Fatal and near-fatal thunderstorm asthma epidemic in a desert country

Ali, Fatima; Behbehani, Nasser; Alomair, Noura; Taher, Assad

doi:10.4103/atm.atm_258_18

Cited by 12 publications

(7 citation statements)

References 14 publications

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“…Although most acute asthma attacks develop over a period of days, patients with brittle asthma may present with a much more dramatic deterioration. [ 223 224 ] It is important to realize that most patients who die from an acute asthma attack had chronically uncontrolled asthma, had received suboptimal treatment with ICS, and had inadequate monitoring of their asthma. [ 225 ] Management of acute asthma is the extreme spectrum of uncontrolled asthma and represents the failure to reach adequate asthma control.…”

Section: Section 7: Management Of Acute Asthma In Adults and Adolescementioning

confidence: 99%

The Saudi Initiative for Asthma - 2021 Update: Guidelines for the diagnosis and management of asthma in adults and children

et al. 2021

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The Saudi Initiative for Asthma 2021 (SINA-2021) is the fifth version of asthma guidelines for the diagnosis and management of asthma for adults and children, which is developed by the SINA group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up to date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is aligned for age groups: adults, adolescents, children aged 5–12 years, and children aged less than 5 years. SINA guidelines have focused more on personalized approaches reflecting better understanding of disease heterogeneity with the integration of recommendations related to biologic agents, evidence-based updates on treatment, and the role of immunotherapy in management. Medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and the current situation at national and regional levels. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan.

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Section: Section 7: Management Of Acute Asthma In Adults and Adolescementioning

confidence: 99%

The Saudi Initiative for Asthma - 2021 Update: Guidelines for the diagnosis and management of asthma in adults and children

et al. 2021

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“…Ali et al . [ 35 ] reported cases of near-fatal and fatal asthma caused by storms in Kuwait on December 1 st , 2016; 17 patients were admitted with near-fatal asthma, 93.8% had a previous history of asthma, with an average duration of 9 years, 33.3% reported receiving inhaled corticosteroids from their physician and 93.8% relying only on a short-acting β2-agonist to control their asthma; 68.8% reported being outdoors during the storm and eleven patients were diagnosed with fatal asthma. Foo et al [ 45 ] reported, in individuals affected by TA, evidence of continuous loss of asthma control in those with previously well-controlled asthma and persistence of symptoms suggestive of asthma in those without a history or symptoms suggestive of previous asthma, even after 36 months of initial TA.…”

Section: Who Is At Risk Of Thunderstorm Asthma?mentioning

confidence: 99%

“…Thunderstorms have been linked to asthma epidemics, especially during the pollen seasons, and there are descriptions of asthma outbreaks associated with thunderstorms, which occurred in several cities, prevalently in Europe (Birmingham and London in the UK [6] and Naples in Italy [1,2]) and Australia (Melbourne and Wagga Wagga) [3,[4][5][6][7]. There are observations that thunderstorms occurring during pollen season can induce asthma attacks sometimes severe and near fatal asthma in pollinosis patients [1,25,35].…”

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confidence: 99%

Thunderstorm allergy and asthma: state of the art

et al. 2021

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Thunderstorm-triggered asthma (TA) can be defined as the occurrence of acute asthma attacks immediately following a thunderstorm during pollen seasons. Outbreaks have occurred across the world during pollen season with the capacity to rapidly inundate a health care service, resulting in potentially catastrophic outcomes for allergicpatients. TA occurs when specific meteorological and aerobiological factors combine to affect predisposed atopic patients with IgE-mediated sentitization to pollen allergens. Thunderstorm outflows can concentrate aeroallergens, most commonly grass pollen but also other pollens such as Parietaria and moulds in TA, at ground level to release respirable allergenic particles after rupture by osmotic shock related to humidity and rainfall. Inhalation of high concentrations of these aeroallergens by sensitized individuals can induce early asthmatic responses which can be followed by a late inflammatory phase. There is evidence that, during pollen season, thunderstorms can induce allergic asthma outbreaks, sometimes also severe asthma crisis and sometimes deaths in patients suffering from pollen allergy. It has been observed that changes in the weather such as rain or humidity may induce hydratation of pollen grains during pollen seasons and sometimes also their fragmentation which generates atmospheric biological aerosols carrying allergens. Asthma attacks are induced for the high concentration at ground level of pollen grains which may release allergenic particles of respirable size after rupture by osmotic shock. In other words, it is a global health problem observed in several cities and areas of the world that can strike without sufficient warning, inducing sometimes severe clinical consequences also with deaths of asthma patients. Due to constant climate change, future TA events are likely to become more common, more disastrous and more unpredictable, as a consequence it is important to have deep knowledge on this topic to prevent asthma attacks. Other environmental factors, such as rapid changes in temperature and agricultural practices, also contribute to causing TA.

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“…The main epidemics were reported from Australia in 2010 and 2016, from London in 1994, from Naples in 2004 [2][3][4], and from Kuwait in 2020 (about data on events occurred in 2016) [5].…”

Section: To the Editormentioning

confidence: 99%

Thunderstorm-asthma, two cases observed in Northern Italy

Spina

Banfi

Nicolini³

2020

Multidis Res Med

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Thunderstorm asthma is a rare event: in this letter we describe two cases observed during the same month of 2018 at an Italian Emergency department, assessed by the same medical team and according to the same methodology and approach. Given the infrequency of such a phenomenon and the debate around its nature, frequency, and - at times - existence, we strongly believe it is important for all specialists who observe such cases to report them, building an evidence base to expand its knowledge and understanding.

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Fatal and near-fatal thunderstorm asthma epidemic in a desert country

Cited by 12 publications

References 14 publications

The Saudi Initiative for Asthma - 2021 Update: Guidelines for the diagnosis and management of asthma in adults and children

The Saudi Initiative for Asthma - 2021 Update: Guidelines for the diagnosis and management of asthma in adults and children

Thunderstorm allergy and asthma: state of the art

Thunderstorm-asthma, two cases observed in Northern Italy

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