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Utah doctors find ‘clue’ to vaping-related illnesses

FILE - In this Aug. 14, 2014, file photo, a man exhales vapor as he demonstrates the use of his electronic cigarette in Salt Lake City. Utah health officials say they have confirmed 28 cases of lung damage linked to vaping and are investigating 14 more potential cases. The state Department of Health announced the new number Tuesday, Sept. 3, 2019, a jump from the 21 cases in teenagers and young adults reported last week.
Rick Bowmer, AP Photo

SALT LAKE CITY — While at least three people have died from a severe lung illness linked to e-cigarette use, University of Utah doctors say they might be one step closer to finding an effective treatment.

Last month, multiple states began reporting youth who had all recently vaped or used other inhalational devices falling ill with symptoms including shortness of breath, fatigue, chest pain and coughs.

Utah so far has seen at least 28 cases that affected people mostly in their mid-20s and younger.

The numbers of young adults battling the illness nationwide have also rapidly increased, prompting a massive, multistate investigation.

U. doctors have found a commonality between those affected by the disease. Lipid-laden macrophages were in the lungs of 10 out of 10 patients from whom samples were taken. Macrophages are immune system cells that clean up debris at infection sites.

Macrophages usually develop when elderly people take mineral oil or caster oil as a laxative, fall asleep and some of the oil drains from their throat into their lungs. They then might get lipoid pneumonia, an illness similar to the new lung illness. People who aspirate things in their stomach at night can also get the cells, as well as some people with asthma, said Dr. Scott Aberegg, U. critical care pulmonologist and lead author of the study published in the New England Journal of Medicine.

“We don’t see them very commonly, so we think they will be a helpful finding,” Aberegg said.

The discovery could be important in understanding what’s happening with patients’ immune systems, and might “provide a clue” to the cause of the disease, according to the doctor.

Eventually, the information could lead to a diagnostic test for the illness, he said.

Three deaths have been reported in Illinois, Oregon and Indiana, officials from the Centers for Disease Control and Prevention said Friday. One other death is being investigated as caused by the illness. Federal health workers say they are “working around the clock” to determine the cause.

The CDC urged people to stop using e-cigarettes while the investigation remains underway.

“I’d say it’s one of the most common things we’re being asked to see as lung doctors at the university within the last week. The number of cases has just skyrocketed in the last week,” Aberegg said.

It took U. doctors about a month to identify the first four cases. The first case appeared in July. Last week, the university treated eight people with the illness.

“We’re really trying to understand it. I think part of (the reason for the high number of cases) is because of the widespread media attention. Everyone is immediately recognizing the illnesses in these young patients who vape as soon as they come to the emergency department now.”

Aubree Butterfield — who spoke out last month while in recovery from the illness then identified as lipoid pneumonia — said Friday that after two months, “I’m getting a lot better as the days go on. I’m still kind of struggling with my breathing, but a lot better than I was.”

Aubree Butterfield, who was recently treated at the University of Utah Hospital for lipoid pneumonia linked to vaping, puts on her oxygen tube after changing her oxygen tank while at her parents’ home in Brigham City on Tuesday, Aug. 6, 2019.
Aubree Butterfield, who was recently treated at the University of Utah Hospital for lipoid pneumonia linked to vaping, puts on her oxygen tube after changing her oxygen tank while at her parents’ home in Brigham City on Tuesday, Aug. 6, 2019.
Scott G Winterton, Deseret News

Before the illness, Butterfield had been working full time and going to nursing school. But while she recovers, she’s needed to work part time. Her job as a certified nursing assistant has been difficult because she still requires help breathing.

Butterfield urged others who haven’t used e-cigarettes before not to use them, as she explained they can be very addictive.

The CDC believes the cases are all linked to a chemical exposure but that it is too early to pinpoint the exact chemical or product.

So far, at least 215 possible cases have been reported in 25 states, the CDC said.

People who are vaping and develop a respiratory illness or flu-like syndrome should seek medical care to determine whether it’s a flu, pneumonia or an injury from vaping.

“Because some of the cases do progress and become very severe and life-threatening,” Aberegg said.