After children head back to school, they go straight into peak virus season. If your child has asthma, this can exacerbate the condition. It’s important to anticipate heightened symptoms and have a plan in place, says Giovanni Piedimonte, MD, Institute Chair for Pediatrics and staff physician for the Cleveland Clinic’s Center for Pediatric Pulmonary Medicine.
Fall and winter are the worst seasons for children with asthma because they become exposed to many more respiratory viruses as school resumes and they return to classrooms, Dr. Piedimonte says.
He warns parents that their child’s asthma may flare up in late August and September because of two key factors:
“The fall/winter season is when we experience a very significant increase in asthma attacks,” says Dr. Piedimonte. “That’s because viruses become highly prevalent in the population and typically cause upper respiratory infections. This, in turn, triggers asthma attacks.”
Throughout the changes of the seasons, your child may have various allergies, depending on pollination and the blooming of various flowers and grasses. Allergic reactions can also spark asthma attacks, alone or in combination with other environmental factors like viruses and indoor and outdoor pollution.
However, during the summer season, there are fewer asthma attacks because children are not exposed to as many potential viral infections and spend less time in the more densely populated school setting.
While some children and adults may suffer because of higher levels of humidity and pollution in the summer, the fall/winter season remains the most challenging because of the increase in exposure to viruses, Dr. Piedimonte says. Studies show that viruses cause more than 80 percent of asthma attacks, he says.
Here’s the usual progression, according to Dr. Piedimonte:
There are several steps you can take as a parent to reduce or prevent a viral-related asthma attack.
“All of these practices are particularly important for children who have had episodes of wheezing in the past and, therefore, are predisposed to have recurrent episodes of wheezing,” Dr. Piedimonte says.
Children with mildly, moderately or severely persistent asthma require corticosteroid medication given through metered-dose inhalers (MDI) with spacers, says Dr. Piedimonte.
“Parents should discuss with their child’s physician the safety and effectiveness of any medications they give them,” he says. “But it’s also important to learn the correct way to deliver those medications.
“For example, without using a spacer device with the MDI, most of the medication will not reach beyond the child’s mouth and throat, so the therapeutic effect on the lungs will be very limited and the side effects will be magnified.”
The side effects of albuterol, used for decades to manage asthma, are similar to those of adrenaline, which has similar molecular composition.
Albuterol tends to increase the heart rate and prompt some tremor, palpitations and hyperactivity, but that is usually well-tolerated, according to Dr. Piedimonte.
Some studies show that corticosteroids, which are the most powerful medication for the control of chronic asthma to date, may inhibit a young child’s linear growth. In other words, they can slow the speed of growing taller, especially in the first year of therapy. Although children tend to catch up after that first year, their final adult height may still be slightly less than those not receiving steroids.
“With children who have moderate and severe asthma, this risk is balanced by the fact that these children need to have the anti-inflammatory therapy to reduce the frequency of their attacks, prevent a faster decline in their lung function and improve their quality of life,” Dr. Piedimonte says.
He says if asthma is not treated appropriately, it may require frequent visits to the doctor’s office or emergency department, and it can even result in hospitalizations.
“It can interfere with sleep, sport activities, school performance, and overall quality of life, and it may be followed by chronic deterioration of the child’s pulmonary function over time.”
He says it’s paramount that people understand how important it is to manage asthma in children. “It should not be forgotten that asthma is a potentially life-threatening condition,” he says.