title: A major outbreak of asthma associated with a thunderstorm: experience of accident and emergency departments and patients' characteristics. Thames Regions Accident and Emergency Trainees Association.
abstract: OBJECTIVE
  To investigate the time course of an epidemic of asthma after a thunderstorm, characteristics of patients affected, and the demand on emergency medical resources.
  
  
  METHODS
  Study of registers and records in accident and emergency departments and questionnaire to staff.
  
  
  METHODS
  London area.
  
  
  METHODS
  All patients presenting at 12 accident and emergency departments with asthma or other airway disease.
  
  
  METHODS
  Numbers of patients, clinical features, information on shortage of resources--equipment, drugs and staff.
  
  
  RESULTS
  The epidemic had a sudden onset on 24 June 1994; 640 patients with asthma or other airways disease attended during 30 hours from 1800 on 24 June, nearly 10 times the expected number. Over half (365) the patients were aged 21 to 40 years. A history of hay fever was recorded in 403 patients; for 283 patients this was the first known attack of asthma; a history of chronic obstructive airways disease was recorded in 12 patients. In all, 104 patients were admitted (including five to an intensive care unit). Several departments ran out of equipment or drugs, called in additional doctors, or both.
  
  
  CONCLUSIONS
  This study supports the view that this epidemic was larger than previously reported epidemics and the hypothesis that "thunderstorm associated asthma' is related to aeroallergens. Demands on resources were considerable; a larger proportion of patients needing intensive care would have caused greater problems.
authors.affiliation: Newham General Hospital, London.
authors.forename: A C
authors.initials: AC
authors.lastname: Davidson
authors.forename: J
authors.initials: J
authors.lastname: Emberlin
authors.forename: A D
authors.initials: AD
authors.lastname: Cook
authors.forename: K M
authors.initials: KM
authors.lastname: Venables
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology*; D004196:Disease Outbreaks; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D010342:Patient Acceptance of Health Care; D006109:Poaceae; D011058:Pollen; D014887:Weather