Asthma is a chronic inflammation of the lungs, with episodes of worsened symptoms known as asthma attacks or exacerbations. Dust, mites, pollen, smoke and smog are among the allergens that can trigger an attack. Allergy control and limited exposure are part of the overall strategy to prevent attacks in children.
Significance
Allergic asthma is the most common form of asthma, affecting more than half of all asthma sufferers, according to the Asthma and Allergy Foundation of America. More than 2 million children have allergic asthma. The National Institutes of Health estimates that 5,000 asthma-related deaths occur every year in the United States, and the rates of asthma continue to rise, particularly among children and minorities. The health-care-related costs of asthma total more than $11 billion annually, according to the NIH.
Serious Complications
Allergies can trigger an asthma attack but can also trigger a severe allergic reaction, or anaphylaxis. Symptoms of anaphylaxis are similar to those of asthma--shortness of breath, wheezing and difficulty breathing. Other symptoms of an allergic reaction include hives and swelling of the tissues under the skin, a condition known as angioedema, which can become life threatening if it occurs in the neck and constricts the the upper airway.
Symptoms
The symptoms of allergic asthma are: a dry, rattling cough; difficult, rapid breathing; chest and abdominal retractions; and wheezing. Wheezing is a high-pitched noise, similar to blowing air into a narrow straw, which occurs when air tries to flow out of the chest through the constricted airways.
Treatment
There are two treatment strategies for children with allergic asthma: prevention and acute treatment. Prevention involves keeping the environment as free of allergens and possible and taking medicines that block the effect of allergens and decrease the inflammation surrounding the lungs. Antihistamines block the effect of histamine, which is the principal substance that triggers the allergic reaction. Inhaled steroids, used on a daily basis, decrease the inflammation surrounding the lungs, lowering the incidence of asthma attacks.
Geography
The Asthma and Allergy Foundation compiles an annual list of “Asthma Capitals.” These are cities that are particularly challenging for children with allergic asthma. They have high pollen counts, poor air quality, lax anti-smoking laws, high mortality rates related to asthma, low preventive medication use and lack of access to certified asthma specialists. In 2010, most of the cities were in the South, with Richmond, Va., ranked as the worst city. Other cities included Atlanta; Memphis and Chattanooga, Tenn.; St. Louis and Philadelphia.
