Stoms cause pollen to rupture into tiny particles, which can be inhaled into the lungs. [Image: Peet Sneekes]
Who does it affect?
Thunderstorm asthma commonly affects young adults with a history of hay fever but not necessarily of asthma. And of those with a previous diagnosis of asthma, many claimed it wasn’t severe enough to warrant preventer medication.
After the Wagga Wagga thunderstorm asthma epidemic in October 1997, researchers compared the data of those who experienced a thunderstorm asthma attack with those who had an asthma attack on other days of the year (the control group). They found that 95% of those affected by thunderstorm asthma had a history of hay fever and 96% tested positive to grass pollen allergies.
Of those with a history of asthma, only one in four (27%) of affected cases were taking regular preventer inhalers compared with more than half (56%) of the control group.
This suggests that regular use of asthma preventer medication, at least during spring, may protect those with asthma and grass allergies from thunderstorm asthma attacks.
How is it treated?
The best way to treat thunderstorm asthma is to prevent it occurring, where possible. So good asthma control is essential.
Anyone with asthma who has allergy symptoms in spring (including hay fever, or worsened asthma symptoms) should use a regular preventer inhaler, even if they feel well. These inhalers are designed to reduce the inflammation in the lungs over a period of time, and prevent an asthma attack occurring.
All asthma sufferers should have a written action plan from their doctor, which describes the steps to be taken if symptoms escalate.
In the event of a thunderstorm asthma attack, treatment will be the same as any other acute asthma attack, which usually involves the administration of inhaled mediation to dilate the airways, plus an anti-inflammatory medication.
What regions are affected?
Thunderstorm asthma was first described in Melbourne in 1987 and has occurred in other parts of the country (south-eastern Australia is particularly vulnerable) and the world, including in England and Italy.
The most recent epidemic occurred in Melbourne on 25 November 2010 after the onset of a thunderstorm, when grass pollen counts were in the extreme range.
Shortly after the thunderstorm began, the Melbourne metropolitan ambulance service was inundated with calls for assistance from people who had trouble breathing and the ambulance disaster management plan was enacted.
Austin Health, a large metropolitan hospital in Melbourne, saw a tenfold increase in patients presenting with acute asthma attacks in the 24 hour period following the storm.
Thunderstorm epidemics are uncommon but the prospect of another wet spring/summer means we need to be vigilant. If you have difficulty breathing – whether you have a history of asthma or not – call 000 for an ambulance immediately.
Megan Howden, Advanced trainee in respiratory medicine, Austin Health
This article was originally published on The Conversation.