Reporting childhood asthma: why? Why not? What else?

Childhood asthma is a chronic inflammatory disorder of the airways. It is a multifactorial disease that has been associated with familial, infectious, environmental, socioeconomic, and psychosocial causes. In the US alone, asthma is the most common chronic disease of childhood. In 1999, the estimated annual cost of treating asthma in children in the US was $3.2 billion. Public health authorities have argued for making childhood asthma a notifiable disease, with the hopes of identifying modifiable sources and reducing adverse consequences. As of the end of the 20th century, however, no jurisdictions in North America require physicians to report pediatric asthma. Would mandatory reporting help public health agencies reduce the asthma burden? What harm might come from obliging physicians to report childhood asthma? In this article we provide a thorough evaluation of these issues, the rationale behind the controversy, and long-awaited answers to these difficult questions.