Every year, about two to four weeks after school starts, a big spike in asthma-related hospital visits occurs among children that experts say could be largely avoided.
This year, the usual September increase in visits to emergency departments and hospital units by asthmatic children in respiratory distress was up to 15 percent higher because of an outbreak of viral cases, Children’s Hospital Colorado physicians say.
Physicians don’t know for certain what causes the annual September spike, said Dr. Monica Federico, pediatric lung specialist and director of the asthma program at Children’s. They do believe that many emergency or urgent cases could be prevented if asthma patients were more consistent in taking asthma-controlling medications.
“People who have asthma — sometimes you feel terrible and sometimes you feel fine. People, in the summer, feel so good they stop taking their meds,” Federico said. “There is data they don’t fill their medications.”
The presumption is that children, when reunited with their classmates in close quarters in classrooms, are exposed to more germs, which can trigger asthma attacks. Late-summer allergens, such as ragweed, might trigger asthma attacks, as about 80 percent to 90 percent of pediatric asthma is triggered by allergies, Federico said.
And, going back to school means parents aren’t around to keep a watchful eye on children’s use of their puffers, the dose-metered inhalers used to take asthma medicine: corticosteroids, which reduce inflammation of airways.
Whatever the September triggers are, Federico said, more consistent use of controller medications could help families avoid many attacks caused by inflammation, spasms and excessive mucous in airways.
In late August and early September of this year, an outbreak of an uncommon virus, of respiratory illness. Case severity for many children has led to hospital treatment, stays of several days and, in the most severe cases, use of ventilators to help them breathe.
“If parents are worried, they should call the doctor right away,” Federico said. “They shouldn’t wait until their kids are really sick and go to the ER.”
Roughly 25 million Americans have asthma — including 7 million children, according to the U.S. Centers for Disease Control and Prevention. Some “outgrow it,” Federico said. For others, it’s a lifelong condition. In any case, physicians believe it results from a combination of genetic and environmental factors, such as exposure to cigarette smoke and allergens.
High altitude doesn’t increase prevalence of the disease, Federico said, but when children and adults need help getting oxygen because of an asthma attack, they need even more help getting oxygen at higher elevations.
When an attack of wheezing and difficulty breathing occurs, sufferers use a puffer or nebulizer (which makes a mist) with so-called rescue medication. Though known by many brand names, the rescue medication for attacks is albuterol, Federico said. Albuterol is a bronchodilator — meaning it opens up airways by relaxing these passages when they are in spasm. It provides quick, but short-lived relief, usually about four hours.
Federico said children should visit their primary-care physicians each July or August, fill and use their controller medications consistently and, through their parents, have an asthma action plan on file with the school nurse.
Electa Draper: 303-954-1276, edraper@denverpost.com or twitter.com/electadraper
By the numbers
The number of Americans diagnosed with asthma: 25 million
Children in the U.S. diagnosed with asthma: 7 million
