Back-to-school means it's almost time for the "September spike" -- the September asthma epidemic.
That's when cold viruses meet the classroom, triggering attacks in asthmatic children who get infected. It causes a surge in emergency room visits and hospital stays in greater numbers than the rest of the year.
"We see this every year ... and it's purely about the spread of infection in classrooms. It's really about crowding," said Jonathan Finder, clinical director, Division of Pediatric Pulmonology at Children's Hospital of Pittsburgh of UPMC.
"Kids have literally just started going back to school. ... You figure a week incubation time to get colds and get sick, so we're at least a week off from the September spike or bump," Dr. Finder said.
Back-to-school stress, the usual late-summer allergens like ragweed and failure to take regular medications during the summer when asthma symptoms are lowest also can contribute to the spike, said David Skoner, director of the Division of Allergy, Asthma and Immunology at Allegheny General Hospital.
How bad is it?
Nationally, there are 600,000 to 650,000 emergency room visits for children with asthma flare-ups a year, and about a third of those visits turn into admissions, Dr. Skoner said. About a third of those emergency room visits -- 200,000 -- occur during September.
In his practice, he may see 10 cases of asthma attacks a week during the summer. "During the month of September, the number of children coming in with exacerbations can bump up to 20, 25 in a week," he said.
These children can pass on infections at home, noted Fernando Holguin, a pulmonary critical care specialist at UPMC.
There are a few things parents can do to try to prevent or ease asthma attacks.
"It's important to be on prescribed medicine," Dr. Holguin said.
Studies show use of inhaled corticosteroids drops by 60 percent in the summer, said Dr. Skoner, who encouraged children to get back on medication immediately. "It takes four to six weeks for some of these medications to have their full effect."
Teach children good hygiene: They should avoid contact with people who have a cold, wash hands and not share utensils or objects with those who are sick.
For outdoor allergens, Dr. Skoner said, stay inside and use air conditioners; for indoor allergens, reduce exposure in the home.
Studies have shown that stress can trigger an asthma attack in a child, and returning to school can be stressful.
"The only way to deal with that one is to try to focus on education and try to lower the stress," he added.
And there's one other piece of advice that Dr. Finder gives parents who smoke: Don't -- not in the home and not in the car.
"That's the single most modifiable risk factor for asthma. Everything after that is second," he said.
Children's Hospital is cooperating with the National Institutes of Health on a study to see whether wheezing in preschoolers can be prevented, Dr. Holguin said. For more information, call 412-692-8929.
Pohla Smith: firstname.lastname@example.org or 412-263-1228.