A noticeable surge in asthma cases among children is being reported across North India as seasonal transition, rising pollen levels, and fluctuating air quality begin to impact respiratory health.
Doctors say children between the ages of five and 12 are the most affected, though younger children are also vulnerable, often presenting with symptoms that are mistaken for routine cough or viral infections. The shift from late winter to early summer, marked by environmental changes, is emerging as a key trigger for asthma exacerbations.
“There is a concerning rise in asthma exacerbations among children in recent weeks,” said Dr Akshay Mehta Senior Consultant Neonatology and Paediatrics at Motherhood Hospitals Greater Noida.
He said asthma can occur at any age, but currently there are more flare-ups in children aged two–12 years. Younger children usually have viral-triggered wheezing, while school-going children are more affected by allergens like pollen, dust, and pollution.
“This pattern is quite typical around the transition from late winter to early summer in North India, when environmental triggers begin to change,” he added. “Increasing pollen levels, dust exposure, fluctuating temperatures, and worsening air quality are the factors contributing to airway irritation and asthma flare-ups.”
He further said that two to three children are coming every day with symptoms such as persistent cough, wheezing, breathlessness, chest tightness, and reduced tolerance to physical activity. “In younger children, recurrent coughing after running or playing and disturbed sleep due to cough can often be early clues.”
Early signs often missed
Experts warn that early symptoms of asthma in children are frequently overlooked or misinterpreted as seasonal illness, leading to delays in diagnosis and treatment.
“We are definitely seeing a rise in asthma cases among children over the past few weeks,” said Dr Ravi Shekhar Jha Director Pulmonology Fortis Escorts Hospital Faridabad.
“The most affected group is typically school going children, roughly between five and 12 years. This is the age where exposure increases and airways are still sensitive.”
He said the earliest symptoms are often subtle and easily missed. “Recurrent dry cough, especially at night or early morning, reduced stamina while playing, or a child who avoids physical activity are common early signs. Many parents dismiss these as seasonal cough or poor fitness.”
Echoing this, paediatric specialists say patterns in symptoms can help distinguish asthma from routine infections.
“One of the biggest concerns is that early signs of asthma are often mistaken for common cough or seasonal illness,” said Dr Sumit Chakravarty Associate Director Paediatrics and Neonatology and Head NICU Asian Hospital.
“Frequent coughing, especially at night or after physical activity, wheezing, shortness of breath, and easy fatigue are early signs of asthma.”
“If the cough is persistent, worsens at night, or is accompanied by breathing difficulty or chest tightness, it could indicate asthma. A routine cough usually resolves within a few days and does not affect breathing.”
Distinguishing asthma from routine cough
Doctors emphasise that recognising patterns is crucial in identifying asthma early and preventing complications.
“A routine cough usually improves in a few days and is not linked to breathing difficulty,” said Dr Vikas Taneja Director and Unit Head Pediatrics and PICU Max Super Speciality Hospital Dwarka. “In asthma, the cough may worsen at night, during exercise, or with cold air, and may be accompanied by wheezing or chest tightness. If the cough keeps returning, it needs attention.”
Environmental triggers behind the surge
The current spike in asthma cases is being attributed to a combination of environmental and lifestyle factors, with pollution and pollen acting together to aggravate symptoms.
“From a pulmonologist’s perspective, the current spike in North India is multifactorial,” said Dr Ravi Shekhar Jha.
“Air pollution remains a constant background trigger, but seasonal pollen, temperature fluctuations, and post-viral airway hyperreactivity are all contributing together.”
“At present, pollution and pollen act synergistically rather than independently. Pollution primes the airway, making it more reactive, and pollen then triggers symptoms more easily.”
Highlighting the broader environmental context, specialists point to urban exposure and seasonal variability as key contributors.
“The spike is largely due to a mix of seasonal changes, post-viral conditions, and increased allergens like pollen and dust,” said Dr Shivanshu Raj Goyal Associate Director and Unit Head Pulmonology Max Super Speciality Hospital Dwarka.
“Sudden temperature shifts also irritate the airways. Urban living, construction dust, and indoor pollution add to the problem, making both children and adults more vulnerable to asthma flare-ups.”
Another expert noted that while pollen is a major seasonal trigger, pollution continues to have a more sustained impact.
“Both pollen and air pollution can make asthma worse, but right now air pollution is a bigger problem in North India,” said Dr Arun Chowdhary Kotaru Head and Senior Consultant Respiratory Disease and Sleep Medicine Artemis Hospitals.
“Fine particles in polluted air can get deep into the lungs and cause irritation and inflammation continuously. Pollen effects are often shorter-lived, whereas pollution exposure is more constant and long-lasting.”
Risks of poor management
Doctors caution that untreated or poorly managed asthma can have long-term consequences on children’s health, including impaired lung development and frequent hospital visits.
“If asthma is not properly managed, it can lead to repeated exacerbations, school absenteeism, sleep disturbance, and in the long term, impaired lung growth,” said Dr Ravi Shekhar Jha.“Severe uncontrolled cases can even lead to emergency hospitalisation.”
Similarly, paediatric experts warn that ignoring symptoms can significantly impact a child’s daily life.
“Uncontrolled asthma can affect a child’s daily life, limiting play, disturbing sleep, and affecting school performance,” said Dr Vikas Taneja.
“Over time, it may lead to frequent hospital visits or severe attacks. Proper treatment and regular follow-up help children live normal, active lives without major restrictions.”
Gaps in treatment adherence
One of the major challenges in asthma management remains incorrect inhaler use and poor adherence to prescribed treatment.
“One of the most common issues we see is incorrect inhaler technique,” said Dr Ravi Shekhar Jha.
“Patients either do not inhale deeply enough, do not coordinate actuation with inhalation, or stop using inhalers prematurely once they feel better. This leads to poor control despite treatment.”
Other experts highlight similar concerns around misuse and discontinuation of medication.
“Many patients use inhalers incorrectly, like not shaking the inhaler, poor coordination between pressing and inhaling, or not holding their breath after use,” said Dr Shivanshu Raj Goyal.
“Some also stop medication once they feel better or use them only when symptoms worsen. These mistakes reduce effectiveness and lead to frequent flare-ups.”
Preventive measures and early care
Doctors stress that effective asthma management depends on early diagnosis, consistent medication use, and minimising exposure to triggers.
“Prevention focuses on good asthma control and trigger avoidance,” said Dr Akshay Mehta.
“Children already diagnosed with asthma should continue their controller medications regularly and not stop inhalers when they start feeling better.”
“Ensuring correct inhaler technique and adherence to treatment reduces flare-ups. Minimising exposure to dust and smoke, maintaining good indoor air quality, and wearing masks outdoors during high pollen or pollution days may also help.”
Experts also recommend simple home-based interventions to reduce exposure.
“Keeping windows closed during peak pollen times, using HEPA filters where feasible, regular wet mopping instead of dry dusting, and ensuring good inhaler adherence are practical and effective steps,” said Dr Ravi Shekhar Jha.
Paediatricians further emphasise the importance of routine care and awareness.
“Parents should not ignore persistent cough or breathing issues in children,” said Dr Sumit Chakravarty.
“Early recognition and proper treatment can help children lead a completely normal and active life.”
Need for awareness amid rising burden
With environmental triggers intensifying and cases rising, experts underline the urgent need for greater awareness among parents and timely medical intervention.
As seasonal transitions continue to impact air quality and allergen levels, clinicians say bridging the gap between symptom recognition and proper treatment will be critical in managing the growing burden of asthma among children
