Asthma: How to protect your kids from the ‘September Spike’

WATCH ABOVE: Dr. Samir Gupta discusses the risks to children with asthma during the “September Spike” as school begins in this week’s On Call.

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TORONTO — Asthma is a chronic disease of airway inflammation, and it’s very common in kids in particular — about 16 per cent of kids under 12 in Canada have asthma.

When asthma flares, it causes people to cough, wheeze and feel short of breath.

For years now, we’ve seen a very interesting phenomenon whereby there is a predictable spike in asthma flares in kids, and a dramatic increase in doctor visits, emergency room visits and hospitalizations, in about the third week of September.

This is what’s referred to as the “September Spike,” a trend that is not only seen in Canada, but in several countries across the world.

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In fact, an Isreali study of about 82,000 kids with asthma published in 2014 showed the same trend.

There are several theories that explain this trend.

A Canadian study published in the Journal of Allergy and Clinical Immunology in 2005 showed that 62 per cent of kids who came to the ER with an asthma flare had a virus, and only 49 per cent of those kids were on an inhaled corticosteroid (asthma preventer inhaler) medication at the time.

On the other hand, 41 per cent of control patients with asthma (who were not actually ill) were also were found to have viruses, but 85 per cent of those kids were on their asthma preventer inhaler.

This strongly suggests that viruses are a major cause of September asthma flares, but are common in all patients at that time of year, and being on a proper asthma preventer inhaler protects the majority of patients who have a virus from having a major asthma flare.

We do know that kids tend to stop taking their inhalers regularly in the summer months, leaving them unprotected come September.

The virus theory is also supported by the observation that preschool and adult asthma patients also tend to have more flares in late September (though the trend is much less impressive than it is for school-aged kids).

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This may suggest that children are bringing home the viruses they get from school and spreading them to their parents and younger siblings, who then have asthma flares.

Environmental triggers also likely contribute to the September Spike.

Fall is ragweed season, and kids are exposed to chalk dust at school, as well as cat dander from other kids’ cats, brought to school on kids’ clothing.

Environmental factors like cold weather, as well as worsening pollution due to more cars on the road may also play a role.

Some have also suggested that the stress of going back to school may be a trigger.

The good news is that recent data suggests that the September Spike in ER visits in Ontario has generally gotten smaller in the last few years, despite an increasing prevalence of asthma.

Also, Ryan’s Law came into effect on May 5, 2015 in Ontario. According to this law, every school must permit students to carry their asthma medications with them, as opposed to having them locked up in the nurse’s office.

This should certainly help kids to stay on their proper asthma medications.

TOP 5 Tips For Preventing The September Spike:

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  1. Know and avoid allergens Parents — have your kids tested for what they’re allergic to, and take steps to help kids to avoid those triggers.
  2. Keep them home if they’re sick — If your child has a virus, it will spread to other kids at school, and a child who has asthma will be particularly affected, so keep the child home until he or she is better.
  3. Keep them on their medications throughout the summer — When patients feel well, they tend to stop taking their preventative asthma puffers, and that’s exactly when they become susceptible to dangerous asthma flares.
  4. Use an asthma action plan — An asthma action plan is a set of instructions that you can get from your doctor, which will tell you how to adjust your puffers as soon as your symptoms start to worsen – if done early enough, this can prevent an outright flare.
  5. Wash hands — This is the simplest but also the most effective way to control the spread of those viruses  – parents and teachers can help by reminding their kids to wash their hands more often.

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