See You in September — with Asthma

Asthma doctor visits for children peak in September and dip in summer

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Certain chronic conditions, such as allergies, vary in their symptoms throughout the year. Asthma appears to fluctuate for children during the year.

A recent study found that asthma-related visits to the doctor were highest in September compared to other months.

In the late fall, children also were more likely to visit the doctor for asthma attacks or to get asthma medications.

The summertime, however, had much lower rates of visits to the doctor related to asthma.

Understanding these seasonal variations may help parents plan if their children have asthma.

"Plan for children's illness at the start of the school year."

The study, led by Herman Avner Cohen, MD, of the Pediatric Ambulatory Community Clinic in Petach Tikva, Israel, aimed to learn what months of the year asthma symptoms appeared worst in children.

The researchers analyzed the medical records of nearly one million children (919,873), aged 2 to 15, for the years 2005 through 2009.

They looked for visits related to asthma attacks and for prescription asthma medications in the children's charts for each week of the year.

Among the children studied, 8.9 percent of them were asthmatic, almost two thirds of whom were boys.

About half were between the ages of 2 and 5. Another quarter were 6 to 9 years old, and the last quarter were 10 to 15 years old.

The researchers found that asthma attack visits doubled in September from August numbers, and prescriptions for asthma medications increased 2.3 times in that month compared to August.

The researchers found that the increase in asthma-related visits that corresponded with the start of school was especially high among the children aged 2 to 5, who were twice as likely to see the doctor for asthma symptoms then compared to the rest of the year.

Children aged 6 to 10 were almost twice as likely to visit the doctor for asthma problems in September than during August.

The researchers also found another peak of asthma-related doctor visits for children in late fall that remained high, with ups and downs, through the winter.

In the summer, however, visits to the doctor for asthma attacks or prescription medications dropped and remained low throughout the summer months.

"Returning to school after summer is strongly associated with an increased risk for asthma exacerbations and unscheduled visits to the primary care physician," the researchers wrote.

John Oppenheimer, MD, a physician at Pulmonary and Allergy Associates in New Jersey, noted that these findings reflect a trend that physicians have known about for a while.

"This is an interesting study that reinforces a phenomenon noted in the past called the September epidemic," he said. Yet two questions remain to be answered about the study findings, he said.

"What is the reason for this rise in morbidity?" he asked. "Some have postulated it is related to allergy, change in temperature, while others state it is a consequence of upper respiratory infections."

In addition, "What can we do to protect asthmatic patients?" he posed. "Some experts stress that this 'epidemic' is a reflection of many patients and/or doctors discontinuing controller therapy during the summer month. Certainly this study confirmed a reduction in asthma prescriptions during the summer months."

Regardless, Dr. Oppenheimer said this phenomenon deserved further research to better understand.

The study was published March 10 in the journal Pediatrics. The research did not receive outside funding, and the authors reported no conflicts of interest.

Review Date: 
March 10, 2014
Last Updated:
March 10, 2014