plant releases extra pollen.
  • Avoid running and cycling along roads and embankments in July and August, where mugwort is densest.
  • Ventilate in the evening, and keep the windows closed in the morning and on windy days.
  • If you have a confirmed mugwort allergy, watch out for celery and spice blends in ready meals and soups.

Note

This is not medical advice. For an assessment of symptoms, treatment, or immunotherapy, consult your doctor or an allergist.