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Why influenza is different when you have asthma

Dr. Ardis Hoven

- 04/12/2018
Chair of Council of the World Medical Association

The influenza season can be a worrying time for patients with asthma; they’re more likely than others to end up in hospital if they catch the virus. Let’s explore exactly why influenza is so dangerous for asthma patients.

At greater risk from influenza

Even if their asthma is mild or well-controlled by medication, asthma patients are more susceptible than others to contracting influenza. Why? Because their chronic condition weakens their immune system. Children with asthma are particularly vulnerable: they lack prior immunity to the virus and are exposed to it more frequently.

And while influenza can leave even healthy patients tired and feverish for days, patients with asthma are likely to be ill for longer than others. They’re also more likely to develop a severe case of the disease or complications such as bronchitis or pneumonia. In fact, asthma is the most common medical condition among children hospitalized with influenza, and one of the more common medical conditions among hospitalized adults too.

At greater risk from their asthma

The influenza virus could set off asthma symptoms or even a life-threatening asthma attack. So, why is the virus an asthma trigger?

While the reasons are not fully understood, we do know people with asthma have swollen and sensitive airways. It’s thought the influenza virus can worsen asthma’s chronic irritation of the bronchial mucosa. The ensuing asthma flare-ups could lead to the airways swelling and secreting more mucus than they normally would.

With less room for air to get through, the patient with asthma finds breathing more difficult. Their asthma symptoms amplify, with increased coughing, wheezing and tightness in the chest. They may then need to increase their reliever medication or even visit their doctor for a course of oral corticosteroids.

Worse still, the virus could trigger an asthma attack – and a visit to the emergency room. For children, influenza may be responsible for almost a quarter of asthma attacks during the peak influenza season.

Help your patients to stay well

Your role is to help people stay healthy; to help ensure they can continue their normal activities, whether it be going to work, attending school or college, or even having fun in the park. But, as we’ve seen, influenza is more likely to be severe for asthmatics, and the virus can trigger asthma symptoms or even an asthma attack – potentially disrupting their daily routines for weeks.

While immunization can help your patients with asthma stay well and free of their symptoms during the influenza season, a report published by the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine (LSHTM) found young people are more sceptical of vaccinations than their elders, with faith in influenza immunization particularly low. The “deluge of conflicting information, misinformation and manipulated information on social media”  described in an article published in Nature could “erode trust in vaccines so much as to render them moot”.

Talk to your patients – especially the young adults who are parents of asthmatic children – about how safe vaccines are and how important they are for preventing the flu. Help your patients with asthma to stay healthy this winter.