Asthma attacks all age groups but it often starts in childhood. It is characterised by recurrent attacks of breathlessness and wheezing, which can vary in severity and frequency from person to person, even hourly in some individuals. In asthma, the air passages in the lungs are inflamed, which makes the nerve endings more sensitive to irritation. During an attack, the lining of the passages swell, causing the airways to narrow making it difficult for a person to breathe.

Because asthma is a chronic condition, it usually requires continuous medical care. The disease cannot be cured, but it can be controlled by a combination of preventive and medication strategies. In children, it is not as stable or predictable as it is in adults and diagnosis distinguishes between symptoms that appear in children under five and in children over that age.

Occasionally, children grow out of the problem but many go on to develop asthma as a permanent condition. It sometimes resolves in the early teens but can then recur at a later age. Preventive and treatment measures must be planned accordingly and, when attacks are severe, hospital admittance may be necessary.

In moderate to severe cases, a person normally takes a daily dose of long-term medication to control the underlying inflammation and prevent symptoms and attacks. Short-term relievers are then used to control symptoms when they occur.

Prevention and treatment in children is trickier than it is in older children and adults, who are able to understand their condition and are capable of some degree of self-management. Young children need support and because the condition is unpredictable in those under five, ongoing medication is usually necessary. A paediatrician with a special interest in respiratory disease could advise parents properly.

Treatment for sufferers of all ages needs to be stepped up in the case of a cough, cold or flu. Generally, it is only necessary for an asthma sufferer to take an increased dosage of the usual medication, under a doctor's supervision, as viral infections cannot be treated with antibiotics.

Armed with the right knowledge and attitude, it seems that most of us can lead a fairly normal life even with asthma. It just takes good planning, sound advice and a hefty dose of self-discipline.

ASTHMA INHALERS, POTENTIAL LIFESAVERS

Death due to asthma is a rare occurrence in Malta, but it is a possibility if treatment is not properly followed. Even school age children should carry their inhaler on their person at all times. Easy access to it during an asthma attack can prevent serious complications. Fears that other children may harm themselves by misusing an inhaler are misplaced and the risks of taking an inhaler away from a child outweigh any potential benefits. 

 

COMMON ASTHMA TRIGGERS AND HOW TO AVOID THEM

Indoor air quality is easier to control than outdoor air quality. If a member of your family suffers from asthma, decreasing the number of allergens in your home will reduce the likelihood of an asthma attack. Be unobtrusive, though. Too much fussing and panicky behaviour can make an asthmatic person feel worse, particularly if that person is a child.

House dust mites thrive particularly in fabrics such as clothing, bedding and soft toys. Aim to reduce exposure to dust mites in your home.

• Wash bedding, including pillows and duvets, at 55-60C, to kill mites. Some dust mite allergens will persist, but killing the mites reduces their number. Use suitable protective coverings for pillows and mattresses.
• Keep your home as dust and fur free as possible. If possible, use a vacuum cleaner with a high efficiency particulate air filter, rather than a broom, and use a damp duster, not a dry one. Vacuum (don't brush) sofas, chairs, carpets and rugs to remove dust.
• House dust mites can be killed by exposure to strong sunlight. Occasionally putting your mattress in a sunny spot for around three hours helps to get rid of the bugs.
• Once a week, put your children's soft toys in the deep-freezer for a while to kill the mites. It's best not to keep all your child's soft toys in her/his bedroom if s/he suffers from asthma.

 

Pets can provoke allergic reactions. Aim to keep your home as free as possible of pet allergens.

• Keep pets away from the bedrooms, and outside the home as much as possible.
• Vacuum carpets, rugs, sofas and chairs regularly to remove pet hair.
• Don't cuddle your pets when wearing your nightclothes, and don't allow your children to do so.

 

Pollen is airborne and difficult to avoid, but you can provide some mechanical barriers that will help you avoid contact.

• Keep windows and doors closed at peak pollen times such as the evening, when airborne pollen moves downwards.
• Avoid being in and around gardens and plants, especially in springtime.
• Don't keep flowers or flowering plants in your home.
• Air conditioners can help filter out pollen, but keep the filters scrupulously clean.

 

Mould is known to cause asthma attacks. The Mediterranean region is especially prone to a particular type of mould, which is particularly common in Malta. Mould thrives in damp conditions, so aim to avoid a damp indoor environment as much as possible.

• Ventilate your home appropriately. Keep air conditioner and dehumidifier filters clean, and ensure that they and any heaters you use are properly maintained.
• Remove mould from damp walls, but avoid using supermarket remedies. Mould should be scraped away professionally, if possible.

 

Vehicle exhaust can hardly be avoided outdoors, though keeping your car windows closed will help, but, to some extent, you can prevent it from getting indoors.

• Keep windows closed during peak traffic hours, particularly if you live close to a busy road.
• Don't air bedding and clothes in windows or terraces overlooking the road.
• If possible, move to a less traffic-dense area.

 

Respiratory illnesses such as coughs and colds can aggravate asthma. Avoid contracting them as much as possible. Simple precautions such as washing your hands before eating can help.

 

Overexertion puts a strain on the respiratory system and can trigger an asthma attack. Controlled exercise, however, is to be encouraged. Swimming (in the sea, not in swimming pools) in especially helpful.

 

Certain foods can cause allergic reactions. Keep an eye open for possible triggers and avoid those foods altogether.

 

Smoking is a major cause of respiratory problems. There are two ways to deal with it in your home: kick the habit and ban smokers from lighting up.›‹