niman Posted October 10, 2019 Report Posted October 10, 2019 (edited) The current flu season is expected to be severe, which will impact vapers. https://www.carolinajournal.com/news-article/flu-vaping-illnesses-difficult-to-distinguish-and-costly-to-treat/ Edited October 10, 2019 by niman
niman Posted October 10, 2019 Author Report Posted October 10, 2019 Flu, vaping illnesses difficult to distinguish and costly to treat October 10, 2019 1:40AM As flu season approaches, doctors fear more young adults will die of vaping-related illnesses. With lungs already damaged by vaping, patients could face higher risks of complications from influenza. Even as doctors fear the flu will drive more patients to the emergency room, doctors don’t know the long-term consequences of the vaping-related illness. Nor can experts pinpoint the potential cost of the epidemic to taxpayers or employers. “We don’t know if people are going to be at higher risk for respiratory failure, or if they are going to die because life support won’t be enough for them,” said Dr. Peter Miller of Wake Forest Baptist Health. “We’re really concerned that if we get another flu season that targets this age group, there’s potential for a lot of young adults to be really sick and a lot to die.” Experts worry a difficult flu season compounded by vaping-related illnesses could wreak financial damage. Most of government spending on health care goes to those with long-term conditions and the elderly. “If these conditions end up being very hard to treat or untreatable, it would be like long-term care,” John Locke Foundation health policy analyst Jordan Roberts said. “Adding a new procedure that we know nothing about would potentially affect premiums if there was a huge spike in claims.” Doctors say they don’t know enough to say how delays in care could affect patients with the vaping-related illness. Nor do doctors know how such delays would affect the cost of patients’ health care. So far, at least 18 people have died, and more than 1,000 people have vaping-related illnesses. The vast majority have self-reported vaping bootlegged products with THC — the psychoactive substance in marijuana that gets users stoned — and almost all of them are less than 35 years old. “These are people who think they’re invincible, but clearly they’re not,” Miller said. “It definitely does impact you, when you see people who are healthy and younger than you lose their lives. We haven’t had a death that we’re aware of related to vaping, but realistically, it’s only a matter of time.” Worse, the two illnesses mimic one another. Both present the same symptoms, but each requires different treatments. People with vaping-related illnesses struggle to breathe, with coughing and chest pain. Many also experience nausea, vomiting, diarrhea, and weight loss. “They can overlap significantly,” said Dr. Bradley Drummond, associate professor of pulmonary medicine at UNC School of Medicine. “It is going to be a challenge to disentangle these two entities as we go into flu season.” The two illnesses appear so similar that the Center for Disease Control’s current definition of vaping-related illness requires the patient to test negative for influenza. “Most patients are often initially suspected of having a viral infection such as influenza. Vaping-related illness is only suspected after viral testing is negative,” Drummond said. “It complicates the diagnosis. If a patient has influenza, according to the current definition from the CDC, that is not vaping-related illness.” Patients with the flu usually get sent home with antibiotics. But antibiotics won’t help patients with vape-related illnesses. Their lungs are inflamed, not infected. Doctors usually use steroids to treat vaping-related illnesses, and sometimes oxygen or life support. At Cone Health, a patient recently came in with a combination of vaping-related illness and adenovirus, a flu-like illness. “For all the world it looks like a vape-related lung injury,” said Dr. Murali Ramaswamy, director of the Interstitial Lung Disease Program for LeBauer Health, part of Cone Health’s medical group. “This patient was in the intensive care unit, but did not end up on life support. But it came close.” Doctors’ ability to recognize vaping-related illness is only one of their concerns. They also fear the flu could hit patients whose lungs are already compromised by the vaping-related illness. “Their airway and lung tissues are not as healthy, and viruses can easily make them sicker than a non-smoker,” Ramaswamy said. “Their susceptibility to a lung injury is exponentially higher.” Doctors can treat the vaping-related illness with steroids, oxygen, and tiers of increasingly extreme life support. “It would basically be what we call supportive care, which can be all the way up through the highest form of life support possible, ECMO, which bypasses their lungs,” Miller said. “If their lungs are so sick that they can’t breathe at all on their own, we can do it for them with a machine.” The N.C. Department of Health and Human Services advises people to get the flu shot and to stop vaping, especially bootlegged products. The state has focused on educating physicians and patients about vaping-related illnesses. “Pretty much all of those symptoms are similar to the flu. So, we are trying to cast a pretty wide net to make sure we get everyone,” said Dr. Elizabeth Tilson, state health director for DHHS. “The big message is that anyone who is experiencing vaping-related sickness — coughing, shortness of breath — or flu symptoms should be seeking medical attention.” Doctors can send patients home by treating them with steroids, but they can’t yet guess at the long-term effects of the vaping-illness. The state hopes to block any potential health crises by marketing the flu shot. “The main message to take home is to get the flu shot … and be sure to tell your health care provider if you have vaped or used e-cigarettes,” Tilson said. “That’s really important information for them to know.”
niman Posted October 10, 2019 Author Report Posted October 10, 2019 HEALTH NEWS OCTOBER 10, 2019 / 2:02 PM / UPDATED 25 MINUTES AGO Amid vaping crisis, U.S. to issue new advice for doctors focused on lung infections Julie Steenhuysen 5 MIN READ CHICAGO (Reuters) - U.S. health officials are preparing to release new guidance for doctors stressing the need to ask every patient with an apparent respiratory infection about their vaping history. Jeffrey Manzanares, 33, lies in the intensive care unit of the University of Utah Hospital while being treated for vaping injury and other lung infections in Salt Lake City, Utah, U.S. in September 2019 and provided October 10, 2019. Courtesy of Marisela Trujillo via REUTERS The updated guidance will also advise physicians on how to diagnose and manage patients who may have both a lung infection and a vaping injury. Dr. Ram Koppaka, a medical officer with the Centers for Disease Control and Prevention (CDC), said doctors need to be aware that there is an overlap between the early symptoms of vaping injury and common respiratory infections. The CDC has already recommended doctors start asking patients about their vaping history during routine visits, but gathering that information is especially important as doctors evaluate patients with respiratory symptoms from infectious causes. “Both diagnoses must be evaluated,” Koppaka said in a phone interview. The CDC reported on Thursday that as of Oct. 8, 1,299 people in the United States have had confirmed or probable cases of lung injuries linked to vaping, and 26 have died. Some U.S. doctors have raised concerns that vaping injury cases will be missed in the crush of patients seeking treatment for seasonal flu and other respiratory ailments. The early symptoms of vaping injury include shortness of breath, cough, chest pain, fever, and in some cases, gastrointestinal symptoms such as nausea, vomiting and diarrhea. “All of those can also be seen with influenza,” Koppaka said. In the United States, flu activity starts to pick up in October and November and typically peaks between December and February. “The fact that a given individual that presents for clinical evaluation could have flu, could have lung injury due to e-cigarettes, or both, makes it complicated for providers,” Koppaka said. As many as 72% of the earliest vaping patients in Illinois and Wisconsin sought medical treatment in outpatient clinics and emergency rooms before doctors admitted them to a hospital with severe lung injuries from vaping, state officials reported last month in the New England Journal of Medicine. Most of those patients initially were given antibiotics. When those failed, many responded to treatment with supplemental oxygen and steroids. ‘ENDED UP IN AGONY’ In addition to flu, many respiratory infections, including fungal infections, can cause symptoms that could confound doctors and delay a vaping diagnosis. The University of Utah Hospital in Salt Lake City has treated 22 patients with vaping injuries, including Jeffrey Manzanares, 33, who was also infected with a cold and human metapneumovirus that led to pneumonia. Manzanares first sought treatment at a local hospital on Sept. 3, where he was given an antibiotic and oxygen for his pneumonia and sent home, his vaping injury undetected, he said in a phone interview. “I ended up in agony from the lack of oxygen. It felt like someone was stabbing a knife into my whole body,” he said. He went to the University of Utah Hospital the next day, where he spent 21 days, including 17 in intensive care. During his illness, Manzanares said he lost 50 pounds (22.7 kg), a third of his normal body weight. “He was wildly sick,” said Dr. Scott Aberegg, a pulmonologist who treated Manzanares. “If that is any harbinger of what is to come in viral pneumonia season, this could be very problematic.” Aberegg participated in a conference call earlier this month with other doctors advising the CDC on how clinicians should diagnose and manage vaping patients. He said many doctors who get back a positive flu test may just assume the patient has the flu and not realize they are also a vaper. State health officials are on alert. “We want to make sure to investigate all cases that are reported and make sure we don’t miss anything that may be thought of as flu or may be associated with vaping or vice versa,” Dr. Pam Pontones, Indiana’s deputy health commissioner and state epidemiologist, said in a phone interview. Influenza can be deadly in people who have other underlying illnesses. “It’s really important that anyone, but especially people who have underlying pulmonary infections of any kind, be vaccinated for influenza,” Pontones said. The CDC recommends everyone over the age of six get a flu shot. Reporting by Julie Steenhuysen; Editing by Bill Berkrot https://www.reuters.com/article/us-health-vaping-cdc-guidance/amid-vaping-crisis-u-s-to-issue-new-advice-for-doctors-focused-on-lung-infections-idUSKBN1WP2P1?utm_source=twitter&utm_medium=Social
niman Posted October 11, 2019 Author Report Posted October 11, 2019 Tonight 11 PM ET Dr.Henry NimanVaping Casualties And Dead Continue To RiseCDC Vaping Update 10/10/19 Many More Cases, DeathsFlu Season Increases Vaping Concerns
niman Posted October 12, 2019 Author Report Posted October 12, 2019 22 hours ago, niman said: Tonight 11 PM ET Dr.Henry NimanVaping Casualties And Dead Continue To RiseCDC Vaping Update 10/10/19 Many More Cases, DeathsFlu Season Increases Vaping Concerns http://mediaarchives.gsradio.net/rense/special/rense_101019_hr3.mp3
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