Feature Article

Thunderstorm asthma: a rare epidemic

Jai N Darvall, Rinaldo Bellomo



Thunderstorm asthma is a cause of potentially catastrophic, widespread bronchospasm that can affect many people simultaneously. The causes, management and implications for primary care of this unique phenomenon are reviewed in this article.

Key Points

  • Thunderstorm asthma is a rare event caused by a unique combination of climatic conditions and airborne allergens affecting susceptible people.
  • Epidemic asthma can occur, having the potential to affect hundreds of patients across a wide geographical area and placing overwhelming demand on ambulance and health services.
  • People considered at risk of thunderstorm asthma are those with seasonal asthma, hay fever or known ryegrass or fungal-spore allergy. Spring predominance has been seen in Australian episodes.
  • Strategies to prevent thunderstorm asthma in susceptible people include having an up-to-date asthma action plan, inhaled preventer use and remaining indoors during high-risk days.
  • GP management is important to identify and educate at-risk patients, optimise preventive strategies and, potentially, treat acute asthma during outbreaks.

    Picture credit: © RapidEye/iStockphoto.com
    Model used for illustrative purposes only