12 Jun 2018

Public health lessons from the 2016 thunderstorm asthma epidemic

Figure 1 from the article, showing
the meteorological conditions
A multidisciplinary collaboration investigated the world's largest, most catastrophic epidemic thunderstorm asthma event that took place in Melbourne, Australia, on Nov 21, 2016, to inform mechanisms and preventive strategies. 11 of the coauthors are affiliated with Monash University including several from the Department of Allergy, Immunology and Respiratory Medicine,  Central Clinical School.

They write, "Convergent environmental factors triggered a thunderstorm asthma epidemic of unprecedented magnitude, tempo, and geographical range and severity on Nov 21, 2016, creating a new benchmark for emergency and health service escalation. Asian or Indian ethnicity and current doctor-diagnosed asthma portended life-threatening exacerbations such as those requiring admission to an ICU. Overall, the findings provide important public health lessons applicable to future event forecasting, health care response coordination, protection of at-risk populations, and medical management of epidemic thunderstorm asthma."

Donald Cockroft writes in a published comment in the same issue, "An unusual observation was the high prevalence of Asian or Indian ethnicity among the patients, including six of the ten deaths." Melbourne's population is one quarter Asian and Indian ethnicity, yet they were almost two fifths (39%) of those presenting to emergency.


Thien F, Beggs P, Csutoros D, Darvall J, Hew M, Davies J, Bardin P, Bannister T, Barnes S, Bellomo R, Byrne T, Casamento A, Conron M, Cross A, Crosswell A, Douglass J, Durie M, Dyett J, Ebert E, Erbas B, French C, Gelbart B, Gillman A, Harun N, Huete A, Irving L, Karalapillai D, Ku D, Lachapelle P, Langton D, Lee J, Looker C, MacIsaac C, McCaffrey J, McDonald C, McGain F, Newbigin E, O’Hehir R, Pilcher D, Prasad S, Rangamuwa K, Ruane L, Sarode V, Silver J, Southcott A, Subramaniam A, Suphioglu C, Susanto N, Sutherland M, Taori G, Taylor P, Torre P, Vetro J, Wigmore G, Young A, Guest C. The Melbourne epidemic thunderstorm asthma event 2016: a multidisciplinary investigation of environmental triggers, health service impact and patient risk factors.  The Lancet Planetary Health; Volume 2, No. 6, e255–e263, June 2018   DOI:  https://doi.org/10.1016/S2542-5196(18)30120-7
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