Staff Writer
More children are dying from asthma in the Augusta area, and local health officials working with the Centers for Disease Control and Prevention are launching another investigation into the causes. The East Central Health District is also working with members of a local asthma coalition to look at high rates of children being readmitted to hospitals for asthma.
Details are sketchy, but several local health officials said there have been two more children who have died from asthma since October, though none could provide details. Local officials are working with the CDC to confirm the number and work with the local asthma coalition to look at potential causes, said William Kanto, the chairman of pediatrics at Medical College of Georgia.
The CDC conducted a similar investigation last year into four child asthma deaths in the Augusta area between September and November 2006. Another child died in October 2007.
The CDC investigator did not return a phone call Friday.
If the new deaths are confirmed, that would make seven children who have died from asthma in the area since September 2006. There were three between 1999 and 2004, according to the CDC investigation, a rate of 0.5 deaths per year, significantly higher than the national rate. The recent death rate would be seven deaths in 17 months.
The previous CDC investigation did not point to any single environmental cause but did find some common factors, including a delay in seeking medical attention or the lack of medical attention once the fatal attack began, according to the report. All four of those children had a history of allergies and had been prescribed inhaled steroids, which is supposed to help control asthma, but all four had a poor history of taking the medication regularly, the investigation found.
"The issue is people not believing how severe asthma can be in children and adults, and therefore not making it a high priority to take their controlling medications on a very regular basis," said Dennis Ownby, MCG's chief of allergy and immunology.
"That child needs to be brought or that person needs to seek help right away," said Vanitcha R. Pintavorn of Augusta Family Allergy and Immunology. "Don't wait to get the (doctor's) appointment."
During a bad asthma attack, many of these children become "very, very fragile" and vulnerable, Dr. Ownby said.
"And it takes almost nothing to push them over the edge to produce a real life-threatening attack," he said.
The CDC investigation concluded there was a need for more community education, a cause taken up by a community asthma coalition, said Vickie Redd, a registered nurse at MCG and an asthma educator. The coalition is stressing things such as creating a plan that the child files with the school on what to do during an asthma attack, she said. But even that idea has its snags, Mrs. Redd said.
"The school nurses tell us they never see these asthma action plans," she said.
At least three of the children who died in the Augusta area were on Medicaid, and the four deaths occurred soon after the state switched from regular Medicaid to Medicaid managed care companies in the region. But there is no evidence that played a role, Dr. Kanto said.
There is also concern over a high number of admissions for asthma to MCG Children's Medical Center, said Dr. Kanto, the facility's medical director. In the past year, there were 1,991 admissions for asthma from Richmond County, 830 from Aiken County, 487 from Columbia County and 101 from Edgefield County, he said.
"I don't think anyone realizes how huge this is," he said.
East Central Health District Director Ketty Gonzalez and other members of the coalition are looking into it, he said.
One of the biggest problems seems to be the lack of a care management plan and a reliance on short-acting "rescue" inhalers that can become less effective over time, Dr. Kanto said. Another problem is when a child is in trouble, it isn't taken seriously enough to seek emergency medical attention, he said.
"We're waiting too long," Dr. Kanto said.
Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.
WHAT PARENTS SHOULD KNOW
WHAT TO DO: Parents whose child is diagnosed with asthma should have a written care plan for what medication the child should take and when. A copy of the plan should be on file with the child's school, and the child's teacher should also get a copy. While treatment can vary, most children should be on some kind of daily controller therapy, such as an inhaled steroid that can help prevent flare-ups, and the child should not rely on a "rescue" inhaler such as albuterol.
WHEN TO SEEK MORE HELP: It can be difficult to tell when an asthma attack has become potentially life-threatening, but Augusta allergists said these signs might alert parents to seek emergency help:
- The child can't finish a sentence without gasping for breath.
- The child is clearly laboring for breath, hollow spaces are visible between the ribs or at the neck when the child breathes, or the child is sweating from the exertion.
- Relief from the rescue inhaler lasts less than four hours before the wheezing returns.
- The child has flared nostrils while breathing or the lips and fingernails look blue.
Sources: Medical College of Georgia Hospital and Clinics; Augusta Family Allergy and Immunology
