What are the health risks of vaping?
People with vaping illness, also called vaping-associated lung injury, have symptoms that could be mistaken for the flu. These can include shortness of breath, dry cough, chest pain, abdominal pain, nausea, vomiting and high levels of inflammatory markers in the blood. Many people also experience fever, body aches, and heavy night sweats. Severity varies widely, with some patients experiencing only mild symptoms while others develop serious, life-threatening illnesses.
How many cases have there been at University of Utah Health?
The first cases were diagnosed in June 2019 and new cases continue to emerge. In December 2019, there were 31 confirmed cases of vaping-related lung diseases. Other suspected cases are awaiting confirmation through testing.
How is vaping illness treated?
Patients are treated with supportive care, including oxygen, while more severe cases are treated with anti-inflammatory steroids. While mild cases improve within 5-7 days, more severe cases can take weeks to recover. The most serious cases are admitted to intensive care, and some require life support.
How is the condition diagnosed?
Lung scans of patients with vaping illness resemble severe viral or bacterial pneumonia, but tests for infection are negative. Instead, the diagnosis is based on the exclusion of known causes of similar respiratory diseases, combined with the knowledge that the patient has a history of vaping.
Doctors at University of Utah Health have done just thatan additional property identifiedin the vast majority of vaping illness cases they've seen. Bronchoscopy reveals signs of inflammation along with immune cells called macrophages, which contain oil or a fatty material, also called lipid-laden macrophages. This finding is obvious and not seen in patients with infection or most other causes of respiratory disease.
Initially, some categorized vaping illnesses as a type of lipoid pneumonia, but current evidence makes this connection unclear. There are significant differences between the two conditions.
Why might identifying the additional marker be useful?
Although it is too early to be sure, lipid-laden macrophages may be a useful marker to confirm or rule out the disease. The marker may also provide clues to understanding the mechanism and cause of the disease. It can also help identify the specific ingredient or component in a vaping product that leads to illness.
Is the cause of vaping-related lung disease known?
So far, no vaping product ingredient or device has been linked to all cases. Some reports have suggested that vaping THC (the psychoactive component of cannabis) is linked to the disease, but a significant number of cases in the United States had not used these products. The Centers for Disease Control and Prevention says that while vitamin E acetate appears to be linked to lung damage caused by vaping, many different substances and product sources are being investigated, and there may be more than one cause.
What is University of Utah Health doing to better understand this disease and the dangers of vaping?
The first step was todescribe this incipient syndrome, including the lipid-laden macrophages found in the lungs of patients by bronchoscopy. Doctors and pathologists are now looking for additional signs and markers that can help better understand the mechanism and cause of the disease.
Furthermore, little is currently known about how people who have experienced vaping illness fare in the long term. U of U Health will follow a group of patients to determine the effects of the disease over time.
Is vaping safe?
Because the specific causes of vaping-related lung diseases are not known, it cannot be said at this time that vaping products are safe. It is recommended that people avoid vaping until the cause of the disease is determined.
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