Thunderstorm asthma: a family’s loss, behind the science and what we could do better

SPEAKING OUT: Dave and Sue Shaw of Wodonga warn thunderstorm asthma is deadly and people who are vulnerable need to protect themselves if a warning, under a new forecasting system, is issued. Picture: JAMES WILTSHIRE
SPEAKING OUT: Dave and Sue Shaw of Wodonga warn thunderstorm asthma is deadly and people who are vulnerable need to protect themselves if a warning, under a new forecasting system, is issued. Picture: JAMES WILTSHIRE

A storm was on the horizon when James Shaw and his team were driving back from Benalla on November 3, 2015, celebrating a win representing the Albury Wodonga Eight Ball Association.

Later that day, James was at his partner’s house when his breathing began to wane, a feeling familiar to the life-long asthma sufferer.

Within half-an-hour of taking his Ventolin, the 27-year-old was unconscious and being worked on by paramedics.

James was declared brain dead just days later.

His parents Sue and Dave were not only crippled by the heart-break, but the shock of the answer to ‘why?’.

“In the ICU, the doctor said it was thunderstorm asthma,” Dave said.

“He explained what happens when pollen gets vaporised – instead of it being in the airways, it actually gets into the lungs, which is 10 times worse.

“We had never heard about it before it happened to James and we’ve learned a lot since.”

TRAGIC LOSS: James "Jimmy" Shaw died quickly following a severe attack at just 27 years old in November 2015. He took Ventolin, but it did nothing. Picture: JAMES WILTSHIRE

TRAGIC LOSS: James "Jimmy" Shaw died quickly following a severe attack at just 27 years old in November 2015. He took Ventolin, but it did nothing. Picture: JAMES WILTSHIRE

It is by no means a new phenomenon, but after nine people died in Melbourne and a further 8500 received treatment across the state last November, ‘thunderstorm asthma’ was a term on the nation’s lips.

The Victorian government has invested $15 million in research, emergency departments and a new forecasting system in the wake of the event.

But Sue is scared those who have asthma – even the mildest form – may not heed the advice.

“James had his Ventolin, and he took it that night – he had his preventatives, everything – it just didn’t work, it was that severe and sudden,” she said.

“About 15 months before this attack, he was fishing near the hospital and felt it coming on, and he got himself to the emergency department at Wodonga.

“He collapsed and they told him he actually died then, but because he was at the hospital, they got the adrenaline into him within seconds and he suffered no brain damage.

“If people feel like their asthma is playing up, they need to be careful.

“I would suggest either staying inside or getting in close proximity to the hospital – even if you have to sit in your car on your phone.”

Jimmy was a vibrant young man who loved soccer, golf, poker, pool and fishing. He was a caring person and five people received his organs. Picture: JAMES WILTSHIRE

Jimmy was a vibrant young man who loved soccer, golf, poker, pool and fishing. He was a caring person and five people received his organs. Picture: JAMES WILTSHIRE

Staying indoors is ultimately the best way asthma sufferers can protect themselves when a thunderstorm asthma warning has been issued.

Asthma Australia chief executive Michele Goldman said it was also important for people to be proactive in their asthma management.

“You can be monitoring pollen counts online, so you are aware when there’s high amounts of pollen in the air,” she said.

“You can make a decision not to be outdoors.”

It's hard to know what set of circumstances could have changed things for James.

The Shaws struggle everyday with the ‘what ifs’, but the thought his story could instill vigilance in the community provides some comfort.

“If we can save a life and save a family from losing a loved one through an asthma attack, it’s worth it,” Sue said.

EYE ON SKY: Bruce Graham provides a daily pollen count to the Murrumbidgee Local Health District. A thunderstorm asthma alert system has operated in Wagga for a decade, following an event in 1997. Picture: LAURA HARDWICK

EYE ON SKY: Bruce Graham provides a daily pollen count to the Murrumbidgee Local Health District. A thunderstorm asthma alert system has operated in Wagga for a decade, following an event in 1997. Picture: LAURA HARDWICK

A device on Bruce Graham’s roof allows him to take a daily pollen count – the particles get stuck to a glass slide in the spore trap, which he puts under a microscope.

This data has helped provide thunderstorm asthma advice for the Murrumbidgee Local Health District every spring for 10 years.

“We had an event in Wagga in 1997 – the outpatients ward was saturated with people who couldn’t breathe,” Dr Graham said.

“We have a counter here because of that; there was a need to monitor this pollen to give people and hospitals advice.”

Dr Graham, a retired CSU lecturer, knows a high pollen day paired with a thunderstorm can mean deadly results, even for people who don’t have a history of respiratory problems.

“Typically, people who are hay-fever prone will get symptoms like itchy eyes or a running nose – that’s because the pollen, in its normal state, is large enough to be impacted at the back of the throat and also be absorbed by mucus in the upper airways,” he said.

“But the problem with a thunderstorm is the strong winds that precede the front whip up pollens into the air and rupture them into tiny granules, which can bypass the filter system in the airways and get into the lung.”

Last week at his Wagga home, Dr Graham was seeing some of the highest pollen counts in years – fortunately, this week’s rain brought down those numbers.

“Early indications are it’s going to be high counts this season,” he said.

“We’re part of a big agricultural region, but as much as it is crops, it’s also the ryegrass, which grows beside roads.

“That’s what they think is the primary culprit in this area.

“One of the challenges is getting people to be adequately prepared and have an asthma plan.” 

You can subscribe to an SMS alert system at www.csu.edu.au/asthma.

The incidence of thunderstorm asthma spans decades, and while two points don’t make a trend, the Melbourne epidemics of 2010 and 2016 were the worst ever seen.

To better prepare for another event, researchers have joined with the Bureau of Meteorology to develop a forecasting system, which issued its first advice last weekend, declaring a ‘moderate risk’ for the North East.

Associate Professor Ed Newbigin, part of the Melbourne University team who provide data, said advice would become more accurate as time progresses.

“Our knowledge of the science perhaps could be better and every season we’ll get better at forecasting,” he said.

“There were two episodes in the 1980s which were described by a group from Melbourne University, and I’ve been aware of it since then.

“Last year was obviously bigger than anything else – every ambulance in Victoria was on the road that night.

“Of people who presented to emergency departments, about one third had no previous history of asthma, but nearly all were allergic to grass pollen.”

Asthma Australia chief executive Michele Goldman described last spring’s event as “unprecedented”.

“I think the Victorian government should be applauded for taking the initiative to say ‘what could we learn from this and put in place so we are better prepared’,” she said.

“Other states that experience high pollen counts and similar conditions in spring should absolutely be taking note.

“We are aware of conversations the South Australian and NSW health departments have been having with Victoria.”

Mrs Goldman said the Victorian government could go a step further in investing further into preventative measures and education of asthma management.

“Our operations in Victoria haven’t previously received VicHealth funding, so we’re hoping this will not be a one-off investment, but a more ongoing effort to ensure asthma is well-managed,” she said.

Investment could also help improve data on pollen during spring in both Victoria and NSW.

Bruce Graham, who oversees counts out of Wagga, said Victoria now had six pollen count locations across the state.

“We don’t have manpower or funding to set up a network to cover all the local districts … to be really effective you need multiple units,” he said.

“What happens in Wagga doesn’t necessarily reflect what happens in Albury.”

Dr Newbigin said the response to thunderstorm asthma may not be perfect yet, but those at risk shouldn’t let fear of another event take over.

“Its something Victorians can live with, it’s something we can prepare for much like bushfires, and it doesn’t have to rule our lives,” he said.​

Be aware, but not alarmed, about the risk of thunderstorm asthma during the grass pollen season. Picture: PETER RAE

Be aware, but not alarmed, about the risk of thunderstorm asthma during the grass pollen season. Picture: PETER RAE