A Louisville doctor says that despite Kentucky having no official record of patients with a mysterious vaping-related lung illness, he’s recently treated two people that may be part of the nationwide outbreak.
As of August 27, the Centers for Disease Control and Prevention had reported 215 cases of a severe lung disease associated with e-cigarette and vaping products across 25 states, not including Kentucky.
Over the past two weeks, pulmonologist Ehab Haj Ali said he’s treated two patients that may be part of the outbreak. Ali is a partner at private medical group Louisville Lung Care and treated both patients at Sts. Mary and Elizabeth Hospital.
He said both were otherwise healthy but showed up with severe symptoms and reported recently starting to use e-cigarettes. Ali said one of the patients was a previous cigarette smoker.
“She’s trying to quit smoking, so she started also vaping — and then all of a sudden, she went into that severe respiratory distress,” Ali said.
That patient was coughing, needed oxygen and was eventually put on a ventilator for two weeks. Ali eventually found that she had a severe lung injury, which he believes is likely from vaping or smoking. He said the patient almost died.
“She would have no chance of survival [without the ventilator],” Ali said. “Zero chance.”
The federal CDC is still investigating if there’s a specific item or a black market product causing the outbreak. Many patients have reported using vapes with liquids that contain THC, the component of marijuana that causes a high.
Symptoms of the vaping-related illness include shortness of breath, cough, chest pain, nausea, diarrhea, fatigue, weight loss and/or fever.
Potential Undercount?
Kentuckyjust started tracking potential cases of the lung illness this week. Because of that, Ali said both of his cases weren’t reported to the state or CDC — at the time he said there was no way to do so. If he had, state and federal health officials would have reviewed medical records and interviewed the patients to confirm or rule out the lung illness.
As such, there may be an undercount coming from Kentucky. Ali said he’ll now be on the lookout for potential cases with a new awareness of what to look for.
“Now, having those two cases, I think when we get some of these similar presentations, I’m going to start asking those questions,” Ali said.
On Wednesday, Kentucky Department for Public Health Acting Epidemiologist Doug Thoroughman said the state hasn’t confirmed any cases, and that officials will update any new cases every Friday.
But the lack of tracking is a nationwide problem. According to a report from Kaiser Health News, there’s never been a clear way for doctors to report vaping-related illnesses to federal health authorities. While the Food and Drug Administration tracks incidents related to medical devices and drugs, e-cigarettes and vapes don’t fall in either category.
Unnecessary Tests
Some are frustrated that Kentucky didn’t start tracking vaping-related illnesses sooner.
Ben Chandler, president of the Foundation for a Healthy Kentucky, told WFPL last week that the state is usually behind in responding to public health issues.
“Welcome to the ninth inning is all I can say: they should have been on this a long time ago,” Chandler said. “Because other states are actually investigating, actively investigating these issues.”
Ali is frustrated, too. If he’d had more information and direction from the state sooner, he might have avoided unnecessary tests for what he said might be the lung-related illness.
“You can minimize a lot of the cost by not spending so much money trying to find other reasons, when you have a clear reason linked to those kind of presentations,” Ali said.
Both of his recent patients received extensive testing — X-rays and CT scans — to rule out lung cancer, bronchitis and pneumonia. Both came back with healthy results but their symptoms persisted.
Ali said that one of his patients was coughing up about a half a coffee cup of blood a day. Though that’s not a symptom of the lung illness listed by the CDC, he thinks the two could be connected.
“And within two weeks of vaping, she started coughing up blood,” Ali said. “We did the work up and couldn’t find any link except vaping.”
He ended up giving the patient a bronchoscopy, which is where a small camera is inserted into lungs to detect damage. That’s when he found severe inflammation that looked like it was the result of smoking or vaping.
“Maybe I could have skipped the bronchoscopy and said, ‘just quit vaping and follow up with me in two weeks,” Ali said.
A spokesperson with the Cabinet for Health and Family Services said health providers should have received instructions and a form for reporting potential cases on Tuesday.
Meanwhile, KentuckyOne’s hospitals — which includes Sts. Mary and Elizabeth, where Ali's patients were treated — U of L Hospital, Baptist Health Hospitals, Norton Hospitals, Hardin Memorial Health and Frankfort Medical Center all said they have no official record of related cases.
