Environmental and occupational respiratory disordersEpidemic asthma and the role of the fungal mold Alternaria alternata
Section snippets
Methods
The study was approved by the local research and ethics committee. Investigation was by means of case-control study of 26 case patients who presented to the hospital with acute asthma during the outbreak and 31 control subjects with seasonal asthma during the grass pollen season. Informed written or verbal consent was obtained from cases and control subjects.
Cases
Ninety-two patients older than 16 years attended the Cambridge University hospital ED with asthma between July 29 and August 5. Based on data for July from August 1999 from 2001, expected attendances would have been 8 to 9 patients over this period. Fifty-seven patients with asthma attended the hospital on July 29-31. Eight subjects younger than 18 years were excluded, 1 subject had left the country, and 22 did not attend follow-up or were not contactable and therefore were not included in the
Discussion
The fungal spores of Alternaria and Cladosporium species are known to cause allergic sensitization and seasonal asthma symptoms. In the United Kingdom in July and August (at the end of the grass pollen season), environmental levels of these spores increase rapidly, and allergic sensitization correlates with the severity of asthma symptoms.11 In sensitive individuals inhalation of Alternaria species spores results in an asthmatic response, followed by an increase in bronchial hyperresponsiveness.
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Disclosure of potential conflict of interest: C. Bryden is employed by the Met Office. The rest of the authors have declared that they have no conflict of interest.