Thunderstorm asthma

What is thunderstorm asthma?

During grass pollen season people may notice an increase in asthma and hay fever. Grass pollen season (October through to December) also brings the chance of thunderstorm asthma.

Thunderstorm asthma is thought to be triggered by a unique combination of high amounts of grass pollen in the air and a certain type of thunderstorm. For people who have asthma or hay fever this can trigger severe asthma symptoms.

When a large number of people develop asthma symptoms over a short period of time, related to high grass pollen and a certain type of thunderstorm, it is known as epidemic thunderstorm asthma. To learn more, visit the Epidemic thunderstorm asthma fact sheet.

If you have current, past or undiagnosed asthma or seasonal hay fever you are at increased risk of thunderstorm asthma. So be prepared to manage any symptoms and stay out of hospital.

You can protect yourself and those in your care by following these simple steps:

• Monitor the epidemic thunderstorm asthma risk forecast on the VicEmergency app.
• Don’t be outdoors in a storm, especially during the winds that precede them.
• Take your preventative medication as directed, even when you’re symptom free.
• Carry your reliever and know how to manage an asthma attack.
• Follow your asthma action plan or use the 4 steps of asthma first aid.

The symptoms of asthma, hay fever and COVID-19 can be similar, and it can be difficult to tell the difference between them. If you are experiencing symptoms different to your usual asthma and hay fever symptoms, they have restarted after a period of absence or if you are unsure – get tested for COVID-19 and stay home until you get your results.

For up to date information on epidemic thunderstorm asthma risk, including the risk forecast, advice and warnings, visit the Vic Emergency thunderstorm asthma page or download the VicEmergency app from Google Play or the App Store and set up a 'watch zone'. The epidemic thunderstorm asthma risk forecast, as well as up to date grass pollen count and grass pollen forecast information is available on the Melbourne Pollen Count and Forecast website or app (App Store or Google Play).

To view thunderstorm asthma resources, including posters, brochures and fact sheets in other languages, visit the Thunderstorm asthma – multicultural resources page.

Who is at risk?

Thunderstorm asthma can affect those with current, past or undiagnosed asthma or seasonal hay fever – especially people who experience wheezing or coughing with their hay fever.

Even if you don't think you have asthma or hay fever, don't ignore symptoms like wheezing or shortness of breath – check with your GP.

Protect yourself this pollen season

Here are some things you can do to prepare for pollen season:

If you have asthma – talk to your GP to review and update your asthma action plan so you know how to manage your asthma. Remember, taking an asthma preventer properly and regularly is key to preventing asthma, including thunderstorm asthma.

If you've ever had asthma – talk to your GP about protecting yourself from the risk of thunderstorm asthma this pollen season.

If you've experienced wheezing, shortness of breath, chest tightness or a persistent cough then you may have asthma. Talk to your GP about whether you may have asthma so you can get those symptoms under control.

If you have seasonal hay fever – see your pharmacist or GP for a hay fever treatment plan. If you've experienced any asthma symptoms with your hay fever or you’re not sure, see your GP. Once a diagnosis is made you can get effective treatment that will make you feel and breath better.

If you have asthma or seasonal hay fever, following these simple steps can help you protect yourself and those in your care from the risk of thunderstorm asthma:

• Monitor the epidemic thunderstorm asthma risk forecast daily during grass pollen season. Download the Vic Emergency app (App Store or Google Play) and set up a 'watch zone' for your location to receive advice and warnings about potential epidemic thunderstorm asthma events during the grass pollen season. You can also visit the Vic Emergency thunderstorm asthma webpage for updates and information.
• 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. Turn off any air conditioner systems that bring air from outside into the home or car (including evaporative air conditioners).
• Take your preventative medication as directed, even when you’re symptom free.
• Carry your reliever and know how to manage an asthma attack.
• Follow your asthma action plan or if you don't have an asthma action plan, follow the 4 steps of asthma first aid.

If you have mild asthma symptoms, call NURSE-ON-CALL (1300 60 60 24), see your local doctor, or speak with a pharmacist. Supercare pharmacies are open 24 hours a day, 7 days a week, with a free registered nursing service on site from 6 pm to 10 pm, every day.

If your condition is urgent, not improving or getting worse, call 000 or attend hospital.

Epidemic thunderstorm asthma risk forecasts in Victoria are available from 1 October 2022 to 15 January 2023 (the duration of the grass pollen season). The epidemic thunderstorm asthma risk forecast is available on the Vic Emergency website and app. You can also stay informed about pollen counts and pollen forecast by visiting the Melbourne Pollen Count and Forecast website or downloading the app (App Store or Google Play).

Read more about epidemic thunderstorm asthma.

Know the 4 steps of asthma first aid

It’s important for everyone in the community to know the 4 steps of asthma first aid.

One of the most common reliever medications in Australia is salbutamol, often known as your ‘blue/grey puffer’. These are available over the counter from a chemist. Bricanyl Turbuhaler (terbutaline 500 mcg) is a different blue reliever medication available over the counter.

If you are not sure if someone is having an asthma attack, you can still use a blue/grey reliever medication because it is unlikely to cause harm.

Not everyone with asthma uses the same reliever medication. See asthma first aid directions using other relievers.

Call triple zero (000) immediately if:

• the person is not breathing
• their asthma suddenly becomes worse or is not improving
• the person is having an asthma attack and there’s no reliever medication available
• the person is unsure if it is asthma
• the person is known to have anaphylaxis. If this is the case, always give adrenaline autoinjector first, and then reliever, even if there are no skin symptoms.

To use asthma first aid with a blue/grey reliever puffer:

Step 1: Sit the person upright

• Be calm and reassuring.
• Do not leave them alone.

Step 2: Give 4 separate puffs of blue/grey reliever puffer

• Shake the puffer.
• Put 1 puff into the spacer.
• Get the person to take 4 breaths from the spacer.
• Repeat until 4 puffs have been taken. (If you don’t have a spacer, simply give the person 4 puffs directly into their mouth).

If using Bricanyl (5 years or older), give 2 separate doses.

Step 3: Wait 4 minutes

• If breathing does not return to normal, give 4 more separate puffs of blue/grey reliever, as with Step 2.

Bricanyl: give 1 more dose.

Step 4: If breathing does not return to normal, call triple zero (000) for an ambulance

• Tell the operator that someone is having an asthma emergency.
• Keep giving the person 4 separate puffs, taking 4 breaths for each puff, every 4 minutes until emergency assistance arrives.

Bricanyl: Give 1 more dose every 4 minutes until emergency assistance arrives.

To access this information in other languages call the Translating and Interpreting Service on 131 450 (free call) and ask them to call NURSE-ON-CALL (1300 60 60 24).

If you are deaf, hard of hearing, or have a speech/communication impairment contact the National Relay Service on 1800 555 677 and ask them to call NURSE-ON-CALL (1300 60 60 24).

Related information

• Epidemic thunderstorm asthma – Health.vic – for health professionals, government agencies and organisations
• Asthma action plans – National Asthma Council Australia
• Asthma first aid – Asthma Australia