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]



There have been events where thunderstorms have caused asthma attacks across cities such that emergency services and hospitals have been overwhelmed. The phenomenon was first recognised and studied 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; [7] Atlanta, United States; [8] and Ahvaz, Iran. [9] The outbreak in Melbourne, in November 2016, that overwhelmed the ambulance system and some local hospitals, resulted in at least nine deaths. [10] [11] [12] [13] [14] There was a similar incident in Kuwait in early December, 2016 with at least 5 deaths and many admissions to the ICU. [15] [16]


Many of those affected during a thunderstorm asthma outbreak may have never experienced an asthma attack before. [17]

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. [18] 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. [19] [20] [21]


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. [22] Preventative treatment found useful for severe asthma includes Allergen immunotherapy (AIT) particularly sublingual immunotherapy (SLIT). [23]

Significant events

Related Research Articles

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.

Ragweed Genus of plants

Ragweeds are flowering plants in the genus Ambrosia in the aster family, Asteraceae. They are distributed in the tropical and subtropical regions of the Americas, especially North America, where the origin and center of diversity of the genus are in the southwestern United States and northwestern Mexico. Several species have been introduced to the Old World and some have naturalized and have become invasive species. Ragweed species are expected to continue spreading across Europe in the near future in response to ongoing climate change.

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.

Food allergy Hypersensitivity reaction to a food

A food allergy is an abnormal immune response to food. The symptoms of the allergic reaction may range from mild to severe. They may include itchiness, swelling of the tongue, vomiting, diarrhea, hives, trouble breathing, or low blood pressure. This typically occurs within minutes to several hours of exposure. When the symptoms are severe, it is known as anaphylaxis. A food intolerance and food poisoning are separate conditions, not due to an immune response.

Allergic conjunctivitis

Allergic conjunctivitis (AC) is inflammation of the conjunctiva due to allergy. Although allergens differ among patients, the most common cause is hay fever. Symptoms consist of redness, edema (swelling) of the conjunctiva, itching, and increased lacrimation. If this is combined with rhinitis, the condition is termed allergic rhinoconjunctivitis (ARC).

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.

Peanut allergy

Peanut allergy is a type of food allergy to peanuts. It is different from tree nut allergies, with peanuts being legumes and not true nuts. Physical symptoms of allergic reaction can include itchiness, hives, swelling, eczema, sneezing, asthma attack, abdominal pain, drop in blood pressure, diarrhea, and cardiac arrest. Anaphylaxis may occur. Those with a history of asthma are more likely to be severely affected.

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.

Allergies to cats are one of the most common allergies among individuals. Among the eight known cat allergens, the most prominent allergen is secretoglobin Fel d 1, and it is produced in the anal glands, salivary glands, and, mainly, in sebaceous glands of cats, and is ubiquitous in the United States, even in households without cats. Allergic symptoms associated with cats include coughing, wheezing, chest tightening, itching, nasal congestion, rash, watering eyes, sneezing, chapped lips, and similar symptoms. In worst-case scenarios, allergies to cats can develop into more life-threatening conditions such as rhinitis and mild to severe forms of asthma. Despite these symptoms, there are many types of solutions to mitigate the allergic effects of cats, including medications, vaccines, and home remedies. Hypoallergenic cats are another solution for individuals who want pets without the allergic consequences. Furthermore, prospective pet owners can reduce allergic reactions by selecting cats of a specific gender or color, which are associated with a lower production of allergens.

Milk allergy Type of food allergy caused by milk

Milk allergy is an adverse immune reaction to one or more proteins in cow's milk. When allergy symptoms occur, they can occur rapidly or have a gradual onset. The former may include anaphylaxis, a potentially life-threatening condition which requires treatment with epinephrine among other measures. The latter can take hours to days to appear, with symptoms including atopic dermatitis, inflammation of the esophagus, enteropathy involving the small intestine and proctocolitis involving the rectum and colon.

ALK-Abelló A/S, also commonly known as ALK, is a Denmark-based pharmaceutical company which specializes in the development and manufacture of allergy immunotherapy (AIT) products for the prevention and treatment of allergy. It is one of the world’s largest makers of allergy immunotherapy products with 81% of its revenue coming from sales in Europe.

Tree nut allergy

A tree nut allergy is a hypersensitivity to dietary substances from tree nuts and edible tree seeds causing an overreaction of the immune system which may lead to severe physical symptoms. Tree nuts include, but are not limited to, almonds, Brazil nuts, cashews, chestnuts, filberts/hazelnuts, macadamia nuts, pecans, pistachios, shea nuts and walnuts.

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.

Enzyme potentiated desensitization (EPD), is a treatment for allergies developed in the 1960s by Dr. Leonard M. McEwen in the United Kingdom. EPD uses much lower doses of antigens than conventional desensitization treatment paired with the enzyme β-glucuronidase. EPD is approved in the United Kingdom for the treatment of hay fever, food allergy and intolerance and environmental allergies.

Laboratory animal allergy (LAA) is an occupational disease of laboratory animal technicians and scientists. It manifests as an allergic response to animal urine, specifically the major urinary proteins (Mups) of rodents, and can lead to the development of asthma. A study of 5641 workers in Japan who were exposed to laboratory animals found 23.1% had one or more allergic symptoms; globally the prevalence among at risk workers is estimated between 11 and 30% According to the National Institutes of Health, prevention of animal allergy depends on the control of allergens in the work environment. This involves a combination of measures to eliminate or control allergen exposure, including engineering controls, administrative controls, and personal protective equipment.

William Frankland (allergist) British immunologist

Alfred William Frankland MBE was a British allergist and immunologist whose achievements included the popularisation of the pollen count as a piece of weather-related information to the British public, speculation regarding the effects of overly sterile living environments, and the prediction of increased levels of allergy to penicillin. He continued to work for a number of years after turning 100.

Ursula Wiedermann is an Austrian medical scientist who has made significant contributions in the field of allergies and of cancer immunotherapy. She is currently Professor of Vaccinology at the Medical University of Vienna. Wiedermann's work in the field of B cell peptide vaccines led to the creation of HER-Vaxx, an immunotherapy for the treatment of HER-2-positive cancers. This vaccine is currently being taken into mid-stage clinical development in gastric cancer by the biotech company Imugene, where Wiedermann is Chief Scientific Officer.

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.


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