Doctors at Children’s Wisconsin became alarmed this summer when a rash of otherwise healthy teens were admitted with serious respiratory problems.
Eight such patients were admitted to Children’s between June 11 and July 25. Their symptoms included fatigue, shortness of breath, a cough and chest pain. Some had nausea and some had anxiety.
Children’s staff tried to determine what was causing those symptoms and why so many patients were suddenly coming down with them.
“We weren’t sure what we were dealing with,” said Dr. Michael Gutzeit, chief medical officer at Children’s Wisconsin. “But we were concerned it was a public health issue because of the intense cluster of patients. The first thought was this could be an infection of some sort that was spreading through the community.”
The patients all had evidence of inflammation of the lungs in the lining of the airways that lead into the lungs.
But what was the cause? Children’s doctors were stumped, at first.
“There wasn’t anything we could put together that would explain why these patients were so sick and why they were having such breathing difficulties,” Gutzeit said. “The thought process was: something’s irritating these lungs and it’s something that happened relatively abruptly, because they were healthy before this. Thinking through that, what would they all have been doing at the same time that would be the common thread here? And that’s what led to vaping. It was the only common thread we could see that would explain the symptoms that were happening.”
Vaping involves inhaling a vapor created by an electronic cigarette (e-cigarette) or other vaping device. E-cigarettes are battery-powered smoking devices that have cartridges filled with a liquid that usually contains nicotine, flavorings and chemicals. The liquid is heated into a vapor, which the user inhales.
All of these teen patients at Children’s with otherwise unexplainable respiratory problems had begun vaping fairly recently. Some had been doing it for a few months, others for less than a week.
“That gave us another indicator that vaping was associated (with their breathing problems),” Gutzeit said.
The staff at Children’s knew they had not proven that vaping was causing respiratory problems in teens, but because of the sudden surge of these patients, the hospital decided it needed to let the public know and issue a warning.
“I really admire the courage of the team to do this,” Gutzeit said. “We didn’t have proof. There was an association, but we didn’t have a cause. We didn’t have enough patients to say there was an absolute cause. It takes a lot longer time (to determine that). But, we were so concerned about the potential impact we were seeing to our youth, we thought it was imperative to put this out as a public health message.”
The hospital collaborated with the Wisconsin Department of Health Services, which helped with the investigation and provided information about similar cases that had been reported to the state.
“They supported our finding with what they were seeing,” Gutzeit said.
Hospital staff also did research and couldn’t find any literature reporting a link between vaping and respiratory problems in teens.
Children’s made the announcement at a July 25 press conference. Soon after, the Centers for Disease Control and Prevention issued an alert, putting the health issue on the national radar. More than 2,200 cases of e-cigarette or vaping product use associated with lung injury have been reported to the CDC, including 48 deaths.
Some states have since banned the sale of e-cigarette products.
In recognition of the work of numerous staff members of Children’s Wisconsin to investigate what was behind the rash of teen patients with respiratory problems and for creating public awareness of the harmful effect vaping appears to have on the lungs of teenagers, the hospital is the recipient of a Special Impact Health Care Heroes Award from BizTimes Milwaukee.
“(The award) really recognizes a big team at Children’s that came together,” Gutzeit said. “This was a lot of different pieces that came together in a puzzle that wasn’t very clear initially, and became more clear as people talked and got better ideas about what we were seeing.”
Months later, many of the teens that came to Children’s this summer with sudden respiratory problems still have breathing issues, Gutzeit said.
“Some of them continue to show lung function that has not returned to normal,” he said. “This is our biggest concern, the potential long-term effects of vaping.”
Since this summer, the hospital has seen more teenage patients with similar respiratory issues.
“We continue to see patients that come into our hospital, as well as our clinics,” Gutzeit said. “Some are more severe than others, but they all have the common thread of vaping and varying degrees of breathing trouble.” ν
