- World Asthma Day has been celebrated since 1998.
- It is a respiratory disease that affects about three million people in Spain.
- There is no cure, but it can be controlled
World Asthma Day has been celebrated since 1998, following the action of GINA, the Global Initiative for Asthma. If until the 2021 edition it was celebrated every May 5, it was decided that from 2022 it would be celebrated on the first Tuesday of the month of May. Thus, today, Tuesday, May 3, is World Asthma Day, with the aim of raising awareness of this pathology around the world.
Although asthma is not a curable disease, there are ways to control and prevent it, even in cases of asthma attacks that can be prevented or its symptoms can be controlled. That is why, since 2008, the slogan of this World Asthma Day is “You can control your asthma”, and aims to raise awareness that it is possible to control and live normally despite suffering from this disease.
Asthma, an approach
“Asthma is a lung disease, the duration of which can be sustained or prolonged over the long term, which is inflammatory and recurrent over time. Mainly, asthma consists of a series of stimuli that trigger inflammation in the airways, which produces a temporary narrowing and gives rise to a series of different respiratory symptoms,” says Dr. Manuel Baca, a pediatric expert in Pneumology in Malaga with more than three decades of experience.
In addition, Dr. Baca points out that asthma “does not have an immediate and definitive treatment”, but that it is “fundamental” to control the symptoms in order to “avoid potential damage to the lungs of children who are still developing and growing”.
Some facts about asthma
Asthma is one of the non-communicable diseases that affects more adults and children in the world. According to data from the World Health Organization, in 2019 more than 262 million people were affected by this pathology, of which it is estimated that nearly half a million died, specifically 461000 people.
According to INE data, almost a thousand people die every year due to complications derived from asthma in Spain. In 2017, the number of deaths due to asthma in Spain reached 1118 people, of which 922 were women. In addition, it is considered that around 5% of the Spanish adult population and 10% of the child population were affected by this disease in 2018, causing the number of affected Spaniards to exceed three million.
Signs of asthma
Asthma does not affect all people equally. In fact, in some cases it is a minor nuisance and hardly interferes with the person’s quality of life. However, in others it can become a major nuisance that considerably affects the rhythm of life and daily activities of the sufferer.
At the same time, a distinction must be made between the different options by which asthma is triggered:
- Asthma as a consequence of physical exercise.
- Asthma as a consequence of an allergic reaction.
- Occupational asthma, which occurs in the usual workplace.
“When an asthma attack occurs, as the airways narrow, breathing difficulties, coughing and uncomfortable noises in the chest, called wheezing, appear,” says Dr. Baca.
Depending on the severity, the main sign of asthma is coughing, although in more severe cases, the main symptom affects breathing, which becomes more complicated, wheezing becomes audible without the need for a phonendo, breathing accelerates and involves more effort… In younger children, there is difficulty in eating or sucking, the “wings of the nose move in search of air, the skin becomes paler…
So, is childhood asthma the same as adult asthma? “Childhood asthma is not a different disease from adult asthma, because it does not involve so much chronicity, and can disappear with proper treatment and growth. They will generate special challenges due to emergency room visits, hospitalizations and absences from school,” points out Dr. Manuel Baca, a pediatrician in Malaga and member of Top Doctors.
Causes of asthma
Genetics is important in asthma. “Most children with asthma have direct relatives with asthma, given the great importance of genetic influence in asthma,” says Dr. Baca.
However, it is not always easy to identify the exact cause of asthma. Nevertheless, three potential triggers of an asthma attack can be established:
- Physical exercise.
- External allergen.
- Physical exercise.
“The most common allergens that can trigger asthma attacks are pollen, dust (dust mites), animal epithelium (dog, cat or horse), mold, some medications, certain foods etc. Coughing and asthma attacks can be triggered by stuffy environments, tobacco smoke, exercise, laughter, and infectious diseases, especially viral ones,” says Dr. Baca.
Treatment of childhood asthma
As such, asthma cannot be cured. Treatment is aimed at palliating or controlling the signs of asthma attacks, while trying to prevent them. In those cases in which it is possible, inhaled medication will be used.
- In acute asthma: bronchodilators and occasionally corticosteroids.
- In chronic asthma: inhaled corticosteroids and sometimes in combination with bronchodilators, as well as with leukotriene modifiers.
- In children with mild or very rare attacks, the drugs should be taken only during asthma attacks.
Children and adolescents should use a metered dose inhaler with a spacer chamber. The spacer chamber allows adequate access of the drug to the lungs and minimizes the possibility of side effects. Children who cannot use inhalers receive inhaled drugs at home through a mask connected to a nebulizer, known as an aerosol machine. Children with very severe episodes are seen in the hospital and given bronchodilators through a spacer bed (MDI) or through a nebulizer.
Children requiring treatment more than twice a week, those with more persistent asthma, or those at risk for frequent or severe attacks should receive daily anti-inflammatory treatment with inhaled corticosteroids. These children may also be given an additional drug, such as a leukotriene receptor antagonist (montelukast), or a long-acting bronchodilator (always mixed with an inhaled corticosteroid in a combined inhaler). The drugs are increased or decreased once the dose that allows a comfortable life is reached. Children who experience symptoms during exercise usually inhale a dose of bronchodilator before starting the activity.
Since asthma is an often chronic disorder with a wide variety of drugs and other treatments, the pediatrician must work with parents and children to ensure adequate control of the disease. It will be essential that they learn what to do in a crisis, when to use the drugs, when to call the pediatrician and when to go to the hospital. Information will also be given at school and day care.
It is important to avoid allergens, to practice exercise and to watch for symptoms that announce a worsening. Correct compliance with the overall treatment plan will allow the child to lead a normal life. Poorly controlled asthma will result in emergency room visits and absenteeism from school and work, in the case of parents. Over time, asthma symptoms will become less severe or even disappear; improper care will lead to chronification of the disease.