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Centers for Disease Control and Prevention reported Wednesday that there were 153 possible cases of serious pulmonary disease related to vape in 16 states: California, Connecticut, Florida, Illinois, Indiana, Iowa, Minnesota, Michigan , North Carolina, New Jersey, New Mexico, New York, Pennsylvania, Texas, Utah and Wisconsin.
The only thing that links the cases is that patients all reported using vaping products containing nicotine or THC, the psychoactive ingredient of marijuana.
In addition to the cases reported by the CDC, NBC News contacted health services and doctors in the country, and found cases in Ohio, Virginia, and Tennessee.
"A patient arrived with a complete respiratory collapse and was essentially to stay alive," said Dr. Jacob Kaslow, pediatric pulmonary pulmonologist at Monroe Carell Jr.'s Children's Hospital in Vanderbilt, Nashville.
Kaslow told NBC News that his hospital had treated four cases of vape-related respiratory illness in the last six months. Case follow-up has been difficult as patients tend to have a variety of symptoms including severe pneumonia and cough.
"We discover this only now because we ask:" Is there a history of vaping or using electronic cigarettes? "Kaslow said.
No deaths have been reported. However, some patients developed severe progressive lung disease and required continuous mechanical respiratory support.
The Centers for Disease Control and Prevention are working with states to try to identify an ingredient, e-liquid, device, or method of electronic cigarette purchase linking all cases.
It is unclear whether there has been some sort of contamination of appliances or e-liquids that has led to 150 cases and more.
Some patients reported buying their vape on the street.
"Evidence continues to show that street-bought vape cartridges containing THC or synthetic drugs are at the root of these diseases," wrote Gregory Conley, president of the American Vaping Association, in a statement. a statement to NBC News.
The American Vaping Association is not a professional group, but advocates what Conley calls a "reasonable regulation" of vaping products.
Patients have usually arrived at the emergency or hospital with coughing, shortness of breath, fatigue and chest pain. The disease initially resembles a serious respiratory infection, but does not improve with the usual treatments, such as antibiotics.
This can delay the diagnosis and lead the detectives of diseases in the wrong way.
In addition, hospitals do not have an effective way of tracking cases, as there is no specific diagnostic code for vaping or emerging disease.
"Given that it's so new, doctors may miss the association with vaping," said Dr. Humberto Choi, a pulmonologist and intensive care specialist at Cleveland Clinic.
Choi has been treating some of the patients in the intensive care unit of the hospital over the past few days and weeks.
"Suspicious cases have to be reported to the CDC, but for the moment, it's hard to follow them," Choi said. "As more cases are confirmed, we can better characterize the disease and determine the best treatment for patients."
Choi also saw people with a similar but less serious illness in an ambulatory setting.
"People who have recently been vaping come with an abnormal CT scan," Choi told NBC News. "The only treatment is simply stopping vaping."
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