218 Thunderstorm-Related Asthma in Patients Sensitised to Olea Europaea Pollen: Twenty Emergency Department Visits for Asthmatic Symptoms in One Single Day

BACKGROUND: Asthma exacerbation associated with thunderstorms has been reported in several countries. Common to all epidemics of thunderstorm-related asthma is a significant increase in atmospheric allergen load during and immediately after a thunderstorm. Sensitization to Alternaria species or to grass and parietaria pollens has been suggested to play a key role in thunderstorm-related asthma. The only reported event of thunderstorm-related asthma in Mediterranean area was attributed to sensitization to parietaria pollen. METHODS: Here we describe a series of 20 patients who accessed to an Emergency Department in Puglia (Italy) for sudden and severe dispnoea between the 27th and the 28th of May 2010 (between 15:36 and 5:02), just after a violent thunderstorm which occurred after a very warm morning (mean atmospheric temperature: 29°C). All patients have been subsequently visited by an allergist and underwent a complete allergological work-up which included skin prick tests and a careful clinical history record. Data from atmospheric pollen count were recorded. RESULTS: In the months between 10th of May and 10th of June 2010, a total of 86 accesses to same Emergency Department were recorded for asthma exacerbations, 20 of them during the studied day. Patients’ mean age was 44.25 ± 18.5 years (range: 9–81), 8/20 females, 2 smokers, 16 with a previous history of known respiratory allergy. All 20 patients were sensitized to Olea europaea pollen, 7 of which were monosensitized. Other sensitizations were: 10 patients to grass, 7 to parietaria, 5 to compositae, 5 to cypress, 5 to house dust mites, 3 to dog and 1 to cat danders. Mean atmospheric pollen count was 170 granules/m(3) for Olea europaea and 60 granules/m(3) for grass pollen. CONCLUSIONS: This is, in our knowledge, the second thunderstorm-related asthma episode described in Mediterranean area and the first one in which sensitization to Olea europaea played a key-role. This result should focus the possibility that not only the increase of molds and grass pollen load after a thunderstorm may raise asthma exacerbations.