Going to School With Asthma

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imageDid you know that asthma exacerbation tends to peak during the fall months as children return to school?  Studies have shown that children often experience a worsening of asthma and asthmatic symptoms after returning to school from summer vacation.  The number of hospitalizations and emergency department visits for asthma attacks reaches a peak approximately two weeks after the start of the school year.  This has been referred to as the “September epidemic.”

Multiple factors likely contribute to this seasonality of asthma exacerbation.  The incidence of viral illnesses does increase with exposure to other children at school.  In addition, children with asthma are particularly susceptible to experiencing a virally-induced exacerbation if they are not receiving any asthma controller therapy.  Asthma controller medications which can be helpful in preventing asthma flare-ups include Singulair and inhaled corticosteroids such as Pulmicort, Flovent, and Advair.  In contrast, albuterol or Xopenex provide short-term relief, but do not result in long term control.

Your child may benefit from receiving an asthma controller medication if there are frequent symptoms, such as coughing, wheezing, or activity limitation, or if albuterol is needed more than twice weekly.  If you have already been prescribed a controller medication, it is important to take it on a daily basis, even if you are feeling well.  Proper inhaler technique is also critical to ensure that the medication is being delivered to your lungs.  Consult our How To Videos for step-by-step instructions on inhaler and spacer technique. 

There is also likely a synergistic interaction between allergies and the effect of respiratory viruses.  Environmental controls thus remain an important part of asthma care.  Avoid or minimize exposure to allergens that your child is sensitive to, such as animal dander, pollen, and dust mites.  If your child is allergic to a family pet and you are unable to remove it from the home, keep your pet out of the bedroom and opt for hardwood floors rather than carpeting.  Cat dander is particularly sticky and adheres to clothes, carpeting and furniture for extended periods.  Exposure to cat dander can thus also occur in the school environment.

Pollen exposure can be minimized by using air conditioning and keeping the windows closed at home and in the car.  Showering or bathing at bedtime also helps to wash away pollen before sleeping in bed at night.  To reduce dust mite exposure, place dust mite covers over your pillows, mattress and box spring and keep stuffed animals off the bed.  If you are unsure whether your child has allergies, skin testing may be performed to identify specific allergens for your child.

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