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Column originally published May 29, 2007

Is There A Way To Prevent Asthma?

Question: Our eight-month-old son was admitted to the hospital six weeks ago with a cold and a bad cough. Our doctor noticed that he was wheezing in his chest. She told us that his bronchial tubes were badly inflamed because of a virus infection. He was given a steroid by mouth as well as medicines through a face mask. We were alarmed when we found out that these medications were also used to treat children with asthma. When we asked the doctor, she told us that the treatment is the same, and said that our son may develop asthma later. Our son has completely recovered and he doesn’t need any more medicine now. We are concerned that he may develop asthma as our doctor had suggested. We want to know whether there is something that we can do to prevent this from happening.


You certainly have a very interesting question. However, the answer is not a simple one. Let me explore your son’s illness first so that you can understand the circumstance easier.

From what you have described, your son had a medical condition called bronchiolitis. Although bronchiolitis does not cause asthma, many children who have severe bronchiolitis that require hospitalization, as in your son’s situation, can go on to develop asthma.

Bronchiolitis is a medical condition where the small bronchial tubes are swollen and inflamed as a result of viral infection. Many viruses that attack the respiratory tract can cause bronchiolitis in young children. The most common one is called Respiratory Syncytial Virus, often known as RSV. This virus most frequently occur in winter time in North America.

Most children under two years of age will get infected with RSV in one of the epidemics. The symptoms include running nose, low grade fever, and cough that last a few days. Only a small percentage of these children will get sick enough to be admitted to hospital with coughing and wheezing that require treatment.

As you may recognize, the symptoms of bronchiolitis are virtually identical to asthma. Parents with children who have asthma know that their children’s asthma is often triggered by colds. With the onset of fever, sore throat, or running nose from a virus infection, many of these children will start coughing. Depending on the severity of asthma, some children will develop a congested cough, while others quickly get into trouble with tight or croupy cough. Wheezing is a hallmark symptom, although some children with asthma rarely wheeze.

Believe it or not, sometimes it is not possible to distinguish whether a child has bronchiolitis or having the first ever attack of asthma. As a result, many physicians treat them the same way. Although there is no possibility to predict whether a child with bronchiolitis will or will not develop asthma in future, I have found that those who have severe bronchiolitis are most likely to develop asthma as they get older.

Asthma is an allergic condition of the lungs. There is often a history of some form of allergy in the extended family. Although a child may be prone to asthma because of the family’s genetic background, parents can often improve the home environment and reduce the severity of a child’s asthma.

If any adult in the family is a smoker, he or she should consider quitting smoking right away. Before this can be achieved, this person should not smoke indoors, even in the basement or in another room, and should not smoke in the car. Cigarette smoke is extremely irritating to the bronchial tubes of these children.

House dust mites have also been shown to trigger asthma in many children. These are microscopic insects present in house dust. They grow in carpets, stuffed toys, pillows, mattresses, bedding, as well as forced-air heating system. There are many ways that you can reduce dust mites, including removing carpets and stuffed toys.

In the Maritimes, many basements are very damp during summer months. The cool and damp basements are ideal for molds to grow. Molds can also grow around windows in winter time, as well as in the soil of indoor plants. Any area where there is water-leak will promote the growth of molds. Molds can trigger allergy and asthma symptoms in susceptible individuals.

The relationship between pets and asthma is less certain. There are contradicting reports that makes it difficult to recommend whether families should have pets indoor or not. If you already have a cat or a dog in the house, watch and see how your son reacts to the animal. I have heard families spending lots of money buying a dog that supposedly doesn’t shed any hair, and therefore cannot cause allergy. This is simply not true: all mammals shed, including us. The hair of some dogs are very fine and therefore difficult to see.

If you want to do something to prevent your son from developing asthma, you can look at some of the possible triggers that I have mentioned here and initiate measures to avoid or reduce them. You can also seek help from your provincial Lung Association, or Asthma Education Centre at your local hospital.