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Back to school asthma and what you can do about it


Boy uses asthma inhalerYou may think that back to school is all about new shoes, pencils and glue sticks. However, if you have a child with asthma or prone to wheezing, it may also be about worsening asthma symptoms.

Researchers around the world – including United States, Canada, and the United Kingdom have found a rise in children’s asthma attacks when they return back to school after the holiday period.

This phenomenon, also known as back to school asthma, results each year in a surge of hospitalisations during the first few weeks of a school term — with asthma admissions tripling in children aged 5 to 14.

What causes back to school asthma?

The cause of back to school asthma is not fully understood; however, one cause may be that children get out of routine with their medication during the long summer holidays.

Another cause may be a new batch of viruses passed around by classmates. As children are mixing together a lot more during school terms than during school holidays, it makes sense they pass around these bugs more easily.

One particular virus that may cause an asthma attack is rhinovirus –- the common cold virus. A recent study showed that rhinovirus infection significantly worsened asthma symptoms in children aged 5 to 12 years.

In this study, researchers asked 67 children with asthma to collect their nasal mucus twice a week for about 10 weeks. They also asked them to record their asthma and cold symptoms.

After analysing all the data and 1232 nasal mucus samples, the scientists found that asthmatic children infected with rhinovirus had an increased risk of worsened day-to-day asthma symptoms.

How can you prevent back to school asthma?

About 10 per cent of Australian children have asthma. However, Asthma Australia has recently created a useful resource to help prevent asthma attacks this season.

This back to school asthma checklist describes, for example, to:

  • Review and update your child’s asthma plan with your GP
  • Ensure medications are up to date and clearly labelled with your child’s name
  • Talk to school staff about your child’s asthma, asthma plan, and their triggers, symptoms and medication

A child’s asthma attack may also be prevented by limiting the spread of rhinoviruses around the home and school. For example, by using good hand hygiene. Teach children to wash their hands frequently with soap and water or use an alcohol-based hand rub –- particularly after sneezing and coughing.

Armed with this knowledge, back to school doesn’t have to mean a hospital trip.

1. Wisniewski et al. (2016) A comparison of seasonal trends in asthma exacerbations among children from geographic regions with different climates. Allergy and Asthma Proceedings, 37 (6): 475-481.
2. Johnston et al. (2006) The September epidemic of asthma hospitalization: School children as disease vectors. Journal of Allergy and Clinical Immunology, 117(3): 557–562.
3. Johnston & Sears (2006) The epidemiology of asthma exacerbations. Thorax, 61(8): 722–728.
4. Lincoln et al. (2006) Childhood asthma and return to school in Sydney, Australia. Public Health, 120 (9): 854-862.
5. Tovey et al. (2015) Rhinoviruses significantly affect day-to-day respiratory symptoms of children with asthma. Journal of Allergy and Clinical Immunology, 135(3):663-669.e12.

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