Tuesday , January 31 2023

Mystery Lung Illness Linked To Vaping. Nearly 100 Cases Suspected In US


Officials are not sure whether the illnesses are linked with the e-cigarette devices. (Representational)

State and federal health officials are investigating almost 100 cases of mysterious lung illnesses linked to vaping and e-cigarette use in 14 states, many of them involving teens and young adults. A large number of those stricken ill have been hospitalized, with some in intensive care and on ventilators.

At least 31 cases have been confirmed by Friday, state officials said, and dozens more are under investigation. Medical authorities say it is unclear whether patients will fully recover.

Officials are warning clinicians and the public to be an alert for what they describe as a severe and potentially dangerous lung injury. Symptoms include difficulty breathing, shortness of breath or chest pain before hospitalization. Health officials said the patients also reported fever, cough, vomiting, and diarrhea.

The Centers for Disease Control and Prevention said Friday that officials have been working with health departments in California, Illinois, Indiana, Minnesota and Wisconsin – to determine the cause of the condition after a "cluster of pulmonary illnesses linked" to e-cigarette use "was reported among adolescents and young adults in recent weeks. CDC officials said they were probing 94 possible cases in 14 states.

To date, there is no consistent evidence that an infectious disease is a culprit, said CDC spokeswoman Kathy Harben. While some of the cases appear similar, officials say they are not knowing whether the illnesses are associated with the e-cigarette devices themselves, or with specific ingredients or contaminants inhaled through them. Health officials have said that patients have vaping a variety of substances, including nicotine, esophagus-based products, and do-it-yourself "home brews."

Underscoring the growing level of concern, CDC officials say they are notifying health-care systems and clinicians across the country about the illnesses and what to watch for. State health departments have also issued warnings.

E-cigarettes have grown in popularity over the past decade despite their little research on their long-term effects. In recent years, health authorities have warned of an epidemic of vaping by underage teenagers. The leading brand, Juul, said it was monitoring the reports of illnesses and has "robust safety monitoring systems in place."

Gregory Conley, president of the American Vaping Association, a group that advocates for vaping products, said that every month, about 10 million adults vape nicotine without major issues. "It seems much more likely that the products are causing lung damage to american-made street vapes containing THC or illegal drugs, not nicotine," he argued.

But health authorities are not at all sure that is correct.

Emily Chapman, Chief Medical Officer at Children's Minnesota, is a healthcare system headquartered in Minneapolis, which has cared for four teens with the illness, ages 16 to 18.

Chapman said in the past month that teenagers were presented with symptoms that appeared manageable and consistent with a viral infection – shortness of breath, coughing, fever and abdominal discomfort. But the teens continued to deteriorate despite treatment, including antibiotics and oxygen support. Some of the teens suffered respiratory failure, requiring the use of ventilators, she said.

Chapman said physicians were eventually making a connection with a swab-related acute lung injury. When the patients were treated with steroids, among other therapies, they showed improvement. Clinicians do not know if the patients will suffer long-term consequences, she said.

"These cases are extremely complex for diagnosis, as symptoms can mimic a common infection, but can lead to severe complications and extended hospitalization," Chapman said. "Medical attention is essential." Respiratory conditions can continue to decline without proper treatment.

E-cigarettes are a diverse group of products that can be consumed by a mouthpiece. Millions of Americans use e-cigarettes, with the greatest use among young adults. In 2018, more than 3.6 million U.S. middle-and high-school students said they had used e-cigarettes in the past 30 days, according to the CDC.

A National Academies of Science, Engineering and Medicine report in January found that while e-cigarettes are less harmful than conventional cigarettes, they still pose health risks. Among the nonsmoking adolescents and young adults, the report says, "their adverse effects are clearly warrant concern," among which "moderate evidence for increased cough and wheeze" and increased insidence of asthma.

But many medical authorities believe that there is not enough data to know their full effects, especially on young people.

Dylan Nelson, of Burlington, Wisconsin, who has asthma and has been vaping for a year, was hospitalized with pneumonia last month after he started having trouble breathing. The 26-year-old described feeling as if he were breathing through a straw. He said he was coughing, his heart was racing and his breathing was hard and fast.

Nelson said he spent the days in the hospital, some of that time attached to a ventilator. His mother, Kim Barnes, said when a nurse told her it could be related to vaping, it was a wake-up call for her.

Now, she wants to convey that sense of urgency to other parents: "You need to sit down and tell them the dangers of this stuff. you decide to pick up this stuff and start using this. "

The state of Wisconsinhad was 15 confirmed cases, including the Nelson's, and another 15 under investigation, the health department said. The first cases were among younger adults, but newer ones included patients in older age groups, officials said. All the patients reported vaping in the weeks and months before being hospitalized, but officials said they did not know the names and types of products used.

Minnesota's health department, meanwhile, has urged providers to "be vaping as a cause for unexplained breathing problems and lung injury and disease." It is asking clinicians to look for similar cases and report them.

"There are still many unanswered questions," said Ruth Lynfield, a Minnesota state epidemiologist and health department's medical director. "But the health harms emerging from the current epidemic of youth vaping in Minnesota continue to increase."

Doctors had seen "scattered cases" of lung illnesses tied to vaping before, but they did not identify a pattern until now, said Chapman of Children's Minnesota.

"I think it's important to understand that vaping is assumed to be safe, and yet we know little about it," she said.

(Except for the title, this story has been edited by NDTV staff and is published from a syndicated feed.)

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