A 20-year-old man was hospitalized for two weeks in serious condition in Meir Hospital in Kfar Sava with a lung disease that was diagnosed and treated as “vaping disease.” It happened after he used an e-cigarette, which contained a liquid refill that was purchased illegally. This is the first case in Israel diagnosed as “vaping disease” – the new lung disease that has spread in recent months in the United States, and is attributed to the use of vape electronic cigarettes, mainly with liquid refills containing THC. The case was reported to the Health Ministry.
The young man was hospitalized early this month in the intensive care unit, in serious respiratory distress, and occasionally in a life-threatening situation. At one point the possibility of anaesthetizing him and putting him on a respirator was considered. “This is a young guy, usually healthy, who arrived after several days of fever, a cough and shortness of breath,” says Dr. Uri Wand, a senior doctor in the pulmonary department of Meir Hospital, who treated the young man.
The doctors’ first feared that it was a serious case of pneumonia and the patient received broad-spectrum antibiotic treatment. However, as the situation became clearer, the doctors realized that it was not pneumonia. “His respiratory situation deteriorated steadily and in his chest X-rays and other tests no infectious factor was found,” says Wand. The doctors also performed a bronchoscopy, in which a tube is inserted through the patient’s nose to the lungs to take a sample of the liquids in the lung. This examination also indicated no signs of any type of infection.
During this time his conditions steadily worsened and the level of oxygen in his blood was low. “During the investigation, it turned out that in the past month he used an e-cigarette whose refill was prepared in the United States, probably illegally,” says Wand.
And therefore, after ruling out infectious inflammations and other possible diseases, the doctors decided to treat the young man with steroids, similar to the treatment administered in the United States to those suffering from vaping disease. As a result of the treatment his condition steadily improved. After 10 days in the ICU in serious condition and connected to special devices, he was transferred to the pulmonary department and four days letter was released, while he continues to take medications and still needs an oxygen tank.
“While we were trying to figure out the problem, we discovered that the background and the symptoms correspond with vaping disease: the radiology picture, the vomiting, the fact that he smoked in the month preceding the disease and not for a longer period - have all appeared clearly in descriptions of cases from the United States,” says Wand, adding: “I really hope that this case doesn’t herald the beginning of the plague in Israel.”
“Vaping disease,” or vaping is attributed to the use of vape electronic cigarettes, has erupted in recent months in the United States and is claiming many victims and agitating the international medical community. It is characterized by serious and relatively quick damage to the respiratory passages to the point of death. According to the statistics of the U.S. Centers for Disease Control and Prevention from recent days, in the United States there have been 2,172 cases of the disease so far, in 49 states. The first case of death from the disease was reported in August, and as of now 42 deaths have been attributed to it.
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The medical community is trying to research and understand precisely what causes the disease. The findings and the analysis of the cases that were discovered in the United States demonstrate that in most instances – 82 percent – there was use of pre-filled liquid cartridges containing THC, the active ingredient in cannabis. But along with that, there is a presence of various plant oils, distillate oil products, vitamin E acetate that is known as a cause of pulmonary diseases, and additional substances.
Recently a team of senor physicians from the Mayo Clinic in the United States published a document in the New England Journal of Medicine, in which they point to the fact that the damage to lungs and respiratory passages that are attributed to the use of e-cigarettes, and have been observed in hundreds of people hospitalized in the United States, are similar to chemical burns caused by gases or the leaking of chemical substances. According to the CDC, most of the patients acquired the refill cartridges containing THC unofficially and illicitly from friends, family, or private or online dealers – that is true of most of the cases and they play a central role in the outbreak.
Israel is carefully following the events in the United States, where the rate of usage of e-cigarettes among teenagers is now over 25 percent. Recently it was reported that the Health Ministry plans to promote an immediate prohibition against the sale of flavored e-cigarettes, and is even examining the possibility of totally banning the marketing and sale of e-cigarettes in Israel – including by means of a temporary injunction to prohibit sales until legislation is completed. However, at this stage, during the government’s transitional period, there has been no progress.