Asthma sufferers and others with breathing problems are turning up at hospitals and doctors' waiting rooms, wheezing and hacking. Schoolchildren are being kept inside at recess. And people whose lungs are easily irritated are being told to close the windows and run the air conditioner if they have one.
Dozens of wildfires that have burned an estimated 190 square miles across the Southeast have thrown a shroud of smoke over the region in the past week or so, even in distant metropolitan areas like Atlanta, leaving cities big and small smelling like a campfire jamboree, but without the fun.
The murk — sometimes yellowish-brown, sometimes gray or milky — has veiled mountaintops, obscured Atlanta skyscrapers and intermittently turned the sun into a pale golden smudge over the city. At times, the flames have also cast a haze over Nashville and Chattanooga, Tennessee, and Charlotte, North Carolina.
For asthma sufferers Lamont Hall and his 12-year-old twin daughters, just stepping outside was enough to make them sick as they breathed in the smoke that settled over Atlanta from a nearly 24,000-acre brush fire in the mountains some 90 miles northwest of the city. He and his girls went to the doctor, who ordered them to stay home from work and school.
"Our chest is very tight, our eyes are burning and we're wheezing," Hall said. "The smell is so bad that I can taste it."
Federal authorities said 50 large fires of 100 acres or more are burning across the Southeast. Some are deep in the woods, while others threaten homes and highways.
The flames have not caused any widespread property damage. But the curtain of smoke has contributed to auto accidents, including a series of wrecks in Kentucky that killed one person and injured 14 others.
Daily air-quality reports from the Environmental Protection Agency and other agencies show pollutants have reached unhealthy levels — meaning people may feel ill even if they don't have respiratory ailments — across much of Georgia, South Carolina and Tennessee as well as portions of Alabama, North Carolina, Kentucky and Virginia.
The elderly and people with asthma or other lung problems are being warned to limit their time outdoors.
"Our patients are definitely complaining," said Dr. Stanley Fineman, an allergist in Atlanta. He said he is seeing more people in need of extra inhalers and other treatments.
More than 200 people have been treated at two Chattanooga hospitals for shortness of breath and other respiratory difficulties, Tennessee emergency officials reported.
In Harlan, Kentucky, Dr. Abdu Dahhan said he has spent the past week treating lots of patients struggling to breathe. Twenty-seven fires in Kentucky have burned more than 25,000 acres.
People with respiratory ailments, compromised immune systems, heart trouble, diabetes and black lung disease — an illness in miners, caused by breathing coal dust — appear to be having the worst problems, said Dahhan, a pulmonary specialist. He said two patients who came to his office Monday were so sick he transferred them to a hospital.
"It's making the life for people terrible," Dahhan said. "Even people who don't have lung problems are suffering from upper airway irritation."
Rodney Adams coughs every few minutes while talking from inside his home in Cumberland, Kentucky, just a few miles from flames burning on Pine Mountain in Harlan County. The 62-year-old former coal miner suffers from black lung and says it is hard for him to breathe even with an oxygen tank.
"I only use it when I have to, but right now it's a have-to," Adams said. "It's a good thing I got it."
Earlier this week, he said, the smoke outside his window looked thick enough to walk on.
"Your body is looking for some air to get down, and it seems like the smoke is sitting there like a catcher catching it and it don't want to let it down through," Adams said.
Even at 3,200 feet, Constance Shulze's mountain home in Spruce Pine, North Carolina, has been shrouded in smoke for days. Mountain ridges normally visible from her windows have disappeared in the haze.
Shulze said Wednesday her asthma is keeping her inside. It's been days since she ventured out to the grocery store or the gym. The last time she went to buy food, she found the entire store reeked of fire and smoke.
"You can tell I'm hoarse," Shulze said. "My nose drips and my lungs hurt at night."
Shulze said she suspects most of the smoke is coming from a fire about an hour's drive from her home.
Back in Georgia, Atlanta-area nanny AnnaLisa Silliman-Patterson has been keeping the children she cares for inside the house since Monday, when the boys, ages 2 and 5, began coughing nonstop after they had been outside playing for 20 minutes.
Silliman-Patterson said her own 11-year-old daughter and her classmates were kept indoors during recess. And she has found herself struggling to breathe at times.
"I almost never have issues and rarely get sick," Silliman-Patterson said. "But I couldn't stop coughing, and my chest burned and felt like an elephant was sitting on it."