Introduction: Asthma epidemics linked to thunderstorms (thunderstorm asthma; TSA) have been reported internationally for several decades. TSA can have severe impact on an individuals' health, resulting in severe outcomes, including death. TSA events can also put intense pressures on local health care services.
Objective: To describe changes in healthcare seeking behavior associated with a period of thunderstorm activity in England, June 2023, using routinely available health surveillance data.
Methods: Asthma and difficulty breathing-type presentations were analyzed from telehealth advice calls and emergency department attendances.
Results: This was the largest TSA event documented in England since the English syndromic surveillance programme was established over 25 years ago. The scale of the increase in asthma-type activity was above previously reported TSA events in England and activity coincided with forecasted storm alerts, both temporally and geographically. However, increases in asthma-type patient contacts were only observed around storm alerts occurring during periods of high pollen activity. Additionally, increases in asthma-type patient contacts during the TSA episode were not observed in young children (under 5 years) or older adults (65 years and over).
Conclusion: This work supports the evidence of the health impact of TSA in England. It also particularly adds to the evidence base that pollen is a leading causal factor in TSA episodes in England. Further investigations into the spatiotemporal relationships between TSA, storm and pollen activity would help in the identification of drivers affecting different age groups, as well as to inform messaging to both healthcare professionals and the public regarding the timing of events and mitigation steps that may be taken.
Keywords: Syndromic surveillance; ambulance; difficulty breathing; emergency department; general practitioner; pollen; telehealth; wheeze.