Childhood asthma rates are up all over the world.  That, in and of itself is troubling news.  But on one tiny island, the trouble is worse than ever.  The U.S. territory of Puerto Rico has one of the highest asthma diagnosis rates in the world – nearly 300 times higher than that of white, non-Hispanic children in the rest of the country.  And health experts are scrambling to find out why.

According to the U.S. Centers for Disease Control and Prevention Puerto Rico already has 2.5 times the death rate due to from asthma as the mainland.  And no one really knows why.  Theories include everything from the volcanic ash that drifts in from Monserrat to the clouds of Sahara dust that blanket the city in the summer to tropical fungi to simple poverty and poorly kept up public housing projects.

But the most troubling piece of the puzzle is that Puerto Ricans aren’t just vulnerable while in Puerto Rico.  Puerto Ricans living in the mainland U.S. have an asthma attack rate 2.5 times higher than for whites.  And for some reason, Puerto Rican children don't respond as well to Albuterol, the medication most often prescribed to treat asthma.

U.S. and Puerto Rican health officials have launched a number of research projects to get to the bottom of the problem, but in the meantime, the epidemic is costing the island untold amounts in missed school and work days, burdening its already overburdened health care system, and worrying parents island-wide.

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