A trans-disciplinary overview of case reports of thunderstorm-related asthma outbreaks and relapse.

During the first 20–30 min of a thunderstorm, patients suffering from pollen allergy may inhale a high concentration of the allergenic material that is dispersed into the atmosphere, which in turn can induce (severe) asthmatic reactions in some cases [3–6]. Even though thunderstorms can induce severe asthma attacks or exacerbations, they are neither frequent nor responsible for a high amount of disease exacerbation. However, physicians and pollen allergy patients should know the mechanisms involved in the release of allergens from airborne pollen grains during thunderstorms and the associated risk in view of prevention. Information about the risk of an asthma attack is also relevant in subjects affected only by seasonal allergic rhinitis who can inhale lower airways pollen aerosol. In addition, there is a potential risk of thunderstorm-related relapse of asthma attacks in some patients. This constitutes a major concern nowadays as the possibility of thunderstorm-associated asthma outbreaks have become of dramatic actuality due to the ‘‘highly likely’’ increase in frequency of heavy precipitation events, including thunderstorms, projected by the climate change scenarios for the future decades [7].