Photo by Dani Ramos/Unsplash
Reports of severe lung ailments in teens and young adults across the nation who have also used e-cigarettes have health officials scrambling to determine what’s going on.
There were 215 people in 25 states with a severe lung illness who had also vaped through Aug. 27, according to the U.S. Centers for Disease Control and Prevention (CDC). There has been one death, in Illinois. As of Thursday, six reports originated in Virginia, but none have been reported in Richmond thus far. Other cases are being investigated in Virginia, according to the Virginia Department of Health.
Since 2014, teens have consumed more tobacco via vaping than by smoking traditional cigarettes, the Virginia Department of Health notes in a release. E-cigarettes are also used with marijuana products, including oils and extracts. The CDC notes that many of the people with respiratory illnesses had used e-cigarettes with “THC-containing products,” the psychoactive ingredient in marijuana.
Some patients have responded to steroid treatments, but there has been no response to antibiotics.
Symptoms in the reported cases are also symptomatic of other illnesses and may be vague, such as fatigue, malaise and nausea, along with chest pain and a cough. Some patients have gone on to develop severe respiratory distress, requiring treatment in an ICU and placement on a ventilator, says Rutherfoord Rose, director of the Virginia Poison Center at VCU Medical Center.
The state health department advises anyone with these symptoms who has used vaping products to see a doctor.
The CDC notes in a statement from its director, Robert Redfield, that vaping exposes a user to an array of substances, including nicotine, cannabinoids, solvents and flavorings. “E-cigarettes are not safe for youth, young adults, pregnant women or adults who do not currently use tobacco products,” according to Redfield.
It’s too soon to know whether there is a definitive link, or what the link may be, though as the number of cases rise, “that association becomes pretty strong,” says Rose.
“We’ve got to get our arms around this and determine if it’s real,” says Danny Avula, director of the Richmond City Health District and the Henrico County Health Department.
The CDC says that state health departments are testing vaping products and patient specimens. There are similarities, but medical investigators need to determine whether they are facing “different diseases with similar presentations,” according to Ileana Arias, the CDC’s acting deputy director for infectious diseases, in a briefing on Aug. 23.
Rose notes that epidemiologists will seek to determine whether there is a contaminant, or one bad product in particular. Many of the e-cigarette products are generic and can be refilled with virtually any liquid, he says.
“People will put almost anything into those cigarettes,” he says. “Hopefully, they can find a common denominator.”
There is much to determine: No mechanism of injury has been described, notes Rose, and there has been no infectious cause reported. That some people responded to steroids implies that inflammation is involved. Also, how long have the people with these illnesses been vaping?
The U.S. Food and Drug Administration is also seeking reports involving seizures in people who have used vaping products. The FDA reported that it has observed a slight but noticeable rise in reports of seizures experienced by people who had used e-cigarettes since June 2018, many of them younger users. The FDA says it is seeking additional information as it seeks to determine whether there is any common risk factor, and whether there is anything about the vaping product that may be involved. There were 127 reports of seizures or other neurological events in people who had vaped since 2019.
