Puerto Rico Baffled by High Asthma Rate

Newsmax, December 27, 2010

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Puerto Rico is a U.S. Caribbean territory where children are nearly 300 percent more likely to have the respiratory ailment than white non-Hispanic children in the continental United States. And this year, Puerto Rico has seen a jump in asthma cases, which health officials suspect might be linked to the heavy rains that have unleashed millions of spores.

The island, with a population of 4 million, already has 2.5 times the death rate stemming from asthma as the mainland, according to the U.S. Centers for Disease Control and Prevention. Puerto Ricans in the U.S. also have been hit hard by asthma, with an asthma attack rate 2.5 times higher than for whites.

Adding to the problem is that Puerto Rican children do not respond as well as those from other ethnic groups to the number one medication prescribed to asthmatics: Albuterol, which comes in an inhaler used to relieve sudden attacks. As a result, several major pharmaceutical companies are working to create another medication, but they are still years away from doing so.

“What’s a challenge is that Puerto Ricans are not all the same,” said Dr. Esteban Gonzalez Burchard, director of the Center for Genes, Environments & Health at the University of California, San Francisco. “(They) are racially mixed.”

Those with European ancestry are likely most at risk of developing asthma, he said.

No one knows for certain why Puerto Ricans suffer so much from asthma, despite decades of research.

Theories include volcanic ash that drifts in from nearby Montserrat, clouds of Sahara dust that blanket the city in the summer and fungi that flourish in the tropical humidity–particularly bad this year, the wettest on record.

Some researchers suspect poverty {snip}.

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Puerto Ricans, even when living in the same environmental conditions as other ethnic groups, still show higher rates of asthma, he said, which suggests that genes are at least partly to blame.

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An average of 25,000 asthma-related emergency room claims are filed a year, and in the span of one year, nearly 90,000 Puerto Rican adults could not work or do regular activities because of asthma, according to a 2007 and a 2009 study by the island’s health department.

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Nearly 30 percent of children in Puerto Rico are diagnosed with asthma, and the rate increases to 40 percent among kids in public housing projects, said Dr. Floyd Malveaux, former dean of the College of Medicine at Howard University.

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