First reported case of thunderstorm asthma in Israel

We report on the first recorded case of thunderstorm asthma in Israel, which occurred during an exceptionally strong eastern Mediterranean multicell thunderstorm on 25 October 2015. The storms were accompanied by intensive lightning activity, severe hail, downbursts and strong winds followed by intense rain. It was the strongest lightning-producing storm ever recorded by the Israeli Lightning Detection Network (ILDN) since it began operations in 1997. After the passage of the gust front and the ensuing increase in particle concentrations, documented by air-quality sensors, the hospital emergency room (ER) presentation records from three hospitals - two in the direct route of the storm (Meir Medical Center in Kfar Saba and Ha'Emek in Afula) and the other just west of its ground track (Rambam Medical Center in Haifa) - showed that the amount of presentation of patients with respiratory problems in the hours immediately following the storm increased compared with the average numbers in the days before. This pattern is in line with that reported by Thien et al. (2018) for the massive thunderstorm asthma epidemic in Melbourne, Australia. The increase in patient presentations to the emergency rooms persisted for an additional 48-72 h before going back to normal values, indicating that it was likely related to the multi-cell outflow. We discuss how the likelihood of incidence of such public health events associated with thunderstorms will be affected by global trends in lightning occurrence.