Doctors associate vaping with four cases of lung injury
Pittsburgh doctors suspect that four recent cases of lung injury may be associated with vaping, joining more than 50 similar cases in 10 states.
Although the cause of the injury is not proven, the young adult patients came to the hospital with symptoms of nausea, fever and weakness — similar to signs of flu or pneumonia, according to Dr. Michael Lynch, medical director of the Pittsburgh Poison Center at UPMC. In all of the concerning cases, the patients said they had vaped recently.
“Nationwide, it’s the same pattern,” Dr. Lynch said Friday.
On Thursday, Wisconsin health officials said they have seen 15 confirmed cases, with another 15 illnesses under investigation.
Dr. Lynch said the patients are older teens and young adults who show signs of an inhalation injury in lung X- rays, like damage caused by breathing in a chemical, such as chlorine.
“Lots of people vape,” he said, “so only a few dozen cases is relatively small. It’s the pattern emerging that makes us concerned. We may not be hearing about a lot of cases. That’s why it’s important to get the concern out.”
He said the federal Centers for Disease Control and Prevention and the Allegheny County and Pennsylvania health departments are on alert for reports of similar cases associated with vaping.
Health officials have been warning of possible vaping dangers for children, teens and young adults, primarily focusing
on the addictive qualities of nicotine, often contained in vaping liquid. Other risks cited by the CDC are the lack of knowledge about the longterm health effects of vaping as well as possible harmful substances in vaping aerosol and flavorings.
As they investigate the cases, Dr. Lynch said, health officials will try to find out about the products the patients used, including nicotine, THC, CBD and other cannabinoids.
“There’s been very little chemical testing yet,” he said, adding that the contents of vaping fluid can vary widely.
Another question, he said, is why the injury is only happening to some people.
In the Pittsburgh cases, he said, patients have had several days of symptoms getting worse, feeling sick to the stomach, getting more tired and weak.
“Over a few days, they get really sick,” he said and recovery can take a few days or a week or longer.
In the hospital, patients can get help breathing through a nose tube or a bipap machine. The sickest patients have needed a ventilator or a more sophisticated lung- bypass machine that brings more oxygen into the blood, known as ECMO ( extracorporeal membrane oxygenation).
Most people who are vaping and feeling sick are getting a viral illness, Dr. Lynch pointed out.
“The odds are they are just getting sick, but at the hospital, we’re getting more suspicious of this,” he said.
The debate over vaping — its safety and risks — will continue, Dr. Lynch said, but vaping products sold online or on the street are probably not as reliable as those sold in retail stores.
“Much like smoking, my recommendation is not to vape,” he said.
“If you make a decision to vape, I recommend only use pods and devices that have not been tampered with, that you’ve bought from a retailer … . Don’t buy from the internet, especially from nonverifiable sources. Don’t buy anything from the street.”
Until the cause of the injuries is known, he said, nothing is certain.
“Is it in a certain product, a flavoring?” he asked. “Does it have something to do with the vaping materials, the vape liquid? All those things are possible.”
Even overheating of the liquid could be the issue, he said, or it could be something completely different.
“We have to keep the possibility that it has nothing to do with vaping,” he said.
Dr. Lynch said the Pittsburgh Poison Center and other specialists at UPMC — pulmonary, pediatric critical care and toxicology — are working with national, state and county health officials to find links and common factors in patients’ cases.
“We can do more chemical testing across the country, to find similarities and find as many cases as we can; to do the forensic work to find the cause. We’re at an early stage now,” he said.
He recommended that people with the symptoms seek medical help.
“If it’s something like this, it can progress fairly quickly to a lung injury,” he said.
People with concerns and questions can call the Pittsburgh Poison Center, 24 hours a day, 7 days a week, at 1- 800- 222- 1222.