September Asthma Epidemic

With the new school year up-and-running, parents of children with asthma will be bracing for the yearly “asthma epidemic”.
Around the country, asthma attacks spike in late summer and early fall when children return to school from summer vacation.  This annual asthma flare-up accounts for a significant increase in emergency room visits, hospital admissions, and unscheduled trips to the doctor.
In Ahwatukee and other communities in Arizona, the spike in asthma symptoms may occur later in the fall  when night-time and day-time temperatures turn cooler, encouraging grass and weed pollination.  Bermuda grass pollen peaks in late summer and fall, just when children are returning to .   School playgrounds and sport fields are typically planted in Common Bermuda grass.  Russian Thistle, Careless Weed, and Ragweed pollen production also peaks in September and October.     Some children also react to pet dander either from direct contact with a classroom pet such as a rabbit or guinea pig, or on the cloths of children who have pets at home.
Although allergen exposure is an important trigger for many children with asthma,  the  most important  cause of asthma flares in children returning to the classroom from summer vacation is exposure to cold and flu viruses.  Although allergy is the primary cause of asthma, viral upper respiratory infections are the primary cause of asthma attacks.
So what can a parent of a child with asthma do to prepare for the fall asthma epidemic?   Although it is often possible for children to back off on their daily asthma controller medications during the months of summer vacation, these medications should be resumed when the children return to the classroom.  It may be too late to start the medication at the first sign of an asthma attack.  Every child with more than very mild, occasional asthma symptoms should have a personal asthma action plan constructed by their physician.  The asthma action plan may be based on symptoms or peak flow meter values or on a combination of the two and should give clear instructions on what actions to take if a child is having increased asthma symptoms.   A copy of the asthma action plan should be given to the school health office along with the child’s asthma rescue medication.  (Example asthma action plan)