An Overview of Thunderstorm-Associated Asthma Outbreak in Southwest of Iran

Abstract

The aim of this study was to report the characteristics and treatment strategies of all patients with acute bronchospasm who were presented to the emergency departments of Ahvaz, Iran, following the occurrence of a thunderstorm on November 2, 2013. A total of 2000 patients presenting with asthma attacks triggered by thunderstorm were interviewed and an initial questionnaire was completed for each individual. After twenty days, patients were asked to complete a supplementary questionnaire, but only 800 of them accepted to do so. The majority of subjects was aged 20–40 years (60.5%) and had no history of asthma in most cases (60.0%). The symptoms had started outdoors for 60.0% of the participants. In most patients, the onset of the condition was on November 2. Short-acting β 2-agonist (salbutamol) and aminophylline were the most commonly prescribed medications in the emergency department. Upon the second interview, 85.3% of the patients were still symptomatic. Overall, 63.6% did not have a follow-up visit after hospital discharge, although all of them were referred to the specialist. The findings of the present study suggest that thunderstorm-associated asthma could affect young adults with no gender priority, with or without asthma history, which put a strain on emergency medical services.

Harnessing Tweets for Early Detection of an Acute Disease Event

“…Being outdoors or inside with open windows before and during the thunderstorm has been reported as a risk factor for developing asthma symptoms. 3,12 It also appears that those with known asthma who are taking inhaled corticosteroids may be protected. 2,3…”

Thunderstorm asthma

“…A similar but less severe outbreak occurred in Melbourne in the spring of 2010, 7 as well as in Wagga Wagga 8 and Newcastle, NSW. Storm-related asthma epidemics have been reported in countries worldwide, including England, Canada, Italy and Iran, [9][10][11][12][13] attributed to grass pollen in England and Australia and to olive tree pollen in Italy. Counts of airborne grass pollen in Melbourne during November 2016 were in the extreme range on 21 November.…”

Thunderstorm asthma: revealing a hidden at‐risk population

“…Previously, the largest events witnessed were in 1994 from the UK (with 640 patients with asthma in hospital emergency departments) and in 2013 from Ahvaz, Iran (where 2000 asthma attacks were triggered). This was surpassed by the Melbourne, Australia, ETSA event on 21 November 2016 that led to 10 deaths and an excess of 3500 patients treated across Melbourne’s hospitals – the first thunderstorm asthma event to lead to more than one fatality . The rapid and unprecedented development of asthma cases challenged the state‐wide emergency response system and brought the phenomenon to the forefront of Australian public health policy, leading to large‐scale emergency management reforms .…”

“…This was surpassed by the Melbourne, Australia, ETSA event on 21 November 2016 that led to 10 deaths and an excess of 3500 patients treated across Melbourne's hospitalsthe first thunderstorm asthma event to lead to more than one fatality. 12 The rapid and unprecedented development of asthma cases challenged the state-wide emergency response system and brought the phenomenon to the forefront of Australian public health policy, leading to large-scale emergency management reforms. 11 The epidemic has been a crucial impetus to investigate susceptibility factors and predictors to inform health management reforms better and mitigate the consequences of further potentially catastrophic thunderstorm asthma events.…”