Asthma: a wake-up call!

Storms taking place in Australia and the Middle East last year brought to the fore the deadly potential of asthma. Asthma can take many forms. It often stays silent until it turns into an emergency. And then anything can happen. As with many other chronic health conditions, instituting effective and consistent treatment is a challenge. The Finns have shown us how to do it. And there is even further good news on the horizon…

Asthma, often but not always due to allergy

Asthma causes wheezing, coughing, shortness of breath and/or chest tightness but the underlying dynamics at play may vary. Hence, swimming in chlorine water, obesity and smoking among others can generate their own “kind” of asthma. By far the most common cause remains allergy, involved in 70% of asthma cases (allergy-induced asthma) and with 40% of people with respiratory allergies suffering asthma. Approximately one person in 12 suffers asthma. In 2007, the treatment of asthma cost some $56 billions to the US healthcare system.

Acute asthma epidemics

For most, the condition seems benign, causing trouble mostly during seasonal allergies or with colds. Yet the situation was nothing short of dramatic in Australia last year when a storm occurring during the grass allergy season suddenly struck thousands of individuals, with hundreds overwhelming emergency services. Dozens required ICU care and several people died. A similar episode struck Kuwait also last year. Several of the patients affected are young and “healthy”. Just allergic to grass pollen…

After an asthma emergency, you are never the same

And yet, for those few but too many patients dying, how many suffer the relentless assault of asthma on their breathing function. It has been documented that if one requires a hospital stay to bring asthma under control, his or her lung function never quite returns to normal. It can be viewed as if some degree of scarring takes place and permanently decreases one’s ability to breathe. Hence the need to tackle asthma effectively early on.

See asthma as an iceberg

The inflammation of the lungs (bronchial tree) at the root of asthma stays silent until it is quite advanced. Merely taking your asthma medication when you wheeze is just not good enough. Just as the largest part of an iceberg remains hidden under water, one must realize that even though the symptoms of asthma have eased off, the inflammation of the bronchial lining may still be quite significant. That is why it is so important to treat this inflammation with inhaled corticosteroids for a while after a cold or even after the allergy season for example.

Finland showed that: Yes, we can!

Over a period of 10 years, a concerted effort involving the Finnish political and medical authorities who indeed put into action all stakeholders made a priority to to diagnose and treat asthma early on, to emphasize in the general population and in affected individuals, the need to stay on top of asthma. This brought about health statistics that the rest of the world can only envy. And they even save money!

The asthma and allergy connection

For the medical community, and especially for allergists, it is our duty to go beyond the immediate symptoms of allergy and to actively unmask allergy. This is now a standard of care. In allergy-induced asthma in particular, FeNO (the measurement of the expired fraction of nitrous oxide) is an invaluable, objective tool that we should consider an important asset in this regard. We owe it to each allergy patient to extend those few minutes needed to convey the importance of recognizing, treating and indeed even preventing asthma. The dogma of mere recommandation of allergen avoidance, in some way, is drawing to an end.

Allergy immunotherapy

Whether through traditional injections or via sublingual allergen preparations, allergy immunotherapy still represents the best means to avoid the development of asthma in patients suffering respiratory allergies. And let me share that there are new means of immunotherapy, in fact true allergy vaccination, presently working their way through to commercial reality. Imagine: better efficacy, fewer side effects… in just a few injections! Stay tuned to learn more on this!

You want to help?

Sign on at www.CallAllergyAsthma.eu before September 30th, 2017. A serious if simple first step!