Media Releases

Timely update to thunderstorm asthma information paper

10 Nov 2022

The National Asthma Council Australia (NAC) today released an updated information paper in time for predictions of high to extreme pollen levels in Victoria this week.

Professor Nick Zwar, Chair of the National Asthma Council Australia Guidelines Committee, said health professionals need to be aware that people with asthma who are allergic to ryegrass pollen and are not using inhaled corticosteroids (ICS) are at highest risk of death or admission to an intensive care unit.

“Thunderstorm-triggered asthma is more clinically important to highlight than thunderstorm asthma epidemics so that information is now right at the start of the paper.

“We know that seasonal (springtime) allergic rhinitis is the most important risk factor, but it is also critical to educate patients without asthma to recognise and report possible asthma symptoms (wheeze, tight chest, dyspnoea) and to know how to access a rapid acting reliever inhaler if needed,” he said.

Respiratory and Allergy Physician, Professor Frank Thien, also on the updated information paper review panel, said in people with allergy to grass pollens, thunderstorm asthma can be triggered by exposure to a high concentration of pollen fragments in wind gusts just before a thunderstorm.

“Grass pollen allergy can trigger life-threatening asthma requiring intensive care admission especially in those with poorly controlled or unrecognised asthma.

“Patients may present with asthma symptoms soon after exposure, or in the following days with an asthma flare-up that they may have been trying to manage on their own,” said Professor Thien.

While epidemic thunderstorm asthma events are uncommon, they occur approximately every 5–7 years in Victoria and some regions in rural New South Wales.

In 2016, those affected by the devastating epidemic thunderstorm asthma included people with asthma or a past history of asthma, those with undiagnosed asthma and also people with seasonal hay fever who had not ever had asthma.

Professor Zwar added: “Thunderstorm asthma epidemics can occur when a storm triggers asthma in many individuals with grass pollen allergy, resulting in a very high demand on ambulance and health services. 

“As a safety precaution in south-eastern Australia over the coming weeks, people with seasonal allergic rhinitis should be given preventive advice about thunderstorm asthma (in the absence of allergy tests) because it is reasonable to assume that sensitisation to ryegrass pollen is likely.

“General practices and pharmacies, particularly those across South Eastern Australia, should ensure they have an Emergency Asthma Plan Policy for patients presenting with an asthma flare up, all staff are trained in asthma first aid and there are good supplies of reliever medications and spacers on hand, particularly for emergency use,” said Professor Zwar.

The 2022 edition of the information paper was developed by the National Asthma Council Australia and Department of Health, Victoria.

Health professionals can download the information paper here

Read more on thunderstorm asthma in the Australian Asthma Handbook here

For further information or an interview with a National Asthma Council Australia spokesperson, please contact: Donna Le Page, Le Page PR Mobile: 0429 825 703

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