Asthma and SARS

There has never been a better time to be sure your asthma is under control. With a proper treatment plan, most asthma symptoms can be prevented or minimized. Uncontrolled, the linings of the airways in the lungs can remain inflamed. This is not healthy for the lungs. It can also mimic symptoms of SARS, or make actual SARS worse.

Rebecca Raleigh, an American citizen who was the first suspected SARS patient in India, turned out not to have SARS, but to have a fever from another cause during a flare-up of her asthma. The core symptoms of SARS are fever greater than 100.4 F (38.0 C) and cough (usually a dry cough), difficulty breathing, or other respiratory symptoms. The respiratory symptoms of SARS and asthma can be the same. Toss in a fever, and you either have anxiety – or a real case of SARS.

Keeping asthma inflammation under control can also make it easier for people with asthma to cope with SARS or other lung infections if they are really present.

Asthma is a lung condition where the airways are sometimes tight – a result of airway hyper-responsiveness. Our airways are designed to be responsive to harmful substances in the air. If we walk through clouds of smoke, our airways will shrink, protecting our delicate lung tissues from the noxious ingredients in the smoke. They should return to normal when we begin to breathe fresh air. People with asthma have an exaggerated tightening response.

Different people with asthma respond to different “triggers.” Viral infections are among the most common triggers, especially in young children. Other triggers include smoke, animal dander, pollens, molds, house dust mites, fumes and fragrances, or cold air.

When we exercise, we breathe rapidly and are unable to bring air temperature all the way up to 98.6 degrees — particularly if we breathe through the mouth. Thus, asthmatics who are sensitive to cold air will often wheeze with exercise. (Wheezing, the classic asthma symptom, is the noise made by air moving through these tight airways.) Because asthmatics respond differently to different triggers, their airways are tighter at some times than at others.

Hyper-responsive airways tighten in three ways in response to triggers. First and most immediately, smooth muscle surrounding the airways constricts, narrowing the caliber of the airways. Second, the airways are narrowed by inflammation and swelling of the airway lining. This leads to the third component of airway narrowing, which is the accumulation of mucus and other fluids, which can plug the airways.

The inflammation is the most important part of the disease. It perpetuates the cycle of airway narrowing. It can cause ongoing damage. It also is the slowest to respond to treatment.

Despite clear treatment guidelines, far too many people have uncontrolled asthma. Albuterol is very effective at helping people breath better for the moment, but does nothing to treat the inflammation.

People with asthma who have symptoms more than twice a week, or nighttime wheezing more than twice a month, benefit greatly from using a preventive, anti-inflammatory medicine rather than using albuterol alone.

Certainly, someone who uses albuterol daily should be on a preventive medicine instead or in addition to inhaled albuterol. Preventive and anti-inflammatory medicines are greatly underused for controlling asthma.

If you or your child has asthma, ask that the National Asthma Education and Prevention Program (NAEPP) guidelines be followed. Preventing inflammation prevents damage to the lungs and can greatly improve the long-term outcome.

More infomation on SARS:
SARS – A Worldwide Threat
SARS Update
SARS Hotel
top Respiratory Infections

SARS – School’s Out
Preventing SARS
SARS and Allergies
Disease – Severe Acute Respiratory Syndrome (SARS)
SARS Unmasked
Prepare for the Worst; Hope for the Best

Published on: April 15, 2003
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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