Asthma

Asthma is a lung disease characterized by narrowing of the airways that causes continuing episodes or attacks of wheezing, shortness of breath, chest tightness and cough. Factors that can trigger an asthma attack include allergens (such as pet dander, dust mites, mold, pollens and food allergies), secondhand tobacco smoke, air pollution, exercise, strong odors and cold weather. Asthma is not contagious, but anyone can have asthma at any age.

Asthma is one of the most common chronic diseases in the United States, affecting more than 20 million adults and more than 6 million children. Annually, asthma accounts for 14.7 million missed school days for children and 24.5 million missed work days for adults. In Kentucky, 10.6 percent of children 11 years of age and younger, 13.6 percent of middle school students, 11.8 percent of high school students and 18.6 percent of adults have asthma. While asthma can affect anyone at any age, it is more common among blacks. In Kentucky, 13.9 percent of blacks have asthma compared to 8.2 percent of whites. Additionally, blacks are two times more likely to die from asthma-related illness than whites.

There is no known cure for asthma, but it can be controlled. People with asthma can lead full, active lives with proper education, treatment and management. The successful management of asthma includes the following four important actions:

• Visit your doctor regularly
• Use long-term controller medications and fast-acting rescue medications appropriately
• Avoid asthma triggers
• Work with your doctor to develop and use a written management and action plan

The successful management and control of a person's asthma will result in better quality of life, decreased asthma attacks, fewer visits to the emergency room, fewer hospitalizations and fewer missed school or work days.

• Asthma affects 7.9 percent  of the U.S. population and is the cause of nearly a half-million hospitalizations each year.
• People with asthma are at increased risk for severe complications of influenza, including 2009 H1N1 flu.
• People with asthma account for approximately 32 percent of 2009 H1N1 hospitalizations in the United States, according to recent data from the Emerging Infections Program, a CDC surveillance system that tracks influenza-related hospitalizations.
• People with asthma need to have their asthma well-controlled and should have an updated asthma action plan. Medication to control asthma (usually inhaled corticosteroids) should be used as prescribed by each patient’s health care provider.
• Less than half of people with asthma seek treatment promptly when they are sick with flu-like symptoms.
• Because people with asthma are at higher risk of serious flu-related complications, they should seek treatment promptly when ill with either influenza like illness (ILI) or an asthma exacerbation.
• People with asthma with suspected 2009 H1N1 infection should be treated promptly with oseltamivir (trade name Tamiflu®). Zanamivir (trade name Relenza®) is NOT recommended for people with asthma.
• People with asthma should get the 2009 H1N1 flu shot (injectable, inactivated formulation only). 
• People with asthma also are recommended to get the seasonal flu shot (injectable, inactivated formulation only). 
• People with asthma should NOT get the live attenuated influenza vaccine (LAIV), also known as the nasal spray vaccine, for either seasonal flu or 2009 H1N1.

2009 H1N1 Hospitalizations in People with Asthma

• People with asthma are at higher risk for serious complications from flu, including 2009 H1N1. As a result, people with asthma are at higher risk of hospitalization.

Helpful links that provide specific information for which vaccines and antivirals should and should not be used in persons with asthma:

• CDC - People at High Risk of Developing Flu-Related Complications
• CDC- Flu Information for Patients and Parents of Patients with Asthma
• CDC - Patients with Asthma: Considerations for Clinicians Regarding 2009 H1N1 Influenza Virus