Asthma Watch

Pharmacy TimesFebruary 2010 Infectious Disease
Volume 76
Issue 2

Kids with Asthma May Have Harder Time with H1N1

Children with asthma may be more prone to pick up more severe cases of H1N1 flu, compared with seasonal flu, according to a study published online November 19 in the Canadian Medical Association Journal. For the study, Canadian researchers studied the medical records of 58 children with pandemic H1N1 influenza admitted to the Hospital for Sick Children in Toronto between May 8 and July 22, 2009. Upton Allen, MBBS, MSc, and fellow colleagues compared risk factors, severity indicators, and outcomes of those children with H1N1 with those of 200 children admitted with seasonal influenza A between 2004 and 2009.

After reviewing the charts of all children, the researchers found that children with H1N1 influenza were significantly more likely to have asthma than those children with seasonal flu (22% vs 6%). Of those children with H1N1, 21% required admission to the intensive care unit (ICU); 14% of those with seasonal influenza had to be admitted to the ICU. The results demonstrated that asthma appears to cause a more severe disease in children with H1N1 compared with seasonal flu. “Because the risk of severe disease appears to have to clear relation to the severity of asthma,” concluded the authors, “even children with mild asthma should receive vaccination and be considered for preemptive antiviral therapy.”

Control Good for Patients with COPD

When patients with chronic obstructive pulmonary disease (COPD) or those who care for patients with COPD were recently surveyed, the findings indicated that patients feel better about themselves and their situation when their disease is managed properly. Findings of the survey of 400 patients and 400 caregivers, conducted via telephone by the COPD Foundation and Dey Pharma LP, included:

• Well-informed patients with self-reported moderate breathing conditions are most likely to have high levels of satisfaction with their current therapy.

• 9 in 10 patients who use nebulizers reported satisfaction with their current treatments.

• Caregivers were more likely than patients to wish that those they cared for had been placed on nebulization therapy sooner.

Pollution May Pose Breathing Problems for Inner-City Children

A recent study from the Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University’s Mailman School of Public Health found that young inner-city children who were exposed shortly after birth to ambient metals from fuel oil combustion and particles from diesel emissions had associated respiratory problems.

In the December 1, 2009, issue of the American Journal of Respiratory and Critical Care Medicine, senior investigator Rachel L. Miller, MD, associate professor of medicine and environmental health sciences at New York-Presbyterian Hospital/ Columbia University Medical Center and co-deputy director of CCCEH, said, “The effects of exposure to airborne metals had not been studied previously in children so young, and these findings could have more important public health implications for members of inner-city communities in New York City and elsewhere.”

Asthma May Be Helped by “The Pill”

A new study suggests that women with asthma who also take oral contraceptives may benefit from reduced asthma symptoms. Typically, women may notice that their asthma symptoms fluctuate during the month—due in part to fluctuating female hormone levels that affect airway inflammation.

A recent study included 17 women— 8 were taking birth control pills that contained estrogen and progesterone (average age: 25.5 years); 9 were not taking birth control pills (average age: 37.5 years). In the latter group, researchers from the University of Alberta in Canada found that increased levels of estrogen were associated with decreased levels of exhaled nitric oxide, signaling decreased airway inflammation, and increased levels of progesterone were associated with increased levels of exhaled nitric oxide, signaling increased airway inflammation. Thus, asthma symptoms are likely to be worse when progesterone levels are elevated (before menstruation). In the group taking the oral contraceptives, however, the birth control pills lessened the dramatic hormone fluctuations, and no difference in asthma symptoms was noted throughout the month.

In the November issue of Chest, lead author Piush Mandhane, MD, PhD, assistant professor of pediatric pulmonology, University of Alberta, said that this study represents “a first step in looking at the relationship between hormones and asthma.” Further studies are necessary, because of the small size of this study. â– 

FAST FACT: Every day in America, 30,000 individuals have an asthma attack.

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