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Holiday Peak in Pulmonary Admissions is Linked to Social Gatherings: Presented at ERS

By David Owen

STOCKHOLM, SWEDEN -- September 17, 2007 -- The Christmas peak in hospital admissions for COPD and asthma -- which always plays havoc with staff holiday rotas -- may be caused by patients catching infections at family get-togethers, according to research presented here at the Annual Congress of the European Respiratory Society (ERS).

Family social gatherings spread respiratory viruses to at-risk patients, according to Neil Johnston, MSc, epidemiologist, Firestone Institute for Respiratory Health, and Clinical Assistant Professor, McMaster University, Hamilton, Ontario, Canada.

Dr. Johnston and colleagues examined annual hospitalisation patterns for asthma, COPD and respiratory infections in a range of countries (Canada, England, New Zealand, Scotland and Sweden).

"For adults, especially the elderly, the risk of being hospitalized for COPD increases by 16% to 51% during the Christmas holidays", Mr. Johnston reported. "For asthma, the excess risk is 18% to 62%; and the hospitalisation risk for a respiratory infection such as pneumonia goes up by 17% to 52%." New Zealand was the only country to escape this trend, with one hypothesis being that their Christmas comes during the summer months.

Hospital admissions for all 3 examined lung conditions also increased during respiratory-virus epidemics, the Canadian team noted, but the "Christmas epidemics" seem to occur independently of influenza virus, respiratory syncytial virus (RSV) or parainfluenza virus and adenovirus isolation rates.

"While no particular virus has been associated with the Christmas epidemic", Mr. Johnston explained, "it is still probable that the phenomenon is caused by viral infections, transmitted from person to person, and particularly from children to adults."

The researchers emphasise that family get-togethers during the holidays provide a perfect opportunity for viruses to spread to vulnerable subjects. The sharp rises in hospitalisation rates cannot, in their view, be explained by the closure of primary medical services during this time.

"Patients at risk of complications…such as asthmatics and people with COPD, should prepare carefully for the flu season and the Christmas holidays. They should, for example, make sure that their prescriptions are up to date and that they are prepared to treat an exacerbation, if one occurs," Mr. Johnston and his colleagues told the Congress.


[Presentation title: Christmas as a Risk Factor for Exacerbations of COPD, Adult Asthma and Respiratory Infections. Abstract E1921]

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