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PUnion health experts warn that the coming flu season could complicate attempts to diagnose new cases of mysterious vaping-related illness – and complicate the search for the cause accordingly.
According to experts, the problem is that influenza and other respiratory viruses can, in many ways, look strikingly similar to a case of vet-related illness. Radiography.
"It will be difficult to separate a case of serious flu and a case of vaping," said Dr. Sean Callahan, a pulmonologist at the University of Utah, who has treated several cases of vaping-related illness.
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According to current guidelines from the Centers for Disease Control and Prevention, physicians are expected to exclude influenza or any other infectious cause of the disease before diagnosing a case of vaping-related illness. But as winter approaches, it's increasingly possible for people who sweat heavily to start testing for flu or another respiratory infection. As a result, the agency may be forced to reconsider its definition of vaping-related diseases, experts said.
When asked, the CDC did not respond directly to the question of whether its definition should eventually be revised.
The flu season "complicates things even more," said Dr. Jeff Duchin, head of public health in Seattle and King County and professor of infectious diseases at the University of Washington.
Just a few months ago, a young, healthy patient who presented to the hospital complaining of breathing difficulties, coughing or night sweats would be suspected of having the flu or pneumonia. Opaque spots on a radiograph would also add to this suspicion. But this summer, this assumption has begun to change, as health officials have sounded the alarm regarding the symptoms of the disease related to vapot inhalation. There have been 805 confirmed and probable cases of the disease as of Tuesday.
Now that flu cases are becoming more common, doctors will have to juggle more and more between the two possibilities. Spray-related diseases and severe influenza can be life-threatening if left untreated.
"You may be hospitalized because of flu complications, use of the non-flu-related electronic cigarette, or a combination of both," said Duchin.
This association is of particular concern because influenza or other viruses may exacerbate the symptoms of an atmospheric disease. If patients already have compromised lungs and develop a viral infection, they may become sicker. And what if a positive test for the virus means a forgotten diagnosis of vaping-related illness?
"[Vaping-related illness] may be missed if the doctor does not look for it, absolutely. If you do not care, patients may become seriously ill, "said Dr. Melodi Pirzada, a pediatric pulmonologist at NYU Langone Health, who has treated several cases of illness related to vapor inhalation.
Pirzada has already seen this happen. She is currently caring for a young man who initially went to an outpatient clinic with coughs, shortness of breath and fever. His tests showed hazy spots on the lungs. It has been tested positive for an infectious bacterium called Mycoplasma pneumoniae. He started taking antibiotics and was sent home.
But instead of feeling better after finishing the antibiotic treatment, he became sicker. He was much sicker than a normal patient suffering from this type of infection, especially from a patient who had not contracted a particularly serious infection, Pirzada said. Last week, the patient was admitted to the hospital. Pirzada discovered that he had been spraying THC daily for more than a year. After several days of steroid treatment – part of the standard treatment for diseases related to vaporization – his condition has improved.
Pirzada is convinced that it is a case of a disease related to vaping, complicated and hidden by an infection.
"We have tons of patients with Mycoplasma infection, and that's not the norm for that," she said.
A CDC spokesman told STAT that during the flu season, the agency recommends taking into account respiratory infections and vaping-related illnesses in patients with both respiratory problems. and a history of electronic cigarette consumption. As doctors may not be able to definitively determine the cause, it may be necessary to treat patients for both cases.
Experts said that overlapping diseases will probably not complicate influenza surveillance because patients will still be tested for influenza. However, it will be more difficult to accurately track cases of vaping-related illness, a crucial step in efforts to control the epidemic.
Duchin said that illnesses related to vapor inhalation were another reason to get vaccinated against the flu this season, noting that influenza infection could be part of public health messages on the risks of vapor inhalation. But others said they would like to see one or more identified culprits when the flu season is in full swing.
"My hope is that whatever is gone at the time the flu season begins," Callahan said.
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