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Health officials are investigating more cases of respiratory illness associated with vaping.
Although the cause remains unclear, officials said Friday that many reports involved electronic cigarette products containing THC, the substance that impairs the spirit of marijuana.
Officials from the Centers for Disease Control and Prevention said on Friday that they were studying 215 possible cases in 25 states. According to data collected by NBC News from state health departments, at least 298 people have been hospitalized for a serious lung disease apparently related to vaping.
In addition to breathing difficulties and lung damage, some people reported vomiting, diarrhea and fatigue.
The CDC has not identified any common product, but the CDC and the Food and Drug Administration have warned the public not to buy vaping products on the street.
The FDA is currently analyzing the content of dozens of vaping samples collected by state health authorities investigating the disease.
Dr. Panagis Galiatsatos, a specialist in pneumology, said that while it was good for the CDC to recommend that certain groups of people avoid electronic cigarettes, this warning should also have been sent to all people using the products.
"I would ask the CDC to take a tougher approach," said Galiatsatos, assistant professor in the Division of Respiratory and Critical Care Medicine and director of the Johns Hopkins Medicine Tobacco Treatment Clinic. "I would recommend to everyone to stop using these products until we know more."
Hundreds of cases of pulmonary diseases related to vaping, "could be the visible part of the iceberg," said Galiatsatos, pointing out that there could be many more people with insufficient symptoms to send them to emergencies.
"Half a dozen" of Johns Hopkins doctor's younger patients came to ask for help quitting electronic cigarettes because of pulmonary symptoms.
"They were healthy teenagers, out of breath," Galiatsatos said.
Secondhand steam exposure
Experts say the impact of e-cigarettes is not limited to users.
Galiatsatos had a patient who developed breathing problems that appeared to be related to regular exposure to second-hand fumes. According to Mr. Galiatsatos, the respiratory symptoms had improved when the patient significantly reduced the vapors.
A study published in the JAMA Network Open earlier this week suggested that exposure to second-hand cigarettes issued by the electronic cigarette was on the rise among middle and high school students. This study, based on a survey of tens of thousands of teenagers, found that second-hand exposure increased from one in four in 2015 to one in three in 2018.
According to another report published in the magazine Chest in January, second-hand vapors could worsen the symptoms of people already suffering from respiratory problems, said the senior author of the second-hand vaping study, Andy Tan, assistant professor of social and behavioral sciences at Dana Farber. Cancer Center and the Harvard Tan TH School of Public Health.
The "chest study" found that pre-existing asthmatic youth exposed to second-hand sprays reported an acute exacerbation of their asthma, "Tan said.
In some cases, people might not even know that they have been exposed to second-hand fumes.
"With new vaping devices producing less visible steam, you may not see them as with traditional cigarette smoke – until you feel a hint of mango or mint, and you're wondering what you're looking for." Where the perfume came from, "Tan said.
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Linda Carroll contributed.
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