A MAJOR OUTBREAK OF ASTHMA ASSOCIATED WITH A THUNDERSTORM - EXPERIENCE OF ACCIDENT AND EMERGENCY DEPARTMENTS AND PATIENTS CHARACTERISTICS

Objective-To investigate the time course of an epidemic of asthma afte r a thunderstorm, characteristics of patients affected, and the demand on emergency medical resources. Design-study of registers and records in accident and emergency departments and questionnaire to staff. Set ting-London area. Subjects-All patients presenting at 12 accident and emergency departments with asthma or other airways disease. Main outco me measures-Numbers of patients, clinical features, information on sho rtage of resources-equipment, drugs, and staff. Results-The epidemic h ad a sudden onset on 24 June 1994; 640 patients with asthma or other a irways disease attended during 30 hours from 1800 on 24 June, nearly 1 0 times the expected number. Over half (365) the patients were aged 21 to 40 years. A history of hay fever was recorded in 403 patients; for 283 patients this was the first known attack of asthma; a history of chronic obstructive airways disease was recorded in 12 patients. In al l, 104 patients were admitted (including five to an intensive care uni t). Several departments ran out of equipment or drugs, called in addit ional doctors, or both. Conclusions-This study supports the view that this epidemic was larger than previously reported epidemics and the hy pothesis that ''thunderstorm associated asthma'' is related to aeroall ergens. Demands on resources were considerable; a larger proportion of patients needing intensive care would have caused greater problems.