As scientists discover the link between storms and asthma, you can find out how you can hunt … thunder fever –

On 17 June 2021, something very special happened at dozens of hospitals in the east of England: the number of emergency rooms for people suffering from asthma attacks increased by 560% of the daily average.

On the same day, the number of asthma-related calls to out-of-hours GPs in the region increased by 422%, while the number of immediate asthma symptoms calling NHS 111 increased by 193%.

A subsequent study by the UK Health Safety Agency (UKHSA), published in the International Journal of Environmental Research and Public Health, found this to be one of the largest increases in asthma attacks ever recorded in the UK, and it all happened because of it. something, thunder – the day before.

Numerous studies have shown a link between thunderstorms and subsequent asthma attacks.

Scientific interest in the complex peaked after a wave in Melbourne, Australia, in 2016, when city hospitals recorded the largest proportion of storm-related asthma attacks since particularly bad weather hit the area.

The death rate rose 672 percent within hours, and ten people died from asthma exacerbations.

“At one point every ICU bed in Melbourne was filled, mostly with asthmatics, and teenagers (the youngest was 18) died of their seizures,” said Ian Pavord, professor of respiratory medicine at the University of Oxford.

It’s unclear how storms make asthma worse. However, the effects appear much worse during the hay fever season, when pollen levels are highest, usually in the UK in late June and early July.

Last week, millions of hay fever sufferers were warned about an impending phenomenon called “thunderstorm,” a combination of high pollen counts and thunderstorms that could make their symptoms worse.

A popular theory is that wind turbulence caused by storms means strong currents “suck” pollen grains into clouds. There, moisture penetrates the pollen grains and causes them to swell and crack.

Studies show that up to 60 percent of patients skip regular doses of the preventer inhaler or are okay with using it at all if they have no symptoms. When symptoms occur, they rely on the inhaler for relief (file image)

This releases much smaller bits of pollen protein that fall to Earth before being respired.

Normally, pollen grains settle in the nose or upper airways, where they cause irritation in people with hay fever but are too large to enter the narrow passages of the lower airways.

However, much smaller particles of broken granules can get into these passages, causing inflammation in the lining of the airways that triggers severe asthma symptoms.

The real question is why so many asthmatics get sick after storms when they have access to a number of highly effective drugs, such as inhaled steroids, that can prevent such flare-ups.

Many asthmatics are prescribed a daily ‘preventive’ steroid inhaler (usually brown) to prevent lung inflammation that can cause wheezing and shortness of breath. They also have a “reliever” inhaler (usually blue) to be used when asthma symptoms occur and work by dilating the airways to improve airflow.

However, studies show that up to 60% of patients skip regular doses of the protective inhaler or are okay with using it at all if they have no symptoms. When symptoms do occur, they rely on the inhaler for relief.

“This may help, but it does not solve the problem of inflammation that lies deep in the airways,” says Professor Pavord.

Many of these patients have mild asthma and find it difficult to use a brown inhaler on a regular daily basis.

‘Yet we see deaths every year in people with mild asthma. I’ve seen patients who use their blue inhaler about 100 times in 24 hours and don’t get better.”

The solution, according to Professor Pavord, is to change course entirely when it comes to asthma treatment.

Instead of using two separate inhalers, he now suggests that lives could be saved if patients were given two drugs—to prevent asthma and treat symptoms—in one inhaler. or suddenly short of breath, such as caused by a storm.

These combination inhalers – the brands Seretide, Symbicort Smart and Fostair – are currently available from the NHS, but are approved for daily use in patients whose asthma is not well controlled despite daily use of a “preventive” hedgehog, the current treatment.

Professor Pavord says switching “on demand” poses less of a problem for patients, but produces equally good results.

In fact, a study published last December in the BMJ journal Evidence-Based Medicine looked at asthma symptoms in 8,000 patients who either adhered to daily doses of steroids—using pain relievers only as needed—or taking combination inhalers for pain relief. weeks or months when they feel symptoms.

The results showed that occasional use of pufferfish was equally effective in controlling asthma and reduced the intake of steroid medications, which can have side effects such as sore throat, hoarseness, and oral thrush. fungal infection. infection in the mouth.

Meanwhile, UKHSA can offer asthma-specific red alerts and weather and pollen forecasts during the hay fever season.

Asthma UK states that asthmatics who have previously been caught in thunderstorms or fear they may trigger an attack should always carry their inhaler with light, stay indoors before, during and after a storm, and keep windows closed to stop storms. pollen is thrown out to enter.