If you or someone you care about has asthma, you know that this time of year brings a special set of challenges to managing the condition.

Referred to in medical circles as the September Asthma Peak, the month brings a number of asthma triggers that cause more asthma attacks, emergency room visits, and hospital stays in this month than any other during the year. Locally, emergency rooms are starting to see a dramatic increase in patients with aggravated asthma symptoms.

Asthma is a disease that narrows the airways and makes it harder to breathe. The narrowing in the airways is caused by swelling (inflammation), small muscles squeezing around the airways (constriction), and extra mucus. This narrowing can get worse when a person with asthma:

• Breathes in substances that bother the lungs (called “irritants”)
• Has an allergic reaction
• Gets sick

According to the Asthma and Allergy Foundation website, people with asthma come in contact with several asthma triggers at once in September:

• Weed pollen (especially ragweed)
• Mold
• Respiratory infections
• Poor indoor air quality in schools
• Extreme weather

Being around all of these asthma triggers at the same time can make asthma harder to control.

The September asthma spike tends to affect children first. When kids start a new school year, they come in contact with a lot of these asthma triggers.

For African Americans, the peak can lead to a trip to the emergency room or worse.

According to a Missouri Department of Health and Senior Services report published in 2021, 11 percent of Black adults and 14.7 percent of Black children have asthma. For emergency room visits, the highest rates were in the Kansas City and St. Louis metro areas. African Americans in Missouri were six times more likely to be hospitalized due to asthma than whites (12.6 versus 2.0 per 10,000 people, respectively).

In 2019, the Journal of Social Science and Medicine released a report that found the highest prevalence of asthma was found in the city’s poorer neighborhoods with majority Black residents. The study found that Zip codes 63102, 63106, 63107 and 63147 were ‘asthma hot spots,’ areas with high rates of asthma clustered together — in downtown and across north St. Louis.

The high prevalence of asthma proves to be problematic in other areas too because it leads to missed work for parents who may have asthma, but also parents who are caregivers for children with asthma. Children lose out on important instructional time at school because they must stay home due to their symptoms.

If you find that you or your child is starting to experience increased asthma symptoms, there are steps you can take to help navigate this September peak.

According to the AAFA, the following steps can help prevent symptoms before they begin.

1. Schedule an appointment with your doctor or asthma specialist. Be ready to talk about current symptoms, medicines, and triggers.
2. Talk with your doctor about creating an Asthma Action Plan. Take your asthma medicines as prescribed by your doctor. If you move into the Yellow/Caution Zone of your plan, follow your plan early so you can get back in the Green/Good to Go Zone.
3. Get your vaccines. They take about 2 weeks to take effect in your body, so get them as soon as they are available. Yearly vaccines are usually available in September.
   • You need a new flu vaccine every year. The flu vaccine can reduce severity of symptoms and risk of dying if you become sick with the flu. It also lowers your risk of dying from flu. Flu vaccines are recommended for everyone ages 6 months and older, with few exceptions.
   • You need a new COVID-19 vaccine every year. The COVID-19 vaccines lower chances of severe illness, getting admitted to the hospital, or death from coronavirus infection. People who are immunocomprised may need the COVID-19 vaccine more often than once per year. COVID-19 vaccines are recommended for everyone ages 6 months and older, with few exceptions. You can get COVID-19 and flu vaccines at the same time.
   • A vaccine for the respiratory syncytial virus (RSV) is available for babies, people who are pregnant, and people who are age 60 and older and have a higher risk of severe RSV. The vaccine lowers your risk of developing a lower respiratory tract disease caused by RSV. At this time, the RSV vaccine is not one that you get every year. One dose of the RSV vaccine provides protection for about two years.
   • Talk with your doctor about the pneumococcal vaccine. You get the shot once and then get a booster later if you need it. You do not need this shot yearly. It helps prevent certain types of pneumonia and other illnesses.
4. Take steps to avoid getting sick. Wash your hands often and for at least 20 seconds. Avoid touching your eyes, mouth, and nose, especially during cold and flu season. Stay away from people who are sick as much as possible.
5. Wear a mask. When respiratory illnesses are spreading, wear a good-fitting N95 mask in crowded indoor spaces. Also wear N95 masks if wildfire smoke is in your area or if you are cleaning up after a natural disaster or flood. Masks can also help if you have pollen or mold allergy.
6. Good ventilation and air filters can improve your indoor air quality (IAQ). HEPA-certified air cleaners, HEPA filters on your HVAC system, exhaust fans, and open doors/windows can improve the air in your indoor spaces. Talk with your child’s school about their IAQ policies. Good IAQ is important to reduce air pollution, airborne allergens, and the spread of respiratory infections.
7. If you are allergic to ragweed or mold, try to limit your exposure to those allergens. AAFA has more information on managing and treating ragweed allergy and mold allergy.
8. Take care of your health. Adequate sleep and water, a healthy diet, and exercise are important. Take action to keep your stress levels down.

Affinia Healthcare has family medicine clinicians and pediatricians on staff to provide treatment and help patients manage their asthma symptoms. To schedule an appointment, call 314.814.8700. For more information on managing allergy and asthma conditions, visit www.aafa.org.