|
 The updated guidance will also advise physicians on how to diagnose
and manage patients who may have both a lung infection and a vaping
injury.
Dr. Ram Koppaka, a medical officer with the Centers for Disease
Control and Prevention (CDC), said doctors need to be aware that
there is an overlap between the early symptoms of vaping injury and
common respiratory infections.
The CDC has already recommended doctors start asking patients about
their vaping history during routine visits, but gathering that
information is especially important as doctors evaluate patients
with respiratory symptoms from infectious causes.
"Both diagnoses must be evaluated,” Koppaka said in a phone
interview.
The CDC reported on Thursday that as of Oct. 8, 1,299 people in the
United States have had confirmed or probable cases of lung injuries
linked to vaping. Some 80% of those patients were under age 35, and
26 deaths have been linked to the illness.
Of 573 patients whose vaping habits have been evaluated so far, 76%
reported using THC - the psychoactive ingredient in marijuana - some
of whom also used nicotine vape products. Nearly a third said they
only vaped THC products, while 13% percent said they only vaped
nicotine.
Some U.S. doctors have raised concerns that vaping injury cases will
be missed in the crush of patients seeking treatment for seasonal
flu and other respiratory ailments.
The early symptoms of vaping injury include shortness of breath,
cough, chest pain, fever, and in some cases, gastrointestinal
symptoms such as nausea, vomiting and diarrhea. "All of those can
also be seen with influenza," Koppaka said.
In the United States, flu activity starts to pick up in October and
November and typically peaks between December and February.
"The fact that a given individual that presents for clinical
evaluation could have flu, could have lung injury due to
e-cigarettes, or both, makes it complicated for providers," Koppaka
said.
As many as 72% of the earliest vaping patients in Illinois and
Wisconsin sought medical treatment in outpatient clinics and
emergency rooms before doctors admitted them to a hospital with
severe lung injuries from vaping, state officials reported last
month in the New England Journal of Medicine.
Most of those patients initially were given antibiotics. When those
failed, many responded to treatment with supplemental oxygen and
steroids.
[to top of second column] |
'ENDED UP IN AGONY'
In addition to flu, many respiratory infections, including fungal
infections, can cause symptoms that could confound doctors and delay
a vaping injury diagnosis.
The University of Utah Hospital in Salt Lake City has treated 22
patients with vaping injuries, including Jeffrey Manzanares, 33, who
was also infected with a cold and human metapneumovirus that led to
pneumonia.
Manzanares, who said he routinely vaped nicotine and occasionally
vaped THC, first sought treatment at a local hospital on Sept. 3,
where he was given an antibiotic and oxygen for his pneumonia and
sent home, his vaping injury undetected.
"I ended up in agony from the lack of oxygen. It felt like someone
was stabbing a knife into my whole body," he said in a phone
interview.
He went to the University of Utah Hospital the next day, where he
spent 21 days, including 17 in intensive care. During his illness,
Manzanares said he lost 50 pounds (22.7 kg), a third of his normal
body weight.
"He was wildly sick," said Dr. Scott Aberegg, a pulmonologist who
treated Manzanares. "If that is any harbinger of what is to come in
viral pneumonia season, this could be very problematic."
Aberegg said many doctors who get back a positive flu test may just
assume the patient has the flu and not realize they are also a vaper.
State health officials are on alert.
"We want to make sure to investigate all cases that are reported and
make sure we don't miss anything that may be thought of as flu or
may be associated with vaping or vice versa," Dr. Pam Pontones,
Indiana's deputy health commissioner and state epidemiologist, said
in a phone interview.
Influenza can be deadly in people who have other underlying
illnesses.
"It's really important that anyone, but especially people who have
underlying pulmonary infections of any kind, be vaccinated for
influenza," Pontones said.
The CDC recommends everyone over the age of six months get a flu
shot.
(Reporting by Julie Steenhuysen; Editing by Bill Berkrot)
[© 2019 Thomson Reuters. All rights
reserved.] Copyright 2019 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
