Under the weather: an epidemic thunderstorm asthma event in Leicester, June 2023

In the context of climate change and increasing global populations, thunderstorm asthma may become a greater threat at both individual and population levels. The unpredictable nature of epidemic thunderstorm asthma events makes them challenging to study; however, they can have devastating consequences. Novel approaches are required to characterise the mechanisms driving these events to allow researchers and other stakeholders to understand who is at risk and when. This will support the development of interventions that protect patients and healthcare services. In this commentary, we provide an overview of thunderstorm asthma and briefly describe an epidemic affecting Leicester, UK in June 2023. Our analysis highlights Cladosporium spores as a key player in mediating UK thunderstorm asthma. Low levels of background treatment in adults and an increase in emergency assessments but not hospitalisations in children suggest that epidemics could be prevented by improving awareness and ensuring access to standard inhaled therapies. Finally, we consider future risk and suggest research priorities with an ultimate goal of minimising the adverse impact related to thunderstorm asthma going forward.