Springtime hay fever, asthma and the importance of symptom management

St Vincent’s Hospital Melbourne (SVHM) clinicians are encouraging people to prepare for the upcoming thunderstorm asthma season and to remain vigilant for both asthma and hay fever symptoms.

The main allergen implicated in Melbourne’s thunderstorm asthma event in 2016 was rye grass, a seasonal grass pollen that usually peaks in October and November. Thunderstorm asthma occurs when pollen grains explode after absorbing moisture in the air, allowing the smaller particles to be breathed into people’s lungs.

Thunderstorm asthma events can occur very suddenly, but severe thunderstorm asthma may be preventable if people are on adequate treatments and have management plans in place.

Dr Matthew Conron, SVHM Director of Respiratory and Sleep Medicine, and Dr Eve Denton, SVHM Respiratory and Sleep Physician were recently interviewed by The Age newspaper, sharing their expertise and advice in this area.

Differentiating between hay fever and asthma

Dr Conron and Dr Denton have noticed people often mistake asthma symptoms for seasonal hay fever symptoms and, therefore, do not seek specific asthma management.

Springtime hay fever and asthma (even if “mild”) can both place people at greater risk of thunderstorm asthma, and having both asthma and hay fever increases this risk further, as the lung disease and the allergic response can occur at the same time and have some similar triggers and symptoms, such as coughing.

People experiencing symptoms including chest tightness, shortness of breath, wheezing or coughing should consult their GP or an asthma clinic in preparation for a thunderstorm asthma event.

In the interview with The Age, Dr Denton explained that another reason people might have unmanaged asthma is because some people might not realise that it’s possible to have asthma that occurs only in spring, a phenomenon she says is particularly common in Melbourne.

“We do have patients in our clinic where if we measure their lung function outside of spring, it’s completely normal. And if we measure their lung function in spring, particularly on those really high pollen count days that tend to occur in November, then we can find on their lung function that they have demonstrable [confirmed] asthma,” said Dr Denton.

Dr Matthew Conron, SVHM Director of Respiratory and Sleep Medicine (photo by Wayne Taylor, for The Age) and Dr Eve Denton, SVHM Respiratory and Sleep Physician 

Asthma management

Dr Conron said the patients who presented at SVHM’s Emergency Department during the 2016 thunderstorm asthma event were typically young and very unwell. They had either had mild asthma in the past or had never been diagnosed with the condition.

At the same time, none of SVHM’s chronic asthma patients presented to the hospital during the event, possibly due to the presence of asthma treatment and management plans.

A later study of 1435 patients who turned up at Melbourne hospitals during the thunderstorm asthma event found more than half had never had an asthma diagnosis before their thunderstorm asthma episode.

Resources

The SVHM Airways Clinic, an asthma clinic that offers treatment for asthma and hay fever, has since provided follow up treatment and care to hundreds of patients following the 2016 thunderstorm asthma event.

Further information about the Airways Clinic and SVHM Respiratory team can be found here.

The Department of Health’s online epidemic thunderstorm asthma risk forecast is updated twice daily during the grass pollen season.

Read the article, Why your hay fever might actually be spring asthma, on The Age's website.