Every few years there is a mini-epidemic. I guess I would say in Melbourne. Generally in November, generally around the same climatic conditions. But Melbourne seems to be the centre and certainly this last event was the largest that we’ve had in the world. The ryegrass in Northern or Northwest Victoria gets taken up when the thunderstorm storm event happens and the granules of pollen of rye grass pollen actually explode. These make them much smaller and able to be breathed into the respiratory tract although the nose normally filters out such granules in this situation we have people at high risk of allergy either having had asthma before or having had a tendency to asthma or an underlying tendency to asthma with their hay fever suddenly having an acute load of what we call allergen and that can present as asthma as wheeze as shortness of breath inability to breathe these may be quite acute in onset and quite distressing if you’ve not experienced them before. Well obviously such unprecedented events can have a major impact on the health system. We have to remember that this can be acute and catastrophic and that we need to take precautions. The people who present with thunderstorm asthma are classically people who have ryegrass allergy, they classically have a history of hay fever. Those people may never have had asthma before may only have had hay fever and if the climatic conditions are right, they may present with their first episode of asthma during such a thunderstorm event. If you know you have asthma and it’s well controlled, be alert, be prepared, take your medications, have your asthma plan ready? So the four steps of asthma first aid are: set the person down and then give them four puffs of the blue or grey reliever inhaler Wait for four minutes. If they’re still not feeling 100% repeat and if they’re still not feeling better call the ambulance. If you have had severe hay fever or hay fever any type really and you know that you’ve got rye grass pollen allergy or you’ve wheezed in the past, see your doctor to discuss how you might prevent an episode of thunderstorm occurring to you.