Does Your Child Have Exercise-Induced Asthma?

On a cool day, your child runs up and down the soccer field joyfully kicking the ball to teammates. You notice the child coughing but aren't unduly concerned. You blame the dry, cool air or the cold the child recently had.

You might be right -- the coughing could be the remnants of a virus. Or it could be a symptom of exercise-induced asthma (EIA).

"Asthma is a disease with many triggers, including allergens and viral infections," says Pamela Georgeson, M.D., clinical assistant professor of pediatrics at Michigan State University. "But for a small set of patients, exercise is the sole trigger."

Symptoms of EIA are the same as those for allergic asthma: coughing, wheezing and shortness of breath. In EIA, the symptoms usually are brought on by vigorous exercise in cold, dry air. Coughing occurs within 10 to 20 minutes after a child starts a physical activity. In many cases, the coughing gets much worse after the activity stops.

Because coughing can be a symptom of many health problems, Dr. Georgeson says parents often overlook the possibility of EIA.

"Other indications of EIA are when a child's chest hurts during exercise or the child has trouble breathing while exercising," she adds.

Allergens that trigger allergic asthma have no effect on a person with EIA alone. Some people, however, may have both allergic asthma and EIA.

EIA occurs most often in children and young adults. Because the symptoms of EIA usually are more short-lived than for allergic asthma, a person with EIA doesn't need long-term asthma therapy.

Steps to take

Dr. Georgeson says most children start experiencing EIA symptoms at age 3 or 4, or when they begin participating in high-energy sports such as soccer or basketball.

If you believe your child could be suffering from EIA, schedule an appointment with an asthma doctor for an accurate diagnosis. The treatments vary, depending on the severity of symptoms.

After a diagnosis, many parents consider taking their children out of sports, a move Dr. Georgeson discourages.

Instead, for youngsters with EIA, Dr. Georgeson recommends restricting their exercise after a viral or respiratory infection and when pollen or air-pollution levels are high.

Pre-exercise treatment could include a puff or two from a short-acting beta2-agonist 10 to 20 minutes before an activity begins. With chronic EIA or asthma induced by additional triggers, a doctor might recommend a long-acting broncodilator. Brief warm-ups before the activity can also lessen EIA symptoms.

"Your child may not outgrow EIA, but it can be managed when parents work with their physician," she says. "If treated properly, children with EIA can often prevent progression of the disease."

 04-27-07 Montreal Children's Hospital - SW