Over 80% of children with asthma exhibit signs and symptoms of the disease before age 5. Forty percent of infants and young children who wheeze in response to a viral respiratory infection continue to have asthma symptoms throughout childhood. Since the 1970s morbidity and mortality rates have increased. For children between the ages of 0 and 4 years there has been 160% increase in asthma incidence from 1980 to 1994. Black Americans are hospitalized and die from asthma each year at a higher rate than other ethnic groups. More children aged 11 to 17 are hospitalized each year for asthma than other age groups. Possible explanations for the high rate of childhood asthma and asthma deaths include failure to diagnosis or adequately treat the disease, lack of recognition of severe signs and symptoms resulting in delayed treatment, an increase in air pollution, and failure to follow prescribed treatment plans.

Asthma is characterized by acute airway inflammation, bronchoconstriction, bronchospasm, edema of the bronchioles, and increased production of mucus. Characteristic signs and symptoms of asthma are chest tightness, cough, tachypnea, wheezing, anxiety, and dyspnea caused by airway narrowing. Unless treated promptly, asthma can lead to ineffective gas exchange and death. Status asthmaticus is a severe prolonged asthma attack that does not respond to usual treatment and is life threatening. Signs of severe bronchoconstriction in children include flaring of the nostrils, intercostals and suprasternal retractions, use of accessory muscles, agitation, and lethargy.

Wearing a face mask that warms the air and retains airway humidity is helpful in preventing exercise-induced asthma. Asthma caused by allergens such as dust mites, animal dander, cockroaches, and mold can be managed by removing as much of the offending allergen as possible from the child’s environment. Air filters, absence of tobacco smoke, hardwood floors rather than carpeting, and dusting daily are some of the measures used to control dust mites and other allergens. Desensitization treatments are also useful in controlling extrinsic asthma.