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Every September, asthma hospital stays rise. Doctors see more people with asthma episodes and attacks. The third week of the month is the worst. It is called the September Asthma Epidemic or Asthma Peak Week.

Everyone with asthma needs to take extra precautions during September. Children tend to be the most affected during the month. But that doesn’t mean adults aren’t at risk. Parents and grandparents can be affected too.

As we head into Asthma Peak Week, it’s important to know if your asthma is under control, how to avoid getting sick, and what to do if you do get sick.

Why Does Asthma Peak in September?

September is the perfect storm for people with asthma and allergies. Ragweed, the most common fall pollen allergy, peaks in September in the United States. Mold counts go up as leaves collect outside. Children return to school and are exposed to respiratory illnesses. Flu season is starting too.

With these happening at the same time, you are exposed to a lot of asthma triggers. This can make it hard for you to keep your asthma under control.

How Can I Stay Healthy During September?

The best way to deal with illness or asthma attacks is to prevent them before they begin.

  1. Stick to your Asthma Action Plan. Take your controller medicine as prescribed by your doctor. If you move into the Yellow Zone of your plan, take action early so you can get back in the Green Zone.

  2. Get the COVID-19 vaccine. Four options are available in the United States, including two options for children ages 6 months and older. The COVID-19 shots can reduce your chances of having more severe illness and being admitted to the hospital. Studies show that having asthma does not put you at greater risk of getting COVID-19 or having severe COVID-19.1,2,3 But getting the COVID-19 vaccine can help you stay healthier overall.

  3. Get the flu shot. A yearly vaccine is available. It takes two weeks to take effect in your body, so get the shot as soon as it’s available – usually in September.

  4. Talk with your doctor about getting the pneumococcal vaccine. You get the shot once and then get a booster later if you need it. You do not need this shot yearly. It helps prevent pneumonia and other illnesses.

  5. Wear a mask. They have helped reduce the spread of the coronavirus, but they have other benefits too. They can help reduce the spread of other respiratory infections and your exposure to pollen. They can help children over 2 years old as well. Studies from 2020 showed that children had fewer asthma-related emergency room visits thanks to face masks, along with other preventive steps.4,5

  6. Take steps to avoid getting sick. Wash your hands often and for at least 20 seconds. Don’t touch your eyes, mouth, and nose. Stay away from people who are sick.

  7. Avoid your asthma triggers. If you are allergic to ragweed or mold, take steps to reduce your exposure to those allergens:
    • Ask everyone to remove their shoes before entering your home.
    • Keep your windows and doors closed during peak pollen times.
    • Use a CERTIFIED asthma & allergy friendly® air filter on your home’s air conditioner and furnace/heater.
    • Cover your hair when you go outside, or shower and wash your hair before bedtime. Consider using a saline nasal rinse.
    • Talk with your allergist about possible treatments for your allergies.

  1. Get plenty of sleep, eat healthy, stay hydrated, and eat well. Take action to keep your stress levels down.

  2. Work with your doctor to make sure your asthma is under control.

asthma peak week take medicine to reduce your chances of having an asthma attack

How Do I Know If My Asthma Is Not Under Control?

If your asthma is well-controlled, you have a better chance of recovering faster or avoiding complications from an illness. It’s important to know if your asthma is under control, especially as the coronavirus, the flu, and other respiratory illnesses are spreading.

Controlled asthma means:

  • You have asthma symptoms two or fewer times per week
  • You use your quick-relief medicine two or fewer times per week
  • You wake up from asthma two or fewer times per month
  • You use oral corticosteroids to treat your asthma fewer than two times per year

If any of these things happen more than two times, then your asthma is not under control.

Also, If you are taking oral corticosteroids (OCS – such as prednisone) two or more times per year, ask your doctor about other options. OCS can have serious, long-term side effects. Some of them may include osteoporosis (brittle bones), diabetes, and cataracts.

asthma peak week your asthma is not controlled if you take oral corticosteroids two or more times each year


Your doctor may run more tests or have you try other treatments. Biologics are a type of treatment used to treat severe, uncontrolled asthma that may reduce the number of asthma attacks you have and reduce the need for OCS. Biologic treatments are given as shots or infusions every few weeks. The treatment targets and blocks a cell or protein in your body that can inflame your airways.

asthma peak week oral corticosteroids can have long-term side effects

What If I Get Sick Anyway?

No matter how hard you try, sometimes you still get sick. As soon as you become sick, contact your doctor. If you treat the illness or asthma episode sooner, you have a better chance of keeping it from getting worse.

  • Contact your doctor as soon as possible once you realize you are sick. If you think you may be contagious, call your doctor first to avoid spreading the illness to others.

  • Tell your doctor all the symptoms you are having and how long you have had them.

  • If you suspect you have been exposed to COVID-19 or the flu or are having symptoms of either, share that information with your doctor. Stay home to reduce the risk of spreading illness to other people.

  • Let them know what medicines you have been taking and how often – including prescription and over-the-counter.

  • Follow your new treatment plan if your doctor gives you one. Asthma can be serious, and you may need a course of OCS to fight the inflammation and help you breathe.

  • Get plenty of rest. Drink water and eat healthy foods. Continue to avoid your asthma triggers.

  • Know your Red Zone signs on your Asthma Action Plan. If you move into the Red Zone, contact your doctor right away or go directly to the emergency room.


asthma peak week get help right away if you have emergency asthma symptoms


If you get sick with a respiratory illness, don’t ignore it or try to push through it. That can make it harder to get your asthma under control if you get to the point where you need emergency treatment. It can also have serious consequences.

Good asthma control year-round is key to staying healthy during September. Stick with your treatment plan, avoid your triggers, and pay attention to your asthma control. Then next year, you’ll be better prepared to face Asthma Peak Week.


Medical Review: Content summarized from aafa.org/blog/coronavirus-2019-ncov-flu-what-people-with-asthma-need-to-know which was reviewed July 2022 by Mitchell Grayson, MD and ASTHMA Care for Adults facilitator's guide

Does your asthma get worse during September? Join our community to get support from others who manage asthma and other conditions. By becoming an AAFA community member, you will receive updates about the latest news about asthma and allergy research and treatments.

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References
1. Chhiba, K.D., Patel, G.B., Vu, T.H.T, Chen, M.M., Guo, A., Kudlaty, E., Mai, Q., Yeh, C., Muhammad, L.N., Harris, K.E., Bochner, B.S., Grammar, L.C., Greenberger, P.A., Kalhan, R., Kuang, F.L., Saltoun, C.A., Schleimer, R.P., Stevens, W.W., & Peters, A.T. (2020). Prevalence and characterization of asthma in hospitalized and non-hospitalized patients with COVID-19, Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2020.06.010.
2. Butler, M. W., O’Reilly, A., Dunican, E. M., Mallon, P., Feeney, E. R., Keane, M. P., & McCarthy, C. (2020). Prevalence of comorbid asthma in COVID-19 patients. Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2020.04.0613. Lieberman-Cribbin, W., Rapp, J., Alpert, N., Tuminello, S., & Taioli, E. (2020). The Impact of Asthma on Mortality in Patients With COVID-19. Chest. https://doi.org/10.1016/j.chest.2020.0air pol.5754. Sheehan, W. J., Patel, S. J., Margolis, R., Fox, E. R., Shelef, D. Q., Kachroo, N., Pillai, D., & Teach, S. J. (2021). Pediatric asthma exacerbations during the COVID-19 pandemic: Absence of the typical fall seasonal spike in Washington, DC. The journal of allergy and clinical immunology. In practice, 9(5), 2073–2076. https://doi.org/10.1016/j.jaip.2021.02.0085. Simoneau, T., Greco, K. F., Hammond, A., Nelson, K., & Gaffin, J. M. (2020, December 4). Impact of the COVID-19 Pandemic on Pediatric Emergency Department Utilization for Asthma. Retrieved from Annals of the American Thoracic Society: https://www.thoracic.org/about...visits-and-covid.pdf

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Comments (8)

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We're glad you're here @Lizz. Welcome!  Can you feel the approaching high season through pollens, mold, or things like return to school? I hope you'll share those ideas and how you deal with them in the Asthma Support forum too.

Compton
@Jeb6708 posted:

Why is this?

That's a great question - why do asthma flares peak in September? It's the height of ragweed season in many areas, mold counts are rise as leaves start to fall, flu season starts, and kids head back to school and pass around respiratory viruses like colds. Also school buildings that have been closed all summer may have a build up of other allergens and irritants.  All of these can be asthma triggers. COVID precautions in schools (masks, distancing, increased airflow) may help reduce some of these factors the a years. But it's best to know what the factors are and keep your/your child's asthma as well controlled as possible.

Why Does Asthma Peak in September?

September is the perfect storm for people with asthma and allergies. Ragweed, the most common fall pollen allergy, peaks in September in the United States. Mold counts go up as leaves collect outside. Children return to school and are exposed to respiratory illnesses. Flu season is starting, and currently, the coronavirus is still spreading.

With these happening at the same time, you are exposed to a lot of asthma triggers. This can make it hard for you to keep your asthma under control.

Kathy P
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