Vaping Associated with Severe Lung Disease

  • This is a message from the Louisiana Department of Health Emergency Operations Center (LDH EOC) to share a Louisiana Health Advisory Network (LA HAN) message on "vaping” associated with severe lung disease in Louisiana. Please share and distribute with relevant stakeholders and partners through your own distribution channels.

    Background

    The Louisiana Department of Health (LDH) is investigating recently reported cases of severe lung disease among individuals in Louisiana who report e-cigarette product use, or "vaping.” According to the Centers for Disease Control and Prevention (CDC), 193 possible cases, including one death, have been reported by 22 states. These illnesses are primarily occurring among adolescents and young adults. No single product has been implicated. Patients have reported high variability in substances/products they used in vaping, including tobacco and tetrahydrocannabinol (THC) containing products as well as other products. LDH is working to determine if the recent cases reported in Louisiana fit the clinical picture being described by other states and the CDC.

    Response

    LDH asks health care providers to be alert for patients presenting with severe lung disease with an unknown etiology who report a history of vaping and to report suspect cases to LDH by calling 1-800-256-2748.

    Clinical Presentation and Evaluation

    Patients have initial respiratory symptoms including cough, shortness of breath, and fatigue with worsening over days or weeks before admission to the hospital. Other symptoms reported by some patients included fever, chest pain, weight loss, nausea, and diarrhea. Patients are typically between 17-35 years old and report no significant past medical history. Chest radiographs showed bilateral opacities, and CT imaging of the chest demonstrated diffuse ground-glass opacities, often with sub-pleural sparing. Because symptoms are consistent with an infection, a thorough evaluation for infectious diseases should be conducted.

    Recommendations for Louisiana Healthcare Providers

    • Clinicians treating patients with significant respiratory disease in the outpatient setting should assess their patients for recent or prior use of vaping products and consider the potential for worsening disease progression if risk factors are present.
    • Clinicians in the inpatient setting who are managing patients with severe pulmonary disease should consider the following:
      1. Assess patients for vaping history including vaping tobacco, THC, and/or other products.
      2. Consider this syndrome in these patients, particularly those who have prior history of respiratory disease and no apparent etiology, infectious or otherwise.
      3. Consider a pulmonology consultation to guide additional diagnostics and management for these patients.
    • Educate all patients on the risks associated with vaping and the use of tobacco products and provide patients information on where to seek care if symptoms worsen or return after initial resolution.
    • Healthcare providers should ask patients about any retained or remaining vaping product, including devices and liquids, in order to ascertain availability for possible testing to be coordinated by LDH.

    Case Reporting

    All cases of suspected severe lung disease potentially associated with vape products should be reported to LDH’s Infectious Disease Epidemiology Section: 1-800-256-2748.