September Epidemic

This information was reviewed and approved by Ann Mullen, RN, CNS, AE-C, CDE, TTS (1/1/2019).

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.

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.

The September epidemic is when we see an increase in asthma exacerbations in the fall when children return to school, resulting in more hospital visits and more ER visits.

This may be because children are acquiring more viruses and the kids are passing it on to one another.

At this time of year, it's really important that students make sure they're taking their daily medication, and parents may be busy taking care of back-to-school shopping lists, but it's really important to add that daily medication and filling it every school year.

September is also when the weather may get a little cold. We know that cold is a major trigger of asthma, so it's really important that kids consistently pre-treat if they have a trigger of exercise before exposure to cold, such as during recess or during PE, would be an important way of preventing exacerbations.

Checking peak flow is a good way to monitor asthma control. Having your children check it daily gives you a good gauge of where they are when they're well, and especially checking it during illness helps parents understand if their children's asthma is not adequately controlled.

The Asthma Action Plan is something that we provide to schools to give them a strategy for dealing with the asthma, and that guidance for schools is important to bridge the gap between the school and the parent regarding asthma care.

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.

Special School Supplies

Keep a spacer and quick relief medicine and peak flow meter (if your child uses one) at school for your child. Make sure the quick relief medicine has not passed its expiration date. Takes these items home at the end of each school year.

Gym Class

Make sure your child has an inhaled medication for a pretreatment before gym class or other physical activities, especially outdoors in cold weather.

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.

Medication Side Effects

Studies have shown that asthma medicines typically don't cause concentration problems. However, a child who receives high doses of medicine during an episode may experience side effects, such as restlessness and trouble concentrating.

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.

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.

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