Peak Month for Pediatric Asthma Flare-Ups

With rates of asthma flare-ups were twice as high in September as in August, researchers suggest that people are lax about asthma medication use during the summer before children return to school and are exposed to viral infections.

September is the riskiest month for asthma flare-ups in children, according to a new study published in the April 2014 issue of Pediatrics.

The rates of asthma flare-ups were twice as high in September as in August, and the study also found more than a 2-fold higher rate of use of asthma medication rescue prescriptions in September compared with August, according to Herman Avner Cohen, MD, at the Tel Aviv University, and Israeli colleagues.

The researchers suggest that during the summer months, people get lax about using asthma medications, and when children return to school in September, they are exposed to viral infections. Fall allergies may also play a role in the increased risk of asthma flare-ups.

The researchers reviewed 5 years of health data recorded by family physicians on more than 919,000 Israeli children between 2 and 15 years of age. The data were analyzed by “week of diagnosis” to assess relative strength of secular trends, seasonality, and age-group of asthma exacerbations. Nearly 9% of children studied had been diagnosed with asthma. Nearly half the children with asthma were between 2 and 5 years of age; close to 25% were between 6 and 9 years old; and just over 25% were between 10 and 15 years of age.

For children between the ages of 2 and 11, the association between the return to school and the incidence of asthma-related visits to a primary care physician was greatest, according to the researchers. Adolescents between the ages of 12 and 15 had a lesser peak.

The investigators also saw another increase in asthma flare-ups in late fall and intermittently throughout the winter. During the summer, the study found that fewer prescriptions for asthma medications were filled. This suggests that the use of asthma-controlling medications are at their lowest point of the year just prior to the children returning to school, where they are exposed to viral infections and fall allergies.