ROSS – The Ross county health District is warning against vaping and issues that are being reported.
Multiple states across the country have reported clusters of patients experiencing severe respiratory disease after using e-cigarette or vapor products. As of August 21, 2019, 153 possible cases have been reported across 16 states.
Patients have reported vaping in the weeks to months prior to illness. Many have acknowledged recent use of tetrahydrocannabinol (THC)-containing products; however, no specific product has been identified by all cases, nor has any product been conclusively linked to this clinical syndrome. An investigation has been initiated with interviews of patients to further study the issue.
Patients present with respiratory symptoms including cough, shortness of breath and fatigue. Symptoms worsen over a period of days or weeks before admission to the hospital. Other symptoms may include fever, anorexia, pleuritic chest pain, nausea, abdominal pain and diarrhea. Chest radiographs show bilateral opacities, typically in the lower lobes and CT imaging of the chest shows diffuse ground glass opacities, often with subpleural sparing. Evaluation for infectious etiologies were negative in all patients. Some patients had progressive respiratory compromise requiring endotracheal intubation but subsequently improved with systemic steroids.
At this time, it is unknown what is causing or contributing to the symptoms. Infectious etiologies should be ruled out. Aggressive supportive care is warranted, and in severe cases, it is recommended that pulmonary and critical care specialists are consulted. If an e-cigarette or vaping product is suspected as a possible etiology of a patient’s illness, it is important to inquire about the type of product and where the product was obtained and if samples of the product are available for possible analysis.
Here is what the CDC Center for Disease Control is saying:
CDC is providing consultation to state health departments about a cluster of pulmonary illnesses possibly related to e-cigarette product use, or “vaping,” primarily among adolescents and young adults. Many states have alerted CDC to possible (not confirmed) cases and investigations into these cases are ongoing. In addition, the U.S. Food and Drug Administration (FDA) is working with CDC and state health officials to gather information on any products or substances used and providing technical and laboratory assistance. FDA encourages the public to submit detailed reports of any unexpected tobacco- or e-cigarette-related health or product issues to the FDA via the online Safety Reporting Portalexternal icon. While some cases in each of the states are similar and appear to be linked to e-cigarette product use, more information is needed to determine what is causing the illnesses.
- More than 149 possible cases of severe lung illness associated with e-cigarette product use were reported by 15 states (CA, CT, IL, IN, IA, MN, MI, NC, NJ, NM, NY, PA, TX, UT, and WI) from June 28, 2019, to August 20, 2019.
- No deaths have been reported.
- CDC and states have not identified a cause, but all reported cases have e-cigarette product use or “vaping.”
- Available evidence does not suggest that an infectious disease is the principal cause of the illness.
- Investigators have not identified any specific product or compound that is linked to all cases.
- In many cases, patients reported a gradual start of symptoms including breathing difficulty, shortness of breath, and/or chest pain before hospitalization. Some cases reported mild to moderate gastrointestinal illness including vomiting and diarrhea and fatigue as well.
- In many cases, patients have acknowledged recent use of tetrahydrocannabinol (THC)-containing products while speaking to healthcare personnel or in follow-up interviews by health department staff; however, no specific product has been identified in all cases, nor has any product been conclusively linked to illnesses.
- Even though cases appear similar, it is not clear if these cases have a common cause or if they are different diseases with similar presentations. The State Departments of Health are investigating the possible cause of the illness by testing patient specimens and e-cigarette products. State-specific epidemiologic investigations are ongoing.
- The Wisconsin and Illinois departments of health have asked CDC for assistance investigating the illnesses in their states. The investigation is ongoing and more information will be shared as it is available.