Back-to-school health: Avoiding September asthma flare-ups

By Andrew MacGinnitie, MD, PhD, associate clinical director of the Division of Immunology at Children’s Hospital Boston

The onset of fall means shorter days, the closing of summer camps and, this year, a less-than-triumphant winding down of the Red Sox’s season. It’s also back-to-school time for thousands of families. For most people this means stocking up on new clothes and school supplies, but for families of children with asthma, September also marks the start of the fall asthma epidemic. Each year the number of children with asthma rushed to emergency departments and admitted to hospitals spikes a few weeks after school starts.

So what’s causing this annual epidemic? Most often it’s the sharing of viral infections—rhinovirus in particular—that spread much more easily when children are cooped up together in classrooms. Typically rhinovirus will cause common cold symptoms, but in children with asthma, infection can spread to the lungs and trigger a severe asthma attack. Kids also tend to spend more time outside in the summer, and sunlight acts as a natural disinfectant for many germs.

Another factor contributing to the epidemic is a seasonal change in medication routines. Because the patients with asthma tend to do better during the summer, many forget—or feel they don’t need to take—their medicine regularly. If the lax routine spills over into the beginning of the school year, when asthma-triggering conditions are less forgiving, it can lead to problems.

Here are tips parents can follow to help their child avoid asthma flare-ups in September:

  • Schedule an asthma visit with your child’s pediatrician or asthma specialist before school starts. Talk to the doctor about how well controlled your child’s asthma has been over the summer and make sure the current asthma action plan (a written treatment plan that all patients with asthma should have) is up to date.
  • Make sure your child’s asthma medicines are current and have been refilled in case they’re suddenly needed.
  • If your child needs daily asthma medicines during the school year, but not during the summer, consider restarting the daily plan two or three weeks before school starts. If you’re unsure about whether daily medicine is still needed, talk to the child’s pediatrician or asthma specialist.
  • Advocate for a strict hand washing policy at home and school. Regular hand washing, especially before and after eating, helps prevent the spread of the rhinovirus, and in turn asthma attacks. Antimicrobial gels like Purell or Dial can also help prevent the spread of viruses and other germs.
  • Get any allergies your child may have under control. Like viral infections, allergies are common asthma triggers. Fall is ragweed season in many areas, which can create problems for children with allergies and asthma. But seasonal allergies aren’t the only asthma triggers; pets and dust mites, which are present year-round, can also lead to asthma attacks. Schools often contain high levels of allergens, complicating matters even more for students with asthma.

Read blogs on how to better manage your child’s asthma or allergies during the spring and winter.

If you’d like to speak with a Boston Children’s allergy expert, please call 617-355-6117 or visit this site.