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CDC: Children experiencing fewer asthma attacks
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Children with asthma experienced fewer asthma attacks between 2001 and 2016, according to a recent Vital Signs report from the CDC.
The percentage of children with asthma who experienced one or more asthma attacks in the preceding 12 months fell from 61.7% in 2001 to 53.7% in 2016, according to the report. The decline was seen in both boys and girls and all races and ethnicities, Anne Schuchat, MD, RADM, USPHS, acting director of the CDC, reported at a press conference.
However, “not all news is good,” Schuchat said, noting that approximately half of children with asthma had one or more asthma attacks in 2016.
Asthma attack prevalence increased significantly between 2001 and 2010, then decreased significantly between 2010 and 2016, she added.
The report also found that one in six children with asthma visits the ED or urgent care and one in 20 is hospitalized each year. Boys, children aged 5 to 17 years, non-Hispanic black children, children of Puerto Rican descent and children from low-income families were more likely to have asthma, according to the report.
The report also noted that asthma attacks were most common in children aged 4 years and younger. The report found that about half (45.5%) of children prescribed asthma control medicine did not use it regularly, Schuchat said.
Encouraging trends included fewer missed school days and fewer hospitalizations between 2003 and 2013 (9.6% hospitalizations in 2003 vs. 4.7% in 2013).
The report was based on findings from the National Health Interview Survey for 2001 to 2016.
“Clearly our work is not done,” Schuchat said. “Asthma cannot be cured, but most of the time we can control asthma symptoms and prevent asthma attacks. Health care providers play a crucial role in these efforts, working with parents and children on asthma control.”
Schuchat mentioned research finding that a home-visit asthma response program targeting high-risk children showed improved asthma control and reduced costs.
“While there is no single strategy for preventing asthma attacks, recent evidence shows that a combination of actions can be highly effective,” Schuchat said. She included using asthma action plans, reducing asthma triggers, using medicines properly, providing self-management education and guideline- based care and avoiding second-hand smoke.
Schuchat also reported that asthma was the most common underlying condition (24%) in a data sample of 180 children who were hospitalized within 13 states for influenza this season.
“The flu can be very hard on people with asthma,” Schuchat said.
“… We recommend everybody with asthma get a vaccine for influenza every single year,” Schuchat said.
“CDC is working with state, territorial, private and nongovernment partners that support good medical management, asthma self-management education and for people at high-risk, home visits to avoid triggers and to help asthma management,” Cathy Bailey, PhD, of the Division of Environmental Hazards and Health Effects, added during her presentation at the conference. “Doctors, nurses and health care providers are working with parents to access each child’s asthma, prescribe appropriate medicine and determine whether a home visit would help prevent an asthma attack.
“By linking the efforts of the health system, state and local health departments, schools, individuals and the CDC, we can control asthma in children.” – by Bruce Thiel
Disclosures: Infectious Diseases in Children was unable to determine relevant financial disclosures at time of publication.
Perspective
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Jonathan A. Bernstein, MD
Decreasing asthma exacerbations among children is attributed to many factors, including better dissemination of guidelines addressing diagnosis and management of children from birth to adolescence, improved therapies and more emphasis on education, and adherence with management recommendations.
Novel approaches to improve adherence with outpatient office follow up and regular use of medications will no doubt further reduce associated asthma morbidity and unnecessary health care costs.
Addressing treatment of concomitant allergic and non-allergic rhinitis and other conditions that can aggravate asthma is essential for meeting these objectives. Finally, more efficient approaches for reducing asthma triggers at home and in school are being investigated that could have further impact on asthma control in children.
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