Epidemic thunderstorm asthma

The information on this page is a comprehensive fact sheet on epidemic thunderstorm asthma.

Visit the thunderstorm asthma public awareness campaign to view resources, case studies and videos.

This material was developed prior to COVID-19. Follow current COVID-19 restrictions and guidelines.

What is epidemic thunderstorm asthma?

View the Thunderstorm asthma overview (video) page for the transcript.

Grass pollen season brings a seasonal increase in asthma and hay fever. It also brings the chance of thunderstorm asthma. When a large number of people develop asthma symptoms over a short period of time, caused by high amounts of grass pollen and a certain type of thunderstorm, it is known as epidemic thunderstorm asthma.

Melbourne experienced the world’s largest epidemic thunderstorm asthma event on 21 November 2016, with thousands of people developing breathing difficulties in a very short period of time.

Epidemic thunderstorm asthma events are thought to be triggered by a unique combination of high grass pollen levels and a certain type of thunderstorm. Grass pollen grains get swept up in the wind and carried for long distances; some can burst open and release tiny particles that are concentrated in the wind gusts that come just before a thunderstorm. These particles are small enough to be breathed deep into the lungs and can rapidly trigger asthma symptoms, making it difficult to breathe.

This can become very severe, very quickly and many people may require medical help at the same time.

Thunderstorm asthma can affect those with asthma or hay fever – especially people who experience wheezing or coughing with their hay fever. That’s why it’s important for people with asthma or hay fever to know about thunderstorm asthma and what they can do to help protect themselves during grass pollen season.

When do epidemic thunderstorm asthma events take place?

Epidemic thunderstorm asthma events are uncommon and don’t occur every year. In south-east Australia they can happen during grass pollen season from October through December.

Who is most at risk of thunderstorm asthma?

Those at increased risk of thunderstorm asthma include:

• people with asthma
• people with undiagnosed asthma (i.e. people who have asthma symptoms but have not yet been diagnosed with asthma)
• people who have had asthma in the past
• people with hay fever who may or may not have asthma.

It’s important to remember:

• People with hay fever in south-east Australia are likely to be allergic to grass pollen, and are therefore at increased risk of thunderstorm asthma.
• Having both asthma and hay fever or poor control of asthma increases the risk further.
• Thunderstorm asthma can affect people living in metropolitan, regional or rural areas, even if they don't have a history of asthma.

It is important to understand that there are a large range of triggers that can set off a person’s asthma symptoms. Symptoms and treatment of epidemic thunderstorm asthma are essentially the same as asthma triggered by other causes.

Recognising asthma symptoms

View the Asthma and thunderstorm asthma (video) page for the transcript.

Asthma affects about one in 9 Australians and can start at any age – even as an adult. It is important to recognise asthma symptoms and see your GP if you experience any of them.

People with asthma may experience one or more of the following common symptoms:

• wheezing – a high-pitched sound coming from the chest while breathing
• breathlessness
• a feeling of tightness in the chest
• a persistent cough.

These symptoms mean that a person’s lungs (lower airways) are affected.

Asthma symptoms come and go over time, and you don’t need to have all of these symptoms to be diagnosed with asthma. Not every person experiences the same symptoms. Sometimes people with asthma don’t notice their symptoms, and sometimes they don’t address or manage their symptoms by seeing their GP or using their asthma medication.

People with well-controlled asthma have mild symptoms, less often.

A diagnosis of asthma is more likely if you have eczema or hay fever, or have close relatives with allergies and/or asthma, and if your symptoms:

• keep coming back, or happen at the same time each year
• are worse at night or in the early morning
• are clearly triggered by exercise, allergies or infections
• improve quickly with reliever medication.

Recognising hay fever symptoms

View the Hay fever and thunderstorm asthma (video) page for the transcript.

Around one in 4 people with hay fever also have asthma, and it is important to recognise that pollen can trigger asthma as well as hay fever symptoms.

People with hay fever may experience one or more of the following common symptoms:

• runny nose
• itchy nose
• sneezing
• itchy, watery eyes.

These symptoms mean that a person’s eyes and upper airways are affected. Hay fever does not include symptoms such as wheezing, shortness of breath or chest tightness, which may be asthma symptoms.

If you have hay fever and have also experienced symptoms such as wheezing, shortness of breath or chest tightness, see your GP.

What can I do to protect myself this pollen season?

Epidemic thunderstorm asthma events are uncommon and don’t occur every year. However, it’s important for everyone in south-east Australia to know about epidemic thunderstorm asthma and what they can do to help protect themselves if an event does occur.

Everyone in the community should also know the signs and symptoms of asthma, and know the 4 steps of asthma first aid so they know what to do if someone is having an asthma attack.

Protecting yourself if you are at increased risk of thunderstorm asthma

All people at increased risk of thunderstorm asthma should:

• Learn about thunderstorm asthma and what they can do to help protect themselves during grass pollen season.
• Where possible, avoid being outside during thunderstorms from October through December – especially in the wind gusts that come before the storm. Go inside and close your doors and windows, and if you have your air conditioner on, turn it to recirculate.
• Have an asthma action plan (if advised to by your GP and developed with them) and know the 4 steps of asthma first aid.
• Have reliever medication appropriately available in grass pollen season and be aware of how to use it (ideally with a spacer).
• Be alert to and act on the development of asthma symptoms as explained in your asthma action plan if you have one, or if you don’t, use asthma first aid.
• Check the epidemic thunderstorm asthma forecast during the grass pollen season at VicEmergency.

In addition to the above bullet list, take the following precautions as relevant.

Protecting yourself if you have asthma

View the Asthma first aid (video) page for the transcript. Note: The first aid steps in this video refer to the blue/grey reliever puffer. See other asthma first aid directions if the person uses a different reliever medication.

If you currently have asthma, make sure you have regular reviews with your GP about your asthma to ensure that you have the right asthma medication, know how to use it properly and that you have good control of your asthma.

It is also important that you have an asthma action plan and that you see your GP to ensure that it includes advice for thunderstorm asthma. Always carry your reliever medication with you – this is your emergency asthma first aid medication.

Protecting yourself if you have symptoms that may be asthma

If you think you have symptoms of asthma it is important you talk to your GP to determine if they are due to asthma.

If you suddenly develop asthma symptoms and you think you are having an asthma attack, follow the 4 steps of asthma first aid and make sure you follow up with your GP.

Protecting yourself if you have had asthma in the past

Talk with your GP about your risk of thunderstorm asthma and what additional actions would be appropriate for you – particularly the need for asthma preventer medication over the grass pollen season.

Protecting yourself if you have hay fever

If you have hay fever, understand that you are at increased risk of asthma, including during an epidemic thunderstorm asthma event. If you think you have experienced symptoms of asthma with your hay fever, for example wheezing, shortness of breath or coughing, then talk to your GP.

If you have hay fever only, see your GP or pharmacist about a hay fever treatment plan and what you can do to help protect yourself from the risk of thunderstorm asthma. This may include having an asthma reliever puffer appropriately available – these are available from pharmacies without a prescription.

If you develop asthma symptoms, follow the 4 steps of asthma first aid and make sure you follow up with your GP.

You can also stay informed about pollen counts by visiting the Melbourne Pollen Count and Forecast website or downloading the app, or you can visit the Deakin AIRwatch website.

How will I know when an epidemic thunderstorm asthma event may happen?

Epidemic thunderstorm asthma forecasts in Victoria are available from 1 October 2022 to 15 January 2023 (the duration of the grass pollen season).

Download the Vic Emergency app from Google Play or the App Store and set up a 'watch zone' for your location to make sure you're notified of the risk of an epidemic thunderstorm asthma event occurring. You can also visit the Vic Emergency thunderstorm asthma webpage for updates and information.

Hay fever, asthma, and COVID-19

The symptoms of hay fever and asthma can be similar to COVID-19 (such as a runny nose, cough, or shortness of breath), and it can be difficult to tell the difference between them. It is critical to get tested for COVID-19 if these symptoms are:

• different from your usual symptoms
• have restarted after a period of absence
• if it is unclear whether they are due to your hay fever or asthma.

If an employee has symptoms and their COVID-19 test is negative, they should stay at home until they feel well. If their symptoms continue, they should speak to their GP.

The best way to prevent hay fever or asthma symptoms is to have an up-to-date hay fever treatment plan or asthma action plan and follow it. If you don’t yet have a plan, now is the time to check in with your GP.

Where to get help

Medical assistance

• In an emergency, always call triple zero (000)
• Emergency department of your nearest hospital
• Your GP (doctor)
• Your nearest pharmacy (for medication)
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• National Home Doctor Service Tel. 13 SICK (13 74 25) – for after-hours home GP visits (bulk billed)

Information about asthma

• Asthma Australia Helpline Tel. 1800 ASTHMA (1800 278 462)
• National Asthma Council of Australia Tel. 1800 032 495
• Asthma Australia apps - Asthma Australia has developed three apps to assist people with asthma and their carers.

Information about hay fever

• ASCIA (Australasian Society of Clinical Immunology and Allergy)

In your language

• በነጐድጓድ ዝናብ የሚከሰት አስም(Amharic)
• ربوعاصف الرعدية (Arabic)
• ܣܘܪܝܬ/Sūreṯ (Assyrian)
• বাংলা(Bengali)
• မုန်တိုင်း ပန်းနာရောဂါ(Burmese)
• 风暴性哮喘 (Chinese (Simplified))
• 雷暴哮喘 (Chinese (Traditional))
• Astma uslijed grmljavinske oluje (Croatian)
• آسم ناشی از توفان رعد و برق (Dari)
• Tuaany pɔ̈t de piɔ̈u (Dinka)
• آسم ناشی از طوفان و رعد و برق (Farsi)
• Καταιγίδα άσθματος (Greek)
• થડરસ્ટોર્મ અસ્થમા(Gujarati)
• हिन्दी(Hindi)
• Asma badai (Indonesian)
• Asma da temporale (Italian)
• ကညီကျိာ်(Karen)
• ជំងឺហឺតបងដោយយព្យុះផ្គររន្ទះ(Khmer)
• تەنگەنەفەسی)ڕەبۆی( پاش بۆرانی بروسکاوی (Kurdish)
• Астма при бура (Macedonian)
• AdhumƐ thuɔ̱ɔ̱l nhial (Nuer)
• Astma burzowa (Polish)
• ਥੰਡਰਸਟੋਰਮ ਅਸਥਮਾ(Punjabi)
• Грозовая астма (Russian)
• Астма за време непогоде (Serbian)
• සිංහල(Sinhalese)
• Neefta danabka dabaysha (Somali)
• Asma de las tormentas eléctricas (Spanish)
• Unos na hika (Tagalog)
• ஆஸ்துமா(Tamil)
• اردو (Urdu)
• Hen suyễn do giông bão (Vietnamese)