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Severe Respiratory Illness Associated with E-cig/Vaping – Resource for Clinicians

The Hawaii Department of Health has confirmed its first case of severe respiratory illness associated with e-cigarette use (also known as “vaping”). The case fell ill in August presenting with tactile fevers, cough, nonspecific gastrointestinal symptoms, and hemoptysis, and required brief intubation.

http://health.hawaii.gov/docd/vaping-resources-for-clinicians/

[niman]

Severe Respiratory Illness Associated with E-cig/Vaping – Resource for Clinicians

The Hawaii Department of Health has confirmed its first case of severe respiratory illness associated with e-cigarette use (also known as “vaping”). The case fell ill in August presenting with tactile fevers, cough, nonspecific gastrointestinal symptoms, and hemoptysis, and required brief intubation. If you suspect a patient under your care may have respiratory illness caused by vaping complete, please the case report form:

Preliminary Vaping Case Report Form (pdf)

Fax to the Disease Outbreak Control Division at (808)586-8347 or email to
[email protected] using encryption or password protection.

 

ACTION ITEMS FOR HAWAII CLINICIANS:

 

INPATIENT SETTING:

• Assess patients for a vaping history for THC, nicotine, and/or any other products in the 90 days before illness onset.
• Consider this syndrome in patients with severe respiratory disease and vaping history,
  especially those with no explicative etiology.
• Consider consulting a pulmonologist to guide additional diagnostics and management.

OUTPATIENT SETTING:

• Assess patients for recent or prior use of vaping products.
• Consider potential for worsening disease progression if risk factors present.

ALL SETTINGS:

• Educate all patients on the risks associated with vaping nicotine and other products.
  Advise patients to seek care if symptoms worsen or return after initial resolution.
• While the national investigation is ongoing, persons should consider not using e-cigarette
  products, especially those purchased from sources other than authorized retailers (e.g., e-cigarette products with THC) and those modified in a manner not intended by the
  manufacturer.
• Contact the Disease Outbreak Control Division immediately (refer to contact information
  below) if you suspect you are managing a case of vaping associated severe respiratory
  illness. If e-cigarette product use is suspected as a possible cause for a patient’s
  respiratory disease, please obtain a detailed history of the substances used, the sources,
  and the devices used. Determine also if any remaining product, devices, and liquids are
  available for testing.

We are advising the public to contact their physician should they have any concerns. E-cigarettes
should never be used by youths, young adults, pregnant women, and adults who do not currently
use tobacco products. If you have any questions or need to report a suspect case of vaping
associated severe respiratory illness, please contact the Department of Health immediately.

Oahu (Disease Reporting Line)………………………………. (808) 586-4586
Maui District Health Office…………………………………….. (808) 984-8213
Kauai District Health Office……………………………………. (808) 241-3563
Big Island District Health Office (Hilo)……………………. (808) 933-0912
Big Island District Health Office (Kona)……………………(808) 322-4877
After hours on Oahu……………………………………………….(808) 600-3625
After hours on neighbor islands……………………………..(800) 360-2575 (toll free)

 

LINKS AND RESOURCES:

Hawai’i Medical Advisory: Probable Vaping Associated Severe Respiratory Illness Case (9/10/19)

CDC Health Alert for Vaping

CDC’s resources for healthcare providers

Preliminary Report in the New England Journal of Medicine