Hay fever or asthma attack can both flare during Melbourne’s spring pollen season, but they are not the same condition. Hay fever usually causes sneezing, an itchy or blocked nose and watery eyes, while an asthma attack affects the lower airways and can cause wheezing, shortness of breath, coughing and chest tightness. For Melbourne residents, knowing the difference is particularly important because grass pollen and certain thunderstorms can trigger sudden and potentially life-threatening asthma symptoms — including in some people who have never previously been diagnosed with asthma.
Melbourne has good reason to take the connection seriously. On 21 November 2016, the city experienced the world’s largest recorded epidemic thunderstorm asthma event. Thousands of people developed breathing difficulties in a short period, and the event contributed to 10 deaths.
That does not mean every bout of spring hay fever is an asthma emergency. It does mean that wheezing or difficulty breathing should never simply be dismissed as “bad hay fever”.
Key Takeaways
- Hay fever mainly affects the nose and eyes, while asthma affects the lower airways and can make breathing difficult.
- Wheezing, shortness of breath and chest tightness are asthma symptoms, not typical symptoms of hay fever.
- People with springtime hay fever can be at increased risk of thunderstorm asthma, even without a previous asthma diagnosis.
- Victoria’s grass pollen season generally runs from 1 October to 31 December, when thunderstorm asthma risk is particularly relevant.
- Knowing asthma first aid can help you respond quickly if someone develops breathing difficulties.
Why Melbourne's Spring Can Be Difficult for People With Hay Fever
For many Melburnians, the arrival of spring is easy to recognise without looking at the calendar. Eyes become itchy, noses start running and sneezing suddenly becomes part of the daily routine.
Hay fever, medically known as allergic rhinitis, occurs when a person’s immune system reacts to allergens in the environment. Pollen is an important seasonal trigger.
Common symptoms of pollen-related hay fever include a runny, itchy or congested nose, sneezing, red or watery eyes and itching around the ears, throat or palate. (Better Health Victoria)
Victoria’s pollen patterns make this particularly relevant. The Victorian Department of Health reports that grass pollen is the most common cause of spring hay fever in Victoria. Although various trees flower in late winter and early spring, the state’s grass pollen season typically runs from October until the end of December, with higher grass pollen levels generally beginning around mid-October. (Health Victoria)
For somebody who regularly experiences hay fever, these symptoms can be irritating, tiring and disruptive.
But breathing difficulty changes the picture.
Hay Fever or Asthma Attack? Look at Where the Symptoms Are Occurring
One useful way to understand the difference is to think about which part of the respiratory system is being affected.
Hay fever primarily affects the upper airways, particularly the nose, as well as the eyes. Asthma affects the lower airways in the lungs.
Typical asthma symptoms include wheezing, shortness of breath, a feeling of tightness in the chest and coughing. (Better Health Victoria)
That distinction matters…
A person who is sneezing repeatedly, has itchy watery eyes and has a streaming nose may be experiencing typical hay fever symptoms.
A person who is struggling to breathe, wheezing or complaining that their chest feels tight may be experiencing asthma symptoms and needs a different response.
It is also possible to have both conditions.
The Australian Asthma Handbook notes that asthma and allergies are closely linked and that allergic rhinitis is common among people with asthma. It also identifies seasonal allergic rhinitis associated with perennial ryegrass sensitisation as an important risk factor for thunderstorm asthma. (Australian Asthma Handbook)
So the question is not always “Is this hay fever or asthma?”
Sometimes it is hay fever and asthma.
Don't Assume Wheezing Is Just Severe Hay Fever
This is an important distinction for first aid.
Hay fever can make someone miserable. A badly blocked nose can make breathing feel uncomfortable, particularly when the person is trying to sleep or exercise.
But wheezing and shortness of breath should not simply be written off as an unusually severe case of hay fever. Victorian health guidance specifically identifies wheezing, shortness of breath, chest tightness and persistent coughing as asthma symptoms.
A person can also develop asthma as an adult. Someone who has never been diagnosed with asthma should therefore not assume that breathing difficulties cannot be asthma.
If a person regularly develops coughing, wheezing or shortness of breath during pollen season, they should discuss those symptoms with their doctor rather than simply treating them as part of their usual hay fever.
For Melbourne residents, there is another reason to pay attention to that distinction.
The Melbourne Connection: Thunderstorm Asthma
Thunderstorm asthma sounds unusual until you understand what is happening in the air.
In Victoria, epidemic thunderstorm asthma can occur when high levels of grass pollen combine with a particular type of thunderstorm.
Grass pollen can be carried by the wind and some pollen grains can rupture, releasing much smaller particles. These tiny allergenic particles can become concentrated in the wind gusts associated with the storm and are small enough to be inhaled deep into the lungs. In susceptible people, they can rapidly trigger asthma symptoms. (Better Health Victoria)
When many people develop asthma symptoms over a short period under these conditions, it is described as epidemic thunderstorm asthma.
These events are uncommon and do not happen every year.
But Melbourne knows how serious they can become.
The 21 November 2016 Melbourne event was unprecedented in scale. Victorian Government reporting records a 672% increase in respiratory-related presentations to Melbourne and Geelong public hospitals during the 30 hours from 6 pm that evening, representing 3,365 more presentations than expected. The event contributed to 10 deaths.
That event led Victoria to establish a comprehensive Epidemic Thunderstorm Asthma Program, including public education, health-system preparedness, pollen monitoring and a risk forecasting system.
You Don't Need to Have Diagnosed Asthma to Be at Risk
This is perhaps the most important point for someone who thinks, “I only get hay fever.”
According to Victorian health advice, people at risk of thunderstorm asthma include those with current asthma, past asthma, undiagnosed asthma and springtime hay fever. The risk is higher again for people who have both asthma and hay fever, particularly when their asthma is poorly controlled.
In south-eastern Australia, springtime hay fever is frequently associated with grass pollen.
This means someone can have a history of hay fever, no previous asthma diagnosis, and still develop asthma symptoms during a thunderstorm asthma event. That is why new wheezing or shortness of breath deserves attention.
The Victorian Government advises people who have experienced wheezing or shortness of breath during grass pollen season to speak with their GP. (Health Victoria)
When Does an Asthma Attack Become an Emergency?
Asthma symptoms can vary considerably in severity.
Someone experiencing a mild to moderate asthma flare-up may have a cough or wheeze and some difficulty breathing while still being able to speak normally.
As an attack becomes severe, breathing can become obviously difficult. The person may have difficulty speaking a complete sentence in a single breath and their reliever medication may not provide its usual relief.
Signs of a life-threatening asthma emergency can include gasping for air, being able to say only one or two words per breath, becoming confused or exhausted, developing blue lips, collapsing or receiving little or no relief from reliever medication. Importantly, a person with life-threatening asthma may no longer be wheezing or coughing. (WPHU)
Do not wait for every possible sign before acting.
Victorian guidance recommends calling Triple Zero (000) immediately if the person’s asthma suddenly becomes worse or is not improving, if there is no reliever medication available during an asthma attack, if you are unsure whether the problem is asthma, or if the person is not breathing.
Asthma First Aid: Know What to Do
When someone is having an asthma attack, knowing a simple first aid sequence can make the situation far less confusing.
If the person has their own written Asthma Action Plan, follow it.
For the commonly taught asthma first aid procedure using a blue/grey salbutamol reliever puffer and spacer:
- Sit the person upright. Keep them calm, reassure them and stay with them.
- Give four separate puffs of the blue/grey reliever puffer, one puff at a time through a spacer where available. Have the person take four breaths through the spacer after each puff.
- Wait four minutes and monitor their breathing.
- If they are still unable to breathe normally, give another four puffs. If the person’s condition is worsening or they have severe breathing difficulty, call Triple Zero (000). Continue giving four puffs every four minutes until the ambulance arrives. (Better Health Victoria)
There can be differences in first aid instructions depending on the person’s age and the type of reliever device being used, so current Australian asthma first aid guidance and the person’s Asthma Action Plan should always take precedence.
And remember: if you are uncertain whether somebody experiencing breathing difficulty is having asthma, Victorian guidance says to call Triple Zero (000).
What if It Could Be Anaphylaxis?
Breathing difficulties are not exclusive to asthma.
A severe allergic reaction or anaphylaxis can also cause breathing problems, and the distinction is critically important because the emergency treatment is different.
If a person is known to be at risk of anaphylaxis and develops sudden breathing difficulty, Victorian guidance says to give the adrenaline autoinjector first and then asthma reliever medication, even when there are no skin symptoms. Call Triple Zero (000).
This is one reason practical first aid knowledge matters.
In a real emergency, the casualty may not present with a neat list of textbook symptoms. A trained first aider needs to assess what is happening, recognise warning signs, follow the appropriate emergency procedure and know when professional medical help is required.
A recognised first aid course with First Aid Pro Melbourne gives participants the opportunity to learn and practise responses to medical emergencies, rather than relying on something half-remembered from an article when somebody is struggling to breathe.
How Melbourne Residents Can Prepare for Grass Pollen Season
Victoria now operates an epidemic thunderstorm asthma risk forecasting system during the grass pollen season, from 1 October to 31 December.
The forecast combines grass pollen information with weather conditions associated with epidemic thunderstorm asthma and provides a three-day risk level of low, moderate or high. The Department of Health recommends using VicEmergency to stay informed and allows Victorians to establish watch zones to receive relevant advice and warnings.
People at increased risk are advised to avoid exposure to storms during grass pollen season, particularly the strong wind gusts that can arrive before a storm. Going indoors, closing doors and windows and switching off air-conditioning systems that bring outside air indoors can reduce exposure.
People with asthma should also manage their condition according to medical advice, keep prescribed reliever medication available and know their Asthma Action Plan.
People with hay fever should not ignore their condition either. Good hay fever management is part of reducing thunderstorm asthma risk, and anyone who experiences wheezing, chest tightness, coughing or shortness of breath should discuss those symptoms with a health professional.
Why First Aid Training Still Matters
Reading about asthma first aid is useful. Having to use it when someone suddenly cannot breathe is very different.
In an emergency, you may need to decide whether the person is experiencing asthma, recognise that their condition is becoming severe, find their medication, use a spacer correctly, call Triple Zero and continue supporting them until paramedics arrive.
Those decisions are easier when you have learned first aid in a structured environment.
HLTAID011 Provide First Aid is a nationally recognised unit that includes responding to a range of emergency situations, and the unit remains current on Australia’s National Training Register. (National Training Register)
For Melbourne workplaces, parents, carers and members of the community, completing a recognised First Aid Pro Melbourne first aid course can build the practical knowledge needed to respond when an ordinary day suddenly becomes an emergency.
You cannot predict when somebody beside you will develop breathing difficulties. You can make sure you have a better idea of what to do if it happens.
Hay Fever and Asthma Can Look Similar — but the Difference Matters
Melbourne’s spring weather gives people with hay fever plenty to complain about. Sneezing, watery eyes and a relentlessly runny nose can make pollen season difficult enough.
But breathing problems belong in a different category.
Wheezing, chest tightness and shortness of breath are signs that the lower airways may be involved. They should not be dismissed as “just hay fever”, particularly during Victoria’s grass pollen season.
Melbourne’s experience with thunderstorm asthma has demonstrated why that distinction matters. A person does not necessarily need a previous asthma diagnosis to experience serious asthma symptoms during the right environmental conditions.
- Know your symptoms.
- Manage diagnosed asthma and hay fever appropriately.
- Pay attention to Victorian pollen and thunderstorm asthma forecasts during the grass pollen season.
- And if someone’s breathing becomes seriously affected, treat it as the emergency it can be.
Learning these responses through a recognised first aid course with First Aid Pro Melbourne can turn first aid information into something much more useful: the ability to act when another person needs help.
Related Reading
Better Health Victoria – Asthma management
Western Public Health Unit – Thunderstorm asthma
Victorian Dept. of Health – Improved protection for Victorians this Thunderstorm Asthma season
Better Health Victoria – Thunderstorm asthma
Australian Asthma Handbook – Allergy and asthma
Better Health Victoria – Asthma explained
Better Health Victoria – Pollen allergies
FAQs
How can I tell the difference between hay fever and asthma?
Hay fever generally causes upper-airway and eye symptoms such as sneezing, an itchy or blocked nose, runny nose and itchy, watery eyes. Asthma affects the lower airways and commonly causes wheezing, shortness of breath, chest tightness and coughing. A person can have both conditions at the same time.
Can hay fever turn into an asthma attack?
Hay fever itself is not simply an asthma attack, but the conditions are closely associated. People with allergic rhinitis are more likely to have asthma, and springtime hay fever associated with grass pollen is an important risk factor for thunderstorm asthma.
Can you get thunderstorm asthma if you have never had asthma?
Yes. Victorian health authorities identify people with undiagnosed asthma and people with springtime hay fever among those at risk. Thunderstorm asthma can cause asthma symptoms in people who have never previously been diagnosed with asthma.
When is thunderstorm asthma season in Melbourne?
Victoria’s grass pollen season typically runs from 1 October to 31 December, and the state’s epidemic thunderstorm asthma risk forecasting system operates during this period. Events are uncommon and do not occur every year.
When should I call Triple Zero for an asthma attack?
Call Triple Zero (000) if the person’s asthma suddenly becomes worse or is not improving, they have severe breathing difficulty, there is no reliever medication available, you are unsure whether the breathing problem is asthma, or the person is not breathing. If the person is known to have anaphylaxis, give their adrenaline autoinjector first and call Triple Zero.
