Three key steps to prevent asthma attacks in children during winter

For most people, the word "autumn" conjures up images of honey crisp apples, pumpkin patches and Halloween. But for many pediatricians, fall also means more patients with asthma flare-ups.

Johns Hopkins Children's Center experts warn that fall is peak asthma time because of high levels of airborne ragweed and mold spores and the arrival of the flu and other seasonal bugs, all of which can worsen asthma.

"Year after year, we see a predictable spike in patient visits for asthma exacerbations in fall and winter, but many of these visits could be easily avoided with simple prevention," says Robert Wood, M.D., director of Allergy & Immunology at Hopkins Children's.

The three key steps to preventing asthma attacks include getting a Flu shot, Avoiding triggers and Regular use of controller medication — or FAR.

•Flu shot: Respiratory infections, including the flu, can cause serious complications in those with asthma and other chronic conditions. Research shows that children with asthma who get the flu are hospitalized more often than flu-infected children without asthma. The flu vaccine can not only prevent infections in the first place, but also minimize complications in those who get the flu, experts say. The CDC recommends an annual flu shot for all children 6 months and older.

•Avoid exposure to allergens and other triggers: The best way to avoid asthma attacks — some of which can be serious enough to send a child to the emergency room — is to avoid the triggers. These include airborne allergens, such as pet dander, cockroach and mouse allergens, industrial smog, household chemicals and bacterial and viral infections.

•Regular use of controller medications. Children with persistent asthma, defined as experiencing wheezing, coughing and shortness of breath two or more times a week, benefit from the regular use of controller medications that suppress airway inflammation and prevent asthma attacks in the first place. Once an asthma attack is under way, rescue medications, like albuterol, can keep it from getting worse. But over-reliance on such quick-relief medications is not recommended because while they treat asthma symptoms, they do not prevent them.

"Over the summer, many patients have fewer asthma symptoms and cut down on their controller meds, but for most kids' symptoms will return with the change of season so reverting to their regular drug regimens is critical," says Elizabeth Matsui, M.D., M.P.H., a pediatric allergist and immunologist at Hopkins Children's.