Severe Asthma Attacks / Exacerbations / Flare-ups

Prior to a severe asthma attack, a person with asthma may experience a period of gradual worsening, or attacks may follow exposure to specific triggers, which vary between different people. These triggers include viral or bacterial infection, exposure to an allergen to which the patient is sensitised, occupational sensitisers, stress, or poor adherence with inhaled preventer therapy. Viral exacerbations are associated with a temporary reduction in response to inhaled beta 2-agonists (Reddel et al. 1999). Epidemics of severe asthma attacks can occur amongst people with allergic rhinitis (with or without a history of asthma) who are sensitised to rye grass pollen, when a thunderstorm-associated with updraft and outflow occurs during high rye grass pollen levels (Girgis et al. 2000, Marks et al. 2001).

Asthma attacks should prompt a review of the patient’s asthma management, as they are burdensome and risky for patients and, in patients not taking inhaled preventers, can lead to greater decrease in lung function (Bai et al. 2007, O’Byrne et al. 2009). Medications should also be reviewed. For more information see Living with Severe asthma – Experience of Attacks