• newswise-fullscreen FAQs: Vaping Illness

    Credit: University of Utah Health

    Chest x-ray of a patient (left) with a severe case of the vaping illness (right) and after recovery. White cloudy areas represent inflammation in the lungs, black is healthy lung tissue.

  • newswise-fullscreen FAQs: Vaping Illness

    Credit: Jen Pilgreen

    Vaping pen

  • newswise-fullscreen FAQs: Vaping Illness

    Credit: Andrew Hansen, MD, Jordan Valley Medical Center

    Lipid-laden macrophages are a previously unrecognized characteristic of vaping-related respiratory illness.

  • newswise-fullscreen FAQs: Vaping Illness

    Credit: Jen Pilgreen

    University of Utah Health critical care pulmonologists Sean Callahan, MD, and Sean Maddock, MD.

What are the symptoms of vaping illness?

People with vaping illness, also referred to as vaping-associated lung injury, have symptoms that can 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 fevers, body aches, and drenching night sweats. The severity varies widely, with some patients experiencing only mild symptoms, while others develop serious, life-threatening illnesses.

What is the treatment?

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 severe cases are admitted to the ICU, and some have required life support.

How many cases have there been at University of Utah Health?

The first cases were diagnosed at U of U Health in June 2019, and new cases continue to arrive. As of September 16, 2019, there have been 15 confirmed cases of vaping-related lung illness. Additional suspected cases await confirmation by testing.

How is the condition diagnosed?

Lung scans from patients with vaping illness look like a serious viral or bacterial pneumonia, but those tests for infection come back negative. Instead, diagnosis has been based on exclusion of known causes of similar respiratory illnesses combined with knowing the patient has a history of vaping. 

U of U Health physicians have identified an additional characteristic in the vast majority of vaping illness cases they have seen. Bronchoscopy reveals signs of inflammation along with immune cells called macrophages that contain oil or a fat-like material, also called lipid-laden macrophages. This finding is distinct and is not seen in patients with infection or most other causes of respiratory illness.

Why might identification of the additional marker be useful?

While it is too soon to be sure, lipid-laden macrophages may be a helpful marker for confirming or ruling out the disease. The marker may also offer clues to understanding the mechanism and cause of illness. It could also possibly help identify the specific ingredient or component of a vaping product that is leading to illness.

Is the cause of vaping-related lung illness known?

So far, no single vaping product ingredient or device has been tied to all cases. Some reports have suggested that vaping THC (the psychoactive component of cannabis) is linked to the illness, but a substantial number of cases throughout the United States had not been using THC products.

What is being done to better understand this illness?

The first step at U of U Health was to describe this nascent syndrome, including the lipid-laden macrophages found with bronchoscopy in the lungs of patients. The next step is to do additional research to look for other clues that could help better understand the mechanism and cause of disease.

In addition, little is known at this stage about how individuals who experienced vaping illness fare over the long term. U of U Health will be following up with a group of patients to determine long-term effects of the disease.

What is the current recommendation on vaping?

Because the specific causes of vaping-related lung illness are not known, it is not possible at this time to say that any vaping products are safe. It is recommended that people should not vape until the cause of illness is determined.

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