How many Americans have asthma?

Asthma is a very common lung disease. It has been described in all ethnic groups and in all ages, from childhood into the golden years.The U.S. Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics reports that asthma currently affects more than 22.2 million Americans or 7.9% of the population, including over 6.7 million children younger than 18 years of age. Another way of looking at the information is that 7.3% of American adults currently have asthma, as do 9.3% of all young persons aged 15 years or younger. Asthma is the most common chronic disease of childhood. It is also the primary cause of school absences due to a chronic condition.

Young people aged 5–17 years with asthma miss more than 12.8 million school days annually in the United States. Asthma is responsible for interference with adults’ daily activities as well, given that over 10 million work days are lost annually to poorly controlled asthma.

The cost of asthma is significant both for individuals and for our society as a whole. Experts refer to the burden of asthma. The CDC estimates that in 2006, asthma accounted for 10.6 million visits to office-based
physicians, 1.3 million visits to hospital clinics, and 1.8 million visits to hospital emergency departments. The rate of emergency department visits for asthma was higher in children than in adults, and the highest rate of asthma requiring emergency department care was for children 4 years of age and younger. Hospitalizations for asthma appear to be decreasing over recent years, and presently approximate close to half a million yearly, with higher rates of hospitalization among children than among adults. The highest rate of hospitalization for treatment of asthma, similar to the rate of emergency room utilization is for children aged 4 and younger.

Experts are interested in reducing the burden of asthma illness and the rates of hospitalization in the United States as in all other countries. The fact that the hospitalization rates for asthma in the United States have been decreasing may reflect the beneficial effects of the introduction of newer asthma therapies, including medications such as those referred to as “controller” or “maintenance”medicines, reviewed later in the text.

Asthma in the United States

Approximately 22.2 million Americans currently have asthma, including 6.7 million children aged 18 years or less—the numbers correspond to 7.3% of adults and 9.3% of children.
Asthma is the most common chronic disease of childhood.
In 2006, asthma accounted for 10.6 million visits to office-based physicians, 1.3 million visits to hospital clinics, and 1.8 million visits to hospital emergency departments.
Asthma is responsible for 12.8 million missed school days and 10 million missed days of work each year.
There were 3613 reported deaths in the United States in 2006 directly due to asthma. Asthma is a contributing factor in nearly 7000 additional deaths.
Asthma-related health costs amount to $19.7 billion annually in the United States.

Source: Adapted from data obtained via the Centers for Disease Control and Prevention, including the brochure: Breathing Easier; accessed via: http://www.cdc.gov/asthma/pdfs/breathing_easier_brochure.pdf

What is Asthma?

What is asthma and what causes it?

Asthma is a very common, highly treatable lung condition. Millions people, children and adults, carry a diagnosis of asthma. Asthma’s symptoms relate to breathing and to the respiratory system. Symptoms of asthma vary in frequency and in intensity and may include cough, wheeze, increased mucus production, uncomfortable breathing, and shortness of breath. Asthma severity not only varies from person to person, but can also fluctuate in a given person over time.

A major goal of asthma treatment is directed at symptom prevention as well as at symptom control. Some people with mild asthma experience infrequent symptoms. Others, whose asthma is more persistent, at the other end of the asthma severity spectrum, may require several daily lung medications taken regularly to control their disease, normalize their lung functioning, and attain a symptom-free state.

Physicians who specialize in asthma care firmly believe that even the most severely affected asthma sufferers can be treated successfully. Modern asthma management and contemporary therapies allow persons diagnosed with asthma to lead full, active lives. Successful asthma treatment requires an understanding of the disease in general as well as how it manifests itself in a particular person, combined with attentive medical care and the forging of a cooperative partnership between patient and physician

Components of Contemporary Asthma Treatment :

Medications tailored to asthma severity and degree of control
Environmental control measures
Immunizations (including against influenza)
Identification and treatment of any co-existing medical conditions
Patient, family, and caregiver education
Self-management strategies and guidelines
Regular aerobic exercise
Forging of a true therapeutic alliance between patient and healthcare provider

Source: 100 Questions and Answers About Asthma

The Definition of Asthma

What is the Definition of an Asthma Attack?

The International Consensus Report on the Diagnosis and Management of Asthma (Global Strategy for Asthma Management and Prevention) defined: ’Asthma is a chronic inﬂammatory disorder of the airways in which many cells and cellular elements play a role. The chronic inﬂammation is described with airway hyper- responsiveness that leads to recurrent episodes of wheezing, breath-lessness, chest tightness, and coughing, particularly at night or in the early morning. These episodes are usually described with widespread, but variable, airﬂow obstruction within the lung that is often reversible either spontaneously or with treatment’.

Asthma is an overall descriptive term but there are a number of more or less distinct phenotypes which may have different causes, clinical patterns and responses to treatment. The clinical picture of asthma in toddlers is recognizeable and reproducible. The difﬁculties in precise diagnosis arise in the very young, in older groups and in verymild asthma. Breathlessness fromother causes, such as increased tendency towards obesity,may be confused with asthma in toddlers.

The clinical characteristic of asthma in toddlers is airﬂow obstruction, which can be reversed over short periods of time or with treatment. This may be evident from provocation by speciﬁc stimuli or from the response to bronchodilators. The airﬂow obstruction leads to the usual symptoms of shortness of breath. The underlying pathology is inﬂammatory change in the airway wall, leading to irritability and responsiveness to various stimuli and also to coughing, the other common symptom of asthma in toddlers. Cough may be the only or ﬁrst symptom of asthma in toddlers.

Asthma in toddlers has commonly been defined on the basis of wide variations in resistance to airﬂow over short periods of time. More recently, the importance of inﬂammatory change in the airways has been recognised. There is no universally agreed deﬁnition butmost contain the elements from the Global Initiative for asthma in toddlers. Low concentrations of non-speciﬁc stimuli such as inhaled methacholine and histamine produce airway narrowing. In general, the more severe the asthma in toddlers, the greater the inﬂammation and the more the airways react on challenge. Other stimuli such as cold air, exercise and hypotonic solutions can also provoke this increased reactivity. In contrast, it is difﬁcult to induce signiﬁcant narrowing of the airways with many of these stimuli in healthy people.

In some ways, increased airway responsiveness is used as part of the deﬁnition of asthma in toddlers. Wheezing during the past 12 months is added to the deﬁnition to exclude those who have increased responsiveness but no symptoms.The clinical equivalent of asthma in toddlers increased responsiveness is the development of symptoms in response to dust, smoke, cold air, and exercise; these should be sought in the history.