In this section: Asthma in Children | September Asthma Peak | Asthma At School

September Asthma Peak

Every year, globally, an epidemic known as the “September Asthma Peak” occurs, typically during the third week of September. This period sees the highest number of asthma-related hospitalizations among children.

Being ready for the September Asthma Peak is one way to help ensure that your child will be spending more time with friends at school, and less time at home, or worse – in the emergency room of a hospital.

What Causes September Peak and Why September?

Several factors contribute to the September Asthma Peak. During the summer months, many families become more relaxed about their child’s asthma management, particularly in consistently administering controller medications, which should be taken all year round, even when the child’s asthma is non-symptomatic.

When children return to school, they are suddenly exposed to a range of asthma triggers and allergens that can worsen asthma symptoms.  The start of the school year coincides with the onset of the cold and flu season and studies estimate that up to 85% of asthma exacerbations (attacks) are triggered by viral infections, with the common cold (rhinovirus) responsible for up to 60% of these exacerbations.

Prepare Your Child for September Asthma Peak:

1. Schedule a checkup with your child’s healthcare professional to ensure your child’s asthma is controlled and to develop or update your child’s written Asthma Action Plan.
2. Ensure that your child takes their asthma controller medication throughout the year, even when symptom-free.
3. Make sure that your child always has access to their reliever (rescue) inhaler, and they know how to use it properly (using a spacer where possible).
4. Identify your child’s asthma triggers and avoid them when possible.
5. Speak to your child about their asthma.
   • • Help them understand their asthma and asthma symptoms
     • Help them to understand their asthma triggers and how to avoid them
     • Teach them about their asthma medications including the importance of taking their controller medication as prescribed, carrying their reliever (rescue) inhaler with them at all times and the importance of good inhaler technique (using a spacer where possible)
     • Have them fill in Asthma Canada’s Back-To-School with Asthma: Kid’s Asthma Diary and use this to identify how well controlled their asthma is
6. Speak to your child’s school about their asthma.
   • • Make them aware of your child’s asthma, asthma symptoms and asthma triggers
     • Explain the importance of your child always carrying their reliever (rescue) inhaler with them (this may contradict their medication policy so you will need to be firm)
     • Ensure they know the steps to take during an asthma exacerbation or asthma attack
     • Give them a copy of your child’s Asthma Action Plan
     • Present them with Asthma Canada’s Back-To-School with Asthma: Guide for Teachers
7. Treat allergies with antihistamines, nasal steroids, allergy shots or pills to help avoid an asthma attack. An EpiPen ^® (or similar device) should always be available to your child if they may have severe life threatening anaphylactic allergic reactions. Speak with your doctor or allergist about the best allergy treatment options for your child.
8. Teach your child correct hand-washing technique and the importance of hand washing to avoid catching the common cold (rhinovirus), flu (influenza virus) or RSV, which are the most common asthma triggers. (Use hand sanitizer where possible)
9. If your child is sick, keep them home from school to prevent them from getting sicker and from spreading their illnesses to other class members.
10. Ensure your child, and everyone in your home, has received all recommended vaccinations to prevent preventable respiratory illnesses spreading into your home and classroom.

To help support parents and teachers keep kids with asthma safe when returning to school and throughout the school year, we’ve developed a Back-To-School with Asthma: Digital Pack for Parents & Teachers.

Is your child’s asthma controlled?

Proper asthma control is key to staying healthy with asthma and preventing possibly life-threatening asthma attacks. Everyone with asthma should be able to achieve good asthma control. If your child is having trouble staying symptom-free or have any of the signs of poor asthma control listed below, we highly recommend speaking with your healthcare provider as soon as possible.

Signs of Poor Asthma Control:

• Frequent breathing difficulties, including coughing or wheezing most days
• Asthma impacting sleep; if asthma wakes your child up at night, their asthma isn’t controlled
• Inability to exercise without experiencing breathing difficulties
• Relying on the reliever (rescue) inhaler more than 2 times per week
• Severe breathing difficulty or inability to wear a mask or face covering
• Recent asthma attack or hospitalization

What to do if your child’s asthma is poorly controlled

If your child’s asthma is poorly controlled you need to speak with your healthcare provider. Uncontrolled asthma is very serious and could lead to a life-threatening asthma attack. It’s vital that you take your child’s asthma seriously and recognize when symptoms aren’t properly controlled. Over time, poorly controlled asthma can cause permanent damage to your airways that cannot be reversed. This is called ‘airway remodeling’. It is important to have proper treatment for your asthma to avoid this permanent damage.

The Importance of Your Child’s Asthma Action Plan

An Asthma Action Plan is an effective tool that can be used to help manage your child’s asthma and help ensure that it stays adequately controlled. List your child’s triggers, daily medicine needs and the reliever/rescue medicines they may need for quick relief during an asthma attack, or when signs of an attack begin to show.

September Asthma Peak: Quick Facts

• With the start of a new school year, kids are in close contact with each other and germs, like the common cold. Colds are the most frequent asthma triggers in young children, causing up to 85% of exacerbations.
• Low use of appropriate asthma medications may fuel what is known as the “September Asthma Peak,” the spike in children’s hospital admissions due to serious asthma attacks aggravated by colds. Low use of medications or sub-optimal control of underlying inflammation can also increase asthma attacks throughout the school year.
• Epidemics of asthma exacerbations requiring hospital treatment occur annually during back-to-school in both the Northern and Southern Hemispheres.
• Compliance and filling of asthma controller medications decreases during the summer months causing airway inflammation to return. Even when children with asthma display no symptoms, they must continue their medication to avoid inflammation.
• The viruses responsible for the majority of “September Asthma Peak” asthma exacerbations include the rhinovirus, coronavirus, influenza virus, parainfluenza virus and respiratory syncytial virus (RSV).
• School-aged children have on average eight colds per year, which can translate into about one asthma flare-up per month if a child’s asthma is not well-controlled.
• Approximately 20-25% per cent of annual hospital admissions for asthma of children in Canada occur in September.
• On average, the hospitalization rate for school-age children peaks 17.7 days after Labour Day – around week 38. (Preschool kids peak 1.7 days later.)
• Because the cold season can last for several months, parents should be extra diligent about adhering to an asthma management plan throughout the year.