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September Asthma Alert

By Fred Little; Health
For several years, doctors and patients have observed that asthma control, including asthma exacerbations, increase in September. Some doctors and scientists have even called the increase in hospitalizations for asthma the "September Epidemic."
The reason for this remained obscure until recent studies that looked into the major causes of worsening asthma control and if they changed in September. It turns out that the increase in asthma worsening and kids going back to school are not merely coincidences. A detailed study of asthma attacks looking at many individuals (using 12 years of hospitalization data from the Canadian health ministry) showed that there is a sharp spike in asthma hospitalization in children about 2 weeks after Labor Day, the usual time of school return after summer vacation.
Even more interesting was the fact that asthma exacerbations were also increased in adults, not just children. Of note, this increase occurred about a week later than in children.
So, what is the connection?
It is well known that respiratory viral infections, especially a common cold virus called rhinovirus, are significant causes of asthma exacerbations. A parallel study to the one above demonstrated that nearly two thirds of children seeking emergency care for asthma had common cold virus in their noses. This suggests that the September Epidemic is largely caused by cold viruses.
In addition, the delay in asthma exacerbations in adults suggests that children, upon returning to school, are sharing colds and cold viruses that they bring to school after summer vacation, causing a rise in colds and a rise in asthma exacerbations. These colds are then brought home and affect parents with asthma.
An interesting aside -- the study mentioned above examined a control group of asthmatics during the same time in September but whose asthma was not in a flare. The researchers found that the children without exacerbations were more likely to be taking anti-inflammatory controller medications that the children whose asthma had flared. This makes another point about long-term asthma control that is especially important going back to school: All asthmatics should be taking their regularly scheduled controller medicine whether their asthma is controlled or not.
Every day in America:
  • 44,000 people have an asthma attack.
  • 36,000 kids miss school due to asthma.
  • 27,000 adults miss work due to asthma.
  • 4,700 people visit the emergency room due to asthma.
  • 1,200 people are admitted to the hospital due to asthma.
  • 9 people die from asthma.
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