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4 Die in Asthma Attack - Is Your City Next?

Alberta health officials are investigating after four people died due to asthma attacks during a two-week period last month. Two men in their 20s and a man and woman in their early 50s died in the second and third weeks of the month, said Dr. Marcia Johnson, acting medical officer of health with Alberta Health Services Edmonton. Dying from a severe asthma attack is so rare these days, Alberta usually registers only three such deaths a year. That’s what spurred the investigation, Johnson said.

Three of the dead were from the Edmonton area and one was from northern Alberta.
“We’re very loathe to say this was just a weird cluster (of deaths), but so far we don’t have any explanation for it,” Johnson said. “The preliminary investigation doesn’t show that there was any identifiable, unusual environmental conditions in terms of air quality.
“The details that have been looked at for all the medical information we can get, is that there was no commonality at all.”

Provincial health officials were alerted to the deaths by concerned doctors in hospital intensive care units. They asked the health authority to tell doctors to re-emphasize to their asthma patients the need to take the condition seriously, follow recommended treatments and report back if they’re not effective.

An information sheet, which was faxed on July 22 to family doctors, pediatricians, emergency doctors and pulmonary specialists, also asked them to tell asthma patients to seek emergency care sooner if their health deteriorated rather than wait and possibly risk their lives.
“You have to be very respectful of asthma because it can turn bad quickly,” Johnson said.

A couple of years ago, a survey asked Canadian asthma patients how well their condition was controlled. The vast majority, 90 per cent, said it was really well controlled, until researchers explained that controlled asthma means not waking up at night wheezing and choking, not missing school or work, and not using a rescue inhaler all the time.

When patients were asked the question again, less than 50 per cent said their asthma was controlled.

“They just didn’t know what they should be aiming for, and that’s a failure of public education,” said Dr. Irvin Mayers, head of pulmonary medicine in the faculty of medicine and dentistry at the University of Alberta.

According to the Public Health Agency of Canada, 20 children and 350 adults — most of them 65 and older and suffering from other diseases besides asthma — die from an asthma attack each year. That’s down from 500 adult deaths nationally in 2004.

Mayers said the decline in asthma mortality can be traced back to the introduction of inhaled corticosteroids in the mid-1980s.

Asthma is often viewed as an episodic disease that mainly affects little kids — they have an attack from time to time, but in between, they’re fine — so people don’t treat it as seriously at they should, Mayers said.

“The reality is that most people’s asthma is there all the time, but you can suppress it with medication.”

Asthma is a chronic inflammatory disease like diabetes, high cholesterol, and hypertension, said Dr. Richard Leigh, chairman of the medical and scientific section of the Lung Association of Alberta and the Northwest Territories.

“You often don’t feel you need treatment, but the inflammation goes on unabated . . . We know now if people take their medication twice a day, every day, seven days a week, that asthma exacerbations and asthma deaths should be, almost to the point of guarantee, preventable.

“Anyone dying of asthma in 2010 is a medical tragedy.”

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