Statistics from Altmetric.com
Sir,Historically, a total solar eclipse has been regarded as a sign of divine discontent and a warning of imminent death and destruction. Fortunately, when on 11 August 1999 the solar eclipse was experienced by millions across the UK and elsewhere, the only major health sequel reported to date has been a handful of cases of solar retinopathy.1 Specific environmental and climatic changes are well-recognised features during a solar eclipse and include a sharp fall in temperature, an ‘eclipse gust front’ despite a drop in overall wind speed, a rise in humidity and a variable change in atmospheric pressures.
We wish to report the case of a 45-year-old pregnant woman with late onset of brittle asthma who experienced an acute exacerbation of asthma during the eclipse. There had been no deterioration in the control of her asthma during the pregnancy, although she had been recently admitted with an early miscarriage of one foetus of a twin pregnancy. She gave a clear history of having experienced increased shortness of breath with wheeze at the time of the eclipse. This was associated with a fall in her peak flow readings and was managed with nebulised bronchodilators. The previously identified major precipitant of her asthma had been changes in environmental temperature.
Exacerbations of asthma have been reported in association with a variety of environmental changes including lightening strikes,2 a high pollen count,2 3 and environmental pollution.4 An absolute fall in ambient temperature3 and the velocity of temperature change5 have also been described as precipitating an exacerbation of asthma. A rapid fall in temperature from 17.2 to 14.5° C and rise in humidity (60–88%) was recorded at the time of the eclipse (personal communication, meteorological office). The pollen count on that day was low. Although we acknowledge that psychological factors related to the eclipse may have played a part, we postulate that it was the rapid change in temperature that was the precipitant in this case. As far as we are aware this is the first case reported of eclipse-associated exacerbation of asthma. As a change in the ambient temperature is linked to exacerbations of asthma, we would expect to hear of similar cases.