Meet health officials who have alerted the world about the alarming disease of vaping

And yet, state officials have discovered the epidemic, which shows no sign of arrest.

"I do not think anyone could have anticipated the magnitude of this problem," said Andrea in an email.

Discover the vaping link

Although isolated problems with vaping-related breathing problems were detected elsewhere, including as early as 2015 in West Virginia, a new wave of cases began to appear across the country from mid-April.

Otherwise, healthy patients, many of them teenagers, complained of shortness of breath. unexplained weight loss, fatigue and gastrointestinal problems. They have often been diagnosed with acute respiratory distress syndrome – essentially lung injury of unknown origin. Cases have confused health providers nationwide.

In North Carolina, clinicians have been surprised to see how healthy teenagers could suddenly be so ill that they need fans for non-infectious tasks, said Zack Moore, head of epidemiology. of the state.

But in Wisconsin, doctors at the Children's Hospital used patient histories to reconstruct the missing link among this group of four cases: vaping.

This is not an easy task when you are dealing with teenagers who may not want to admit that they are vaping in front of their parents – especially with regard to THC oil, the psychoactive chemical of the marijuana. But for D & Andrea, a 25-year veteran specializing in respiratory problems in children and leading the hospital's pulmonary team, opening up patients is part of what has made this discovery possible.

"They were part of the" team "trying to help us understand that," she said.

After discussing the cases with Meyer and other colleagues, Dr. Andrea called Dr. Michael Gutzeit, the hospital's medical officer, on July 8th. This phone call triggered the children's hospital warning to the local health department and then to the state health department. and finally to the Atlanta Centers for Disease Control and Prevention – which actually puts this health crisis on the radar of the nation.

"It's amazing that they have seen this," said Dr. Jeffrey Gotts, a pulmonologist at the University of California at San Francisco. "As frontline clinicians, there is very little that we would report to the public health authorities of the intensive care unit.It is not unusual that people come forward with a respiratory failure."

From local to state

Given that the four patients with these symptoms at the Wisconsin Children's Hospital were from Waukesha County, just outside of Milwaukee, the hospital's infection specialists called the local health department.

Shortly after, Ben Jones, the Waukesha Public Health Officer, went to Thomas Haupt, an epidemiologist of respiratory diseases, whom he had known for 15 years.

"They did not know how vapotage would be involved" with these mysterious cases, said Haupt, a 34-year-old veteran of the health services department. "They called me right away."

Haupt was immediately alarmed. He hung up the phone and headed to his boss's office, Chief Medical Officer Jonathan Meiman, on July 10, interrupting a meeting.

"We have to talk about it," he recalls.

At this point, the hospital and Haupt only knew that it was a local problem, which was worsening. "The number of cases has gone from four to eight," said Haupt. The team realized retroactively that it treated a patient admitted on June 11th with similar symptoms and that three other patients entered on July 19th.

Haupt has gone to work informing its public health colleagues from one country to another, in case this mysterious disease spreads beyond Wisconsin, by sending an e-mail to two groups. Twelve years ago, he set up a group of flu coordinators in the Midwest, made up of representatives from 11 states in the region, to better manage the flu season. He also participated in the leadership of the State Council and Territorial Epidemiologists.

"Communication is always the greatest asset you have for investigating an illness," Haupt said.

This has not detracted from the fact that most recipients of these emails have been in the same public health circles for years. Several responded that they would check with their poison control centers and public health departments.

In the meantime, the state's health department and children's hospital coordinated a press announcement and alert clinicians on July 25. Communication and trust were easy – Meiman and Gutzeit had already worked together on Ebola preparedness efforts a few years earlier.

The press conference was broadcast live on Facebook. After the day's briefing, another group of Wisconsin parents took a teenager with similar symptoms to the hospital.

The case in Illinois

Within days, an Illinois clinician who had seen the blanket, called the Wisconsin Health Department, was worried that an Illinois patient might have the same problem. It was at this point that Meiman called his Illinois counterpart, Dr. Jennifer Layden, to let him know that his condition might also be suffering from the mysterious disease.

"We started calling health departments and hospitals to find out if other people had this very vague description," Layden said. "In a few days, just by these calls, we had two other patients."

In San Francisco, Dr. Elizabeth Gibb saw a patient whose mother had heard the news from Wisconsin and asked if it could be related to her hospitalized teenage daughter.

On August 2nd, Illinois had issued an alert to clinicians looking for new cases. Wisconsin was up to 11 cases.

While more cases have emerged across the country, Wisconsin has developed a questionnaire that states could send to clinicians so that they can all have a similar case definition and work from similar data, said Haupt. . At least 20 people from the Wisconsin Health Department have mobilized – in addition to their usual workload.

The turning point of Epi-X

As a result of the news of a cross-border case in Illinois – and a month after Andrea's first phone call to Gutzeit – the Wisconsin Health Department has decided to go ahead with the case. send an alert to Epi-X on August 8th. This is an alert for all state health services on the Epidemic Information Exchange network run by the CDC.

After the bulletin announcing that Wisconsin has had up to 25 suspected cases related to a vaping, calls from New Jersey have flocked to North Carolina.

From there, he began to snowball.

In a few days, the CDC sent a team – two people in Illinois and two in Wisconsin – who helped to process the cases. Meiman and Layden continued to work together to further define the condition and coordinate information from other states.

As the number of cases has quintupled, there is still much to learn about the disease. Many experts do not believe this epidemic will end any time soon. Despite everything, Haupt said it is extremely proud of the work done by Wisconsin officials – from the Children's Hospital to the State Department of Health -. He believes that their notification may have helped save lives.

"This is how public health is supposed to work," he said. "And believe me, it does not always work that way."