Thunderstorm asthma

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A thunderstorm in Tamworth, New South Wales, Australia Tamworth Storm 15th Feb 2006 a.sized.jpg
A thunderstorm in Tamworth, New South Wales, Australia

Thunderstorm asthma is the triggering of an asthma attack by environmental conditions directly caused by a local thunderstorm. It has been proposed that during a thunderstorm, pollen grains can absorb moisture and then burst into much smaller fragments with these fragments being easily dispersed by wind. [1] [2] While larger pollen grains are usually filtered by hairs in the nose, the smaller pollen fragments are able to pass through and enter the lungs, triggering the asthma attack. [3] [4] [5] [6]

Contents

History

There have been events where thunderstorms have caused asthma attacks across cities such that emergency services and hospitals have been overwhelmed. The phenomenon has been recognised for a significant period of time with a study of an event in Birmingham noting the correlation between thunderstorms and hospitalisations. [7] This fact that these were not isolated events and were part of an ongoing pattern of events is clearly documented in the review "Thunderstorm asthma, an overview of the evidence base". [8] A significant impetus in the study of the phenomenon occurred after an event in 2016 in Melbourne, Australia. Since then there have been further reports of widespread thunderstorm asthma in Wagga Wagga, Australia; London, England; Naples, Italy; [9] Atlanta, United States; [10] and Ahvaz, Iran. [11] The outbreak in Melbourne, in November 2016, that overwhelmed the ambulance system and some local hospitals, resulted in at least nine deaths. [12] [13] [14] [15] [16] There was a similar incident in Kuwait in early December, 2016 with at least 5 deaths and many admissions to the ICU. [17] [18]

Statistics

Many of those affected during a thunderstorm asthma outbreak may have never experienced an asthma attack before. [19]

It has been found 95% of those that were affected by thunderstorm asthma had a history of hayfever, and 96% of those people had tested positive to grass pollen allergies, particularly rye grass. [20] A rye grass pollen grain can hold up to 700 tiny starch granules, measuring 0.6 to 2.5 μm, small enough to reach the lower airways in the lung. [21] [22] [23]

Prevention

Patients with a history of grass allergies should be tested for asthma and treated for the grass allergies and asthma if also present. Patients with known asthma should be treated and counseled on the importance of adherence to preventative medication protocols. [24] Preventative treatment found useful for severe asthma includes Allergen immunotherapy (AIT) particularly sublingual immunotherapy (SLIT). [25]

Significant events

Related Research Articles

Asthma Long-term inflammatory disease of the airways of the lungs

Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath. These may occur a few times a day or a few times per week. Depending on the person, asthma symptoms may become worse at night or with exercise.

Pollen The grains containing the male gametophytes of seed plants

Pollen is a powdery substance consisting of pollen grains which are male microgametophytes of seed plants, which produce male gametes. Pollen grains have a hard coat made of sporopollenin that protects the gametophytes during the process of their movement from the stamens to the pistil of flowering plants, or from the male cone to the female cone of coniferous plants. If pollen lands on a compatible pistil or female cone, it germinates, producing a pollen tube that transfers the sperm to the ovule containing the female gametophyte. Individual pollen grains are small enough to require magnification to see detail. The study of pollen is called palynology and is highly useful in paleoecology, paleontology, archaeology, and forensics. Pollen in plants is used for transferring haploid male genetic material from the anther of a single flower to the stigma of another in cross-pollination. In a case of self-pollination, this process takes place from the anther of a flower to the stigma of the same flower.

Allergy Immune system response to a substance that most people tolerate well

Allergies, also known as allergic diseases, are a number of conditions caused by hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic dermatitis, allergic asthma, and anaphylaxis. Symptoms may include red eyes, an itchy rash, sneezing, a runny nose, shortness of breath, or swelling. Food intolerances and food poisoning are separate conditions.

An allergen is a type of antigen that produces an abnormally vigorous immune response in which the immune system fights off a perceived threat that would otherwise be harmless to the body. Such reactions are called allergies.

Thunderstorm Type of weather with lightning and thunder

A thunderstorm, also known as an electrical storm or a lightning storm, is a storm characterized by the presence of lightning and its acoustic effect on the Earth's atmosphere, known as thunder. Relatively weak thunderstorms are sometimes called thundershowers. Thunderstorms occur in a type of cloud known as a cumulonimbus. They are usually accompanied by strong winds, and often produce heavy rain and sometimes snow, sleet, or hail, but some thunderstorms produce little precipitation or no precipitation at all. Thunderstorms may line up in a series or become a rainband, known as a squall line. Strong or severe thunderstorms include some of the most dangerous weather phenomena, including large hail, strong winds, and tornadoes. Some of the most persistent severe thunderstorms, known as supercells, rotate as do cyclones. While most thunderstorms move with the mean wind flow through the layer of the troposphere that they occupy, vertical wind shear sometimes causes a deviation in their course at a right angle to the wind shear direction.

Allergic rhinitis Human disease

Allergic rhinitis, also known as hay fever, is a type of inflammation in the nose which occurs when the immune system overreacts to allergens in the air. Signs and symptoms include a runny or stuffy nose, sneezing, red, itchy, and watery eyes, and swelling around the eyes. The fluid from the nose is usually clear. Symptom onset is often within minutes following allergen exposure and can affect sleep, and the ability to work or study. Some people may develop symptoms only during specific times of the year, often as a result of pollen exposure. Many people with allergic rhinitis also have asthma, allergic conjunctivitis, or atopic dermatitis.

Immunoglobulin E Immunoglobulin E (IgE) Antibody

Immunoglobulin E (IgE) is a type of antibody that has been found only in mammals. IgE is synthesised by plasma cells. Monomers of IgE consist of two heavy chains and two light chains, with the ε chain containing 4 Ig-like constant domains (Cε1-Cε4). IgE's main function is immunity to parasites such as helminths like Schistosoma mansoni, Trichinella spiralis, and Fasciola hepatica. IgE is utilized during immune defense against certain protozoan parasites such as Plasmodium falciparum. IgE may have evolved as a last line of defense to protect against venoms.

Rhinitis

Rhinitis, also known as coryza, is irritation and inflammation of the mucous membrane inside the nose. Common symptoms are a stuffy nose, runny nose, sneezing, and post-nasal drip.

Allergen immunotherapy Medical treatment for environmental allergies

Allergen immunotherapy, also known as desensitization or hypo-sensitization, is a medical treatment for environmental allergies, such as insect bites, and asthma. Immunotherapy involves exposing people to larger and larger amounts of allergen in an attempt to change the immune system's response.

Aeroplankton

Aeroplankton are tiny lifeforms that float and drift in the air, carried by the current of the wind; they are the atmospheric analogue to oceanic plankton.

Anemophily Wind pollination

Anemophily or wind pollination is a form of pollination whereby pollen is distributed by wind. Almost all gymnosperms are anemophilous, as are many plants in the order Poales, including grasses, sedges, and rushes. Other common anemophilous plants are oaks, pecans, pistachios, sweet chestnuts, alders and members of the family Juglandaceae. Approximately 12% of plants across the globe are benefited by anemophily, including cereal crops like rice and corn and other prominent crop plants like wheat, rye, barley, and oats. In addition, many pines, spruces, and firs are wind-pollinated, and people rely on these hardwood trees for their survival.

Oral allergy syndrome (OAS) is a type of food allergy classified by a cluster of allergic reactions in the mouth and throat in response to eating certain fruits, nuts, and vegetables that typically develops in adults with hay fever.

Wheat allergy

Wheat allergy is an allergy to wheat which typically presents itself as a food allergy, but can also be a contact allergy resulting from occupational exposure. Like all allergies, wheat allergy involves immunoglobulin E and mast cell response. Typically the allergy is limited to the seed storage proteins of wheat. Some reactions are restricted to wheat proteins, while others can react across many varieties of seeds and other plant tissues. Wheat allergy is rare. Prevalence in adults was found to be 0.21% in a 2012 study in Japan.

Eosinophil cationic protein

Eosinophil cationic protein (ECP) also known as ribonuclease 3 is a basic protein located in the eosinophil primary matrix. In humans, the eosinophil cationic protein is encoded by the RNASE3 gene.

Extreme weather events in Melbourne

Extreme weather events in Melbourne, Australia have occurred on multiple occasions. The city has experienced a number of highly unusual weather events and extremes of weather. An increase in heat waves and record breaking temperatures in the 21st century has led to much discussion over the effects of climate change in the country.

Pathophysiology of asthma

Asthma is a common pulmonary condition defined by chronic inflammation of respiratory tubes, tightening of respiratory smooth muscle, and episodes of bronchoconstriction. The Centers for Disease Control and Prevention estimate that 1 in 11 children and 1 in 12 adults have asthma in the United States of America. According to the World Health Organization, asthma affects 235 million people worldwide. There are two major categories of asthma: allergic and non-allergic. The focus of this article will be allergic asthma. In both cases, bronchoconstriction is prominent.

Alpha-gal allergy — or mammalian meat allergy (MMA) — is a type of red-meat allergy characterized by a delayed onset of symptoms after ingesting the provoking food and resulting from past exposure to tick bites. It was first reported in 2002.

OPALS is an acronym for Ogren Plant Allergy Scale. It is an allergy rating system for plants that measures the potential of a plant to cause allergic reactions in humans.

The Rotorod sampler is a scientific instrument that is used for collecting pollen grains and fungus spores from the atmosphere.

Allergies in children

Allergies in children are those causes, pathophsiology, treatments, management, practices and control of allergies that develop in children. Up to 40 percent of children suffer from allergic rhinitis. And children are more likely to develop allergies if one or both parents have allergies. Allergies differ between adults and children. Part of the reason for this that the respiratory system in children is smaller. The bronchi and bronchioles are narrower so even a slight decrease in diameter of these airways can have serious consequences. Many children outgrow their allergies.

References

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