ABSTRACT

Introduction

Epidemic thunderstorm asthma (ETSA) is due to a complex interaction of environmental and individual susceptibility factors, with outbreaks reported globally over the last four decades. Australia has been particularly susceptible with nearly half of episodes reported internationally, culminating in the catastrophic Melbourne 2016 event.

Areas covered

Reported ETSA episodes are reviewed for common environmental and meteorological risk factors. Allergen aerobiology interaction with thunderstorm activity and rapid weather condition changes is examined. Assessment of the clinical and immunological data highlights risk factors for ETSA presentation, hospital admission, and intensive care admission. Risk factors associated with ETSA deaths are evaluated. Public health strategies, as well as pharmacological and immunological management approaches to reduce individual susceptibility and prevent ETSA are discussed.

Expert opinion

Improved understanding of the specific meteorological factors predisposing to the greatest risk of ETSA to improve forecasting is required. Better monitoring of aeroallergen levels in areas of greatest geographic risk, with further research into allergen aerobiology underpinning mechanisms of allergen exposure is needed. The role of climate change in increasing the risk of ETSA outbreaks requires further research. Public awareness and education are required to reduce exposure, and to improve uptake of pharmacological and immunological risk reduction and preventive strategies.

中文翻译：

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雷暴哮喘：机制和管理策略概述。

摘要

介绍

流行性雷暴哮喘 (ETSA) 是由环境和个体易感因素的复杂相互作用造成的，在过去的 40 年中全球报告了暴发。澳大利亚特别容易受到影响，国际上报道了近一半的事件，并在 2016 年灾难性的墨尔本事件中达到高潮。

覆盖区域

对报告的 ETSA 事件进行审查，以确定常见的环境和气象风险因素。检查了过敏原空气生物学与雷暴活动和快速天气条件变化的相互作用。临床和免疫学数据的评估突出了 ETSA 表现、住院和重症监护的危险因素。评估与 ETSA 死亡相关的风险因素。讨论了降低个体易感性和预防 ETSA 的公共卫生策略以及药理学和免疫学管理方法。

专家意见

需要更好地了解导致 ETSA 最大风险的特定气象因素，以改进预测。在地理风险最大的地区更好地监测空气过敏原水平，需要进一步研究过敏原空气生物学的过敏原暴露机制。气候变化在增加 ETSA 爆发风险方面的作用需要进一步研究。需要公众意识和教育来减少接触，并提高对降低药理学和免疫学风险和预防策略的采用。