Everyone at this time of year is back to school. While the house might be quieter during the day, I can tell you that both my office and emergency rooms across the country reflect what has come to be known as the week 38 phenomenon.

Research has shown that hospitals see a sudden spike in emergency room visits for both children and adults who suffer from asthma. Mid September, just where are right now in the calendar, sees this flurry in flares. Why? There are a number of reasons why. Among them viral respiratory infections begin to rise and kids in close contact at school spread these viral infections from one to another. Kids bring the infections home to their adults. In addition there are also allergens in the air and children are exposed to children who may bring allergens on their clothing from home, such as cat allergen.

About 25 per cent of all children's asthma hospitalizations are known to occur in the five week period after kids go back to school. Often over the summer, kids can become complacent about taking their asthma medication. Couple that with close crowding, virus transmission and allergens create what many have called the perfect storm for an asthma flare.

Asthma affects three million Canadians and six out of 10 do not have control of their asthma.  One in five Canadian kids have been diagnosed with asthma and it is the number one emergency room visit for kids.

Asthma is a two component disease. Many of the symptoms of cough, wheeze and shortness of breath are caused by narrowing or constriction of the bronchial breathing tubes that happens when the muscles around the airways becomes tight. Then the airway lining can become swollen and inflamed leading to mucous production. This too narrows the airway.

Asthma triggers include air pollution pollen, certain foods, spray on deodorants, perfumes, dust, exercise, tobacco smoke mold and pets.

Some of the signs that asthma is flaring includes needing more reliever medication, a cough, nausea or light headedness and difficulty in sleeping. The 30 second asthma test can identify whether or not you might be having a flare.

Treatment of asthma is designed to reduce the inflammation on an ongoing basis with the use of inhaled steroid medication. This preventive medication is critical to ongoing control of asthma. Dilators can be long acting or short acting. There are many medications on the market to control asthma.

As a parent it is important to make sure your child is taking their medication regularly. Often when a child feels better, they stop taking the medication. Your child's teacher should be informed about management of asthma for your child including the use of rescue medication should they have a flare. Make sure you talk to your child about the importance of hand washing. Education for all is important.