On 21st of November 2016, Melbourne witnessed a phenomenon that the emergency services were not prepared for. It is called ‘Thunderstorm Asthma’. A drastic change in weather conditions filled the environment with huge amounts of pollen and triggered massive asthma attacks and allergies in people all over the state. Eight people died as a result of this, 8,500 were hospitalized and many thousands were affected with respiratory problems. The problem was so severe that the emergency services struggled to cope with the demand of care. Since then, another mild episode of thunderstorm asthma as occurred again in Melbourne.
We spoke to Dr Angraj Khillan about this condition to understand the problem and be better prepared for this kind of emergency in the future.
So what is thunderstorm asthma?
Thunderstorm asthma is different than a regular asthma condition. Usually ‘regular ‘asthma occurs in winter season in which something triggers the muscles around a person’s airways to squeeze tight, swell and create more mucus. But thunderstorm asthma is mostly caused by large storms, like cool change in spring which can cause breathing problems in people who do not have the condition. For example, if it is hot during the day the flowers and their pods get dry, but the sudden change in temperature and rain then causes them to absorb water and burst open, spilling all the pollen and seeds etc in to the atmosphere which in return triggers allergies and respiratory problems like thunderstorm asthma.
How can we be better prepared for thunderstorm asthma at home?
Many people suffered severe breathing problems and even death because they stayed at home waiting for an ambulance. Dr Khillan advises that people should keep themselves prepared at home for any emergency. Those who usually get hay fever symptoms should always keep a steroid nasal spray at home. This type of spray is available off the counter sat most pharmacies and should be taken if someone experiences regular sneezing, red and itchy eyes etc. another option is to keep a Ventolin inhaler at home and when such conditions occur, use the inhaler according to the age of the patient. Dose instructions are usually mentioned at the back of the packet or consult your GP for correct dosage of the inhaler.
Dr Khillan also pointed out that many people have reservations regarding the use of Prednisolone steroid. He reassured that there is nothing to fear and that people should consult their doctor and take the medication for three days – oral or spray – to avoid admission in the hospital. Dr khillan pointed out that in severe cases of thunderstorm asthma, Prednisolone can be lifesaving.
How can we monitor small children during this time?
With small children, it is important to keep an eye on their breathing. The tell signs could be that a child who usually does not wake up during the night is waking up often due to discomfort or is coughing during the night which is unusual for him. This will indicate that the child is having breathing difficulties.
Also, if parents can hear a child breath, that is, the child is wheezing, it is a sign that he/she is having problems breathing.
Another sign is if the child’s mouth turns blue or if he/she is lethargic during the day and is not his usual active self.
Dr khillan suggests that parents should place their hand over the child’s stomach and count how many times the stomach goes up and down in a minute. For a small child (under 1 year of age), if the count is more than 60 per minute and for kids over 1 year of age the count is over 40 per minute, then it is an indication that the child is breathing faster than normal and needs immediate medical attention.
Note: Please note that this is general advice and symptoms and condition may vary from person to person. Please see your GP or specialist before consuming any medication.