September Epidemic

Respiratory infections and emergency room visits sharply rise during first month back in school

Most people associate cold-and-flu season with the cold, dark days of late fall and winter. But as soon as children are confined in classrooms and start swapping germs, the incidence of respiratory infections rises sharply. Colds due to rhinovirus peak in September, with other viral infections also increasing. While this poses a problem for all parents, it is especially hazardous for parents of children with asthma.

“The kids once again get around each other and the germs spread like wildfire,” said Kirstin Carel, MD, Assistant Professor of Pediatrics at National Jewish Health and NJ4Kids. “Unfortunately children with asthma run a much higher risk of contracting a serious illness.”

Viral infections cause more than 80% of asthma attacks in children and more than half of all asthma attacks in adults. Asthma attacks requiring hospitalization are so frequent in September that the "September epidemic of asthma exacerbations" is a recognized phenomenon. A quarter of all children hospitalized for an asthma attack are admitted in September.

All parents can reduce their children’s chances of catching a cold or other respiratory infection by having their children wash their hands well and often. Lung Line nurse Deborah Fending recommends says people need to wash their hands for 20 to 30 seconds. She recommends children sing two refrains of “Happy Birthday” to make sure they wash their hands are truly clean and germ-free. Other strategies to prevent getting and spreading colds include avoiding touching the nose, eyes and mouth, covering the mouth while coughing and sneezing, and using disposable tissues.

No matter how vigilant they are, however, children will still get colds.

One of the most effective ways to prevent respiratory infections from causing asthma attacks is for patients to properly manage their disease, especially with the controller therapy. Inhaled steroids are the most effective controller therapy for most patients. Research at National Jewish has shown that proper use of inhaled steroids reduces hospitalizations, urgent care visits and oral-steroid use. Unfortunately, many children and their parents become lax about asthma care during the carefree months of summer.

“Studies have shown that use of asthma controller therapy is at its lowest level immediately before school returns,” said Dr. Carel. “Children and parents both need to be extremely diligent about making sure that medication prescriptions are being closely adhered to and that inhaler technique does not slip with the chaos of the back-to-school period.”

Dr. Carel practices at both National Jewish Highlands Ranch and the main campus in Denver. For appointments at National Jewish Highlands Ranch call 303-703-3646.