FORT LEE, Va. – The Centers for Disease Control and the Food and Drug Administration are investigating more than 150 cases of severe pulmonary illness in multiple states among users of electronic cigarette products. These cases have been reported from June 28 - Aug. 20.
“At this time, Virginia does not have a confirmed case,” noted Stephen Pinkerton from the Fort Lee Public Health Emergency Office. “Information regarding the specific electronic cigarette products used is still being investigated. All cases have consistently involved regular use of various e-cig devices, also commonly referred to as ‘vaping.’ Many have reported the use of tetrahydrocannabinol-containing electronic cigarette fluids.”
The symptoms all patients have experienced include headaches, fatigue, nausea, coughing, pleuritic chest pain, shortness of breath, fever, diarrhea, anorexia and rapid weight loss.
Symptom onset has ranged from days to weeks, health officials report. While no deaths have occurred to date, some patients have had progressively worsening coughs, chest pains and shortness of breath. Many reported cases have required hospitalization, however, others have presented with less severe symptoms requiring only outpatient care.
At this time, there is no specific treatment for patients with symptoms “consistent with electronic cigarette-associated pulmonary disease and in which other likely causes of illness have been ruled out,” according to Pinkerton. Treatment is supportive. Most cases have not had clinical indications of infection and did not improve with antibiotics. Several reported cases have responded positively to steroid therapies. Some cases have required intensive care and mechanical ventilation. Other cases have self-resolved with close clinical monitoring and minimal supportive care over several days.
In recent years, e-cigarettes have become the most commonly used tobacco product among middle and high school students in the U.S. The CDC noted that between 2017-2018 alone, the number of youths who used e-cigarettes increased by 1.5 million. The U.S. Surgeon General has called e-cigarette use by young adults “an epidemic,” and warned it threatens decades of progress toward making sure fewer members of tomorrow’s generation use tobacco.
Electronic cigarettes are battery-operated devices that emit doses of vaporized nicotine or non-nicotine solutions for the user to inhale. It aims to provide a similar sensation to inhaling tobacco smoke, except there is no actual smoke in an e-cig. Other descriptions of e-cigs in advertising include vapes, e-hookahs, vape pens and electronic nicotine delivery systems. Some look like regular cigarettes, cigars, or pipes, and there are devices that look like USB flash drives, pens and other everyday items.
An increasingly popular e-cigarette device is the Juul. It is available in several flavors including fruit medley, mango, cool cucumber and mint. Use of the Juul is sometimes called Juuling. All have a high-level of nicotine. According to the manufacturer, a single Juul pod contains as much nicotine as a pack of 20 regular cigarettes. Since 2017, it has been was the top-selling e-cigarette brand in the U.S.
Although many people promote e-cigs as less harmful than traditional cigarettes, it’s important to recognize that the harmful effects of these products are still unknown.
“Whereas vaping is seen as socially acceptable in today’s society, the evidence confirms the toxic materials and unknown substances in vape cartridges have numerous risks associated with lung and heart disease,” said KAHC Army Public Health Nurse Cindie Rice. “We recognize this as a public health concern and are planning initiatives to educate service members, beneficiaries, civilians and the greater community of Fort Lee on the dangers associated with vaping and options to quit this and utilization of all tobacco products.”
Overall, studies have concluded that although e-cigarettes may be of some benefit among adults who are trying to quit smoking combustible cigarettes, they may act as a gateway product in teenagers and young adults to smoke traditional cigarettes and, eventually, becoming daily smokers.
This is due to most e-cigarettes containing nicotine, which has known health effects. Nicotine is highly addictive and acute exposure can be toxic. Nicotine can harm adolescent brain development, which continues into the early to mid-twenties. Children who smoke may immediately experience increased heart rates and blood pressure. Long-term effects include respiratory problems, reduced immune function, increased illness, tooth decay, gum disease and precancerous gene mutations.
For information on electronic cigarettes, visit www.cdc.gov/e-cigarettes. For assistance with quitting tobacco, call Kenner’s Army Public Health Nursing office at 804-734-9304.