Back to school with asthma : Canadian Lung Association

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Back to school with asthma

How to avoid the “September spike” in asthma symptoms

Buying new school supplies is a late summer ritual for many parents. But for parents of children with asthma, getting ready for school also means getting prepared for the “September spike” – the annual peak in asthma flare-ups that sends hundreds of school children and their family members to emergency rooms in the weeks after school begins.

"September is a difficult time for children with asthma," says Dr. Piush Mandhane, a pediatric respirologist who is studying the September spike. In Canada, between 20 to 25 per cent of children’s hospital admissions for asthma happen in September.

Doctors think the cold virus is the main cause for asthma flare-ups in September. When children go back to school, they’re in close quarters with many other kids – and the viruses they carry. Viruses, including the common cold, are the number one cause of asthma flare-ups in kids. For kids with asthma, especially uncontrolled asthma, a simple cold can lead to dangerous symptoms and unscheduled visits to the doctor or emergency room.

School children bring cold germs home from school and spread them to their parents and younger siblings. Doctors think this spread of cold germs explains why there’s a small rise in preschoolers’ and adults’ asthma flare-up in late September, soon after the spike in school kids’ flare-ups.

"Washing your hands properly and frequently is the best line of defence for everyone against any kind of cold or flu," says Dr. Peter MacLeod, medical spokesperson for the Canadian Lung Association.

Doctors also list other things that can cause or contribute to September flare-ups:

not taking preventer medicine as prescribed
the stress of returning to school
allergic triggers at school, like cat dander on kids’ clothes, mould and dust
more pollution as school buses and commuters return in full force

New data shows that the use of asthma preventer medicine (inhaled corticosteroids) drops in the summer by 60 per cent, according to Dr. Mandhane, an assistant professor at the University of Alberta. “Because their routine is disrupted in the summer, families don’t take their [preventer medicine] medication. So these kids are left unprotected,” he explains¹ . When they don’t get regular asthma preventer medicine, children may have swollen airways. If the children catch a virus, their swollen airways are less able to fight it off.

If your child has asthma but has not been taking his or her medication during the summer, now is the time to start. It’s important to have your child’s asthma symptoms are under good control. That way, if your child does catch a cold or the flu, your child’s lungs will be better at fighting it off.

Dr. Mandhane has these words of advice for those who don’t want to be hit by the September spike: "Keep taking your medication year-round. There are no holidays from asthma medication."

How to prepare your child with asthma for back-to-school

Help protect your child from the September spike by making sure she has good asthma control all year round:

Teach your child and everyone in your family, how to fight germs by washing hands properly. Keep viruses in check with proper hand washing – use plenty of liquid soap and running water, or hand sanitizer. Rub hands for at least 20 seconds.
Know your child's asthma triggers and how to avoid them
Make sure that your child is taking his or her asthma preventer medicine as prescribed.
Check the expiry date on medicines and replace if necessary.
Have a written asthma action plan and know how to use it. You can download an asthma action plan and ask a doctor or certified asthma educator to explain how to use it.
See your doctor or health-care provider if your child’s action plan or medicine need adjusting.
Work with a certified asthma educator to learn how to better manage asthma. Search this online directory to find an asthma clinic or asthma education program in your area.
Make sure your child and family members get the regular seasonal flu shot and H1N1 flu (swine flu) shot as soon as they are available.

Make sure school and daycare staff know about your child’s asthma

Talk to teachers and daycare staff about your child’s asthma, preferably before classes start.

Give teachers and caregivers a copy of your child’s asthma action plan and explain how to use it.
Explain your child’s triggers and usual symptoms.
Teach them what to do in an emergency.
Make sure your child’s rescue medicine (blue puffer) is always nearby.
Ask that they remind children to wash their hands properly.

Learn more about managing asthma at school.

If your child does get sick, here’s what you can do:

Keep following the advice in your child's asthma action plan. You may need to increase her medicine, see her doctor, or go to the emergency department.
Offer your child lots of clear fluids, especially water, to thin mucus.
Encourage extra rest. Wait until your child’s asthma in under control before allowing her to exercise.
Remind your child to wash her hands often, especially after school, after blowing her nose, after using the washroom, and before eating. Make sure everyone in the family washes hands properly and often.
Keep germs covered: Show your child how to cough or sneeze into the crook of her arm or her shoulder. Ask her to toss used tissues right away.
Keep your child away from smoking and from any place people usually smoke.

Learn more

Asthma and children

Asthma at school

Special advice on H1N1 flu (swine flu) for people with asthma

Download our asthma handbook

Find asthma programs near you: use our search tool to find asthma support groups, asthma clinics, and asthma education centres in your area.

References

1. Annals of Allergy, Asthma and Immunology, Volume 102, Number 3, March 2009 - Seasonal patterns in health care use and pharmaceutical claims for asthma prescriptions for preschool - and school-aged children pp. 198-204(7)

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