Avoiding the "September Epidemic"
Most people associate cold-and-flu season with the cold, dark days of
late fall and winter. But as soon as children are confined in
classrooms and start swapping germs, the incidence of respiratory
infections rises sharply. Colds due to rhinovirus peak in September,
with other viral infections also increasing. While this poses a problem
for all parents, it is especially hazardous for parents of children
with asthma.
Viral infections cause more than 80 percent of asthma attacks in children and
more than half of all asthma attacks in adults. Asthma attacks
requiring hospitalization are so frequent in September that the
"September epidemic of asthma exacerbations" is a recognized
phenomenon. A quarter of all children hospitalized for an asthma attack
are admitted in September. Below are several tips to help parents of children with asthma prepare for the new school year.
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Asthma Action Plan. Ask your doctor for a written Asthma Action Plan
for the school. This plan should include what medicine to use to treat
asthma symptoms and changes in peak flow zones, what medication to use
as a pretreatment before exercise, emergency telephone numbers and a
list of things that make your child's asthma worse.
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Meet with school staff.
Plan a meeting with school staff before or in the beginning weeks of
the school year. It is helpful to have the school nurse, health aide,
teacher and physical education teacher at the meeting. Your child also
can be involved in the meeting. Take the written Asthma Action Plan to
the meeting. Review the Asthma Action Plan, use of the peak flow meter, medicines and things that make your child's asthma worse.
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Special school supplies.
Keep a peak flow meter, spacer and rescue medicine at school for your
child. Make sure the rescue medicine has not passed its expiration
date. Takes these items home at the end of each school year.
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Gym class. Make sure your child has a pretreatment for gym class or other physical activities, especially outdoors in cold weather.
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Field trips.
Asthma should not keep your child from participating in an off-site
field trip. Be prepared to take medicines along to use for flare-ups.
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Medication side effects.
Studies have shown that asthma medicines typically don't cause
concentration problems. However, if a child who receives high doses of
medicine during an episode may experience side effects, such as
restlessness and trouble concentrating.
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Keep in touch.
Continue talking with your child and school staff about managing asthma
at school on a regular basis, even if everything is fine at school.
Talk with the school staff if your child misses school and assignments.
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When to stay home.
Talk with your child's doctor about when it is okay to stay home from
school because of asthma or illness. Mild asthma symptoms can usually
be handled at school but there are a number of factors (what triggered
the asthma, the stability of peak flows, fever, how much medicine your
child is taking, etc.) to consider when deciding whether to keep your
child at home
This information has been approved by Kirstin Carel, MD (August 2009).
