The Role of Fungal Spores in Thunderstorm Asthmaa

Dales, Robert; Cakmak, Sabit; Judek, Stan; Dann, Tom; Coates, Frances; Brook, Jeffrey R.; Burnett, Richard T.

doi:10.1378/chest.123.3.745

Cited by 151 publications

(117 citation statements)

References 22 publications

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“…This trend which has also been reported in England and Canada 4,17 may not be unconnected with airborne substances including respiratory viruses and moulds and other allergens from abandoned classroom which can be triggers. Johnston et al 17 on this observation suggests that rhinovirus infections contracted from school mates may play a role in this exacerbation.…”

Section: Discussionmentioning

confidence: 89%

Prevalence and pattern of asthma exacerbation in children seen at the University of Nigeria Teaching Hospital, Enugu

Edelu¹,

Eze²,

Ayuk³

et al. 2016

Nig. J. Paed.

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Abstract:Background: Acute exacerbation is a major cause of morbidity in asthmatic children. It can occur even in well controlled asthma. Aim: To determine the prevalence and pattern of acute exacerbation of asthma in children seen at the emergency room of the University of Nigeria Teaching Hospital (UNTH), Enugu. Materials and methods:This was a descriptive, cross sectional study in which consecutive children with acute exacerbation of asthma presenting to the Children Emergency Room (CHER) of UNTH, Enugu were recruited. Information from the history and examination were documented with a structured questionnaire completed by the attending doctor. Severity of their exacerbation was determined using the Global Initiative for Asthma (GINA) guidelines. The children were treated using the written management protocol used in CHER, UNTH, Enugu which was adapted from GINA guidelines.Results: There were a total of 114 presentations (episodes) of acute exacerbation asthma by 104 children within the study period with eight children having multiple episodes. This represented 6.5% of the overall number of emergency cases seen during the period. Nearly an equal number (ratio; 1: 1.04) of males and females were enrolled with the mean age of 7.9 ± 4.7 years. More children with asthma exacerbations were admitted during the rainy season months of May and June, while the dry season months of December and January recorded lower number of episodes.Most (86.0%) cases were mild to moderate exacerbations and 16 (15.3%) were severe. Three of the 22 (13.6%) children on controller medications were among the 16 that had severe exacerbation. No death was recorded during the period. Conclusion:The prevalence of asthma exacerbation is relatively high in our tropical environment and the pattern is similar to those of the developed countries in terms of age and sex distribution, however, the peak period of presentation differ in our environment.Key words: Asthma, exacerbation, children, prevalence, pattern tized asthmatics.2 These exacerbations are characteristically worse at night and can progress to severe airflow obstruction, shortness of breath, and respiratory distress and insufficiency.2 Rarely, severe sequelae such as hypoxic seizures, respiratory failure, and death can occur. It has also been noted that severe asthma exacerbation can occur in children with mild or controlled asthma. 3Exacerbations of asthma symptoms produce significant cost to health care systems and seriously diminish the quality of life of patients and their families. 4,5 It also accounts for disproportionate health care costs when compared to the management of stable state asthma.5 It is the most common cause of childhood emergency room visits, hospitalization and school absenteeism in

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Section: Discussionmentioning

confidence: 89%

Prevalence and pattern of asthma exacerbation in children seen at the University of Nigeria Teaching Hospital, Enugu

Edelu¹,

Eze²,

Ayuk³

et al. 2016

Nig. J. Paed.

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“…The data of TARGONSKI et al [25] provide strong evidence that asthma deaths in Chicago (IL, USA) are more likely to occur on days when local mould spore counts are high. High mould spore counts have been associated with asthma admissions in New Orleans (LA, USA; adults), Derby (UK) and Mexico City (adults and children), and Ottawa (Canada; children) [44][45][46][47][48]. In the Canadian study there was a positive association with spore counts, but not pollen counts, and emergency asthma attendance at hospital [46].…”

Section: Early Descriptionsmentioning

confidence: 84%

The link between fungi and severe asthma: a summary of the evidence

Denning

O’Driscoll²,

Hogaboam³

et al. 2006

European Respiratory Journal

720

631

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There is current evidence to demonstrate a close association between fungal sensitisation and asthma severity. Whether such an association is causal remains to be confirmed, but this is explored by means of a detailed literature review. There is evidence from two randomised controlled trials that, in the example of allergic bronchopulmonary aspergillosis (ABPA), treatment with systemic antifungal therapy can offer a therapeutic benefit to ,60% of patients. ABPA is only diagnosed if a combination of clinical and immunological criteria is achieved. It is not known whether such cases are a discrete clinical entity or part of a spectrum of the pulmonary allergic response to fungi or fungal products.This paper describes the epidemiological evidence that associates severity of asthma with fungi and discusses possible pathogenetic mechanisms. Many airborne fungi are involved, including species of Alternaria, Aspergillus, Cladosporium and Penicillium, and exposure may be indoors, outdoors or both. The potential for a therapeutic role of antifungal agents for patients with severe asthma and fungal sensitisation is also explored.Not only are many patients with severe asthma desperately disabled by their disease, but, in the UK alone, asthma accounts for 1,500 deaths per yr. The healthcare costs of these patients are enormous and any treatment option merits close scrutiny. Within this report, the case for the consideration of a new term related to this association is put forward. The current authors propose the term ''severe asthma with fungal sensitisation''. However, it is recognised that enhanced and precise definition of fungal sensitisation will require improvements in diagnostic testing.

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“…Biogenic material (fungi, spores, bacteria and a variety of organic particles) present in humid air, could account for these peaks 36. , as well as the concentration of fungi in the environment during the rainy season. Atkinson et al 37 and Dales et al 38 observed a correlation between fungal spores and asthma exacerbations in the United States. In Brazil, Valença et al 39 found in Brasilia, a prevalence of emergency visits for asthma for children during the rainy season, possibly influenced by changes in microorganisms concentrations in the environment.…”

Section: Discussionmentioning

confidence: 99%

Distribuição espacial das internações por asma em idosos na Amazônia Brasileira

Rodrigues

Ignotti²,

Rosa

et al. 2010

Rev. bras. epidemiol.

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Introduction: In Brazil, there are approximately 370,000 asthma-related hospitalizations per year, representing the fourth leading cause of hospitalizations in public health services. In 2007, 157,000 elderly patients were hospitalized, 2.3% of which due to asthma in the Brazilian Amazon. The rate of hospitalizations during the dry season was as much as three times that of the rain and intermediate seasons, with the highest rates in Rondônia (5.8 ‰) and Mato Grosso (3.3 ‰). Conclusion: Asthmarelated hospital admissions in the elderly presented a declining trend and a significant seasonal variation, with the highest rate of hospitalizations observed during the dry season.

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The Role of Fungal Spores in Thunderstorm Asthmaa

Cited by 151 publications

References 22 publications

Prevalence and pattern of asthma exacerbation in children seen at the University of Nigeria Teaching Hospital, Enugu

Prevalence and pattern of asthma exacerbation in children seen at the University of Nigeria Teaching Hospital, Enugu

The link between fungi and severe asthma: a summary of the evidence

Distribuição espacial das internações por asma em idosos na Amazônia Brasileira

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