Health professionals now required to report suspected vape illness or injury

Maryland’s Secretary of Health, Robert J. Neall, has ordered health professionals to report any suspected cases of lung illness or injury connected to vaping.

BALTIMORE — As the number of lung illnesses suspected of being connected to vaping rises in Maryland and across the country, health professionals in Cecil County are now under orders to report any cases they are treating.

Citing health advisories issued by the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention, Robert R. Neall, Maryland Secretary of Health has issued a directive and an order to all health professionals to become familiar with the criteria for vape associated lung injuries and report them within one working day to the Cecil County Health Department.

Henry Taylor, M.D. and health officer for the county health department, said clinicians that use computers in patient care already have easy access to the reporting system, which requires the reporting of others diseases as well.

“This will just add it to the mandatory reporting system just as they report communicable diseases,” Taylor said Thursday. Taylor said there is staff at the county office in Elkton to act as the reporting agency for the county to the state health department.

“We need to find the cause,” Taylor said.

Patients with any kind of breathing illnesses not associated with an infection, or another chronic condition who have used a vape or dabbing product within 90 days of presenting these symptoms must be reported, the directive reads. Local reports are sent to the county health department, which are then forwarded — with no personal patient information — to the state health department.

The directive is statewide and went into effect immediately. As of Oct. 1 there were 23 cases reported in the state.

Until the data can assure him otherwise, Dr. Naveed Hasan, a pulmonologist at Union Hospital in Elkton, said he does not see where vaping is safer than traditional tobacco smoking in a cigarette.

“We have no controls, no minimum or maximum for the chemicals,” he said. While he agrees that the percentage of illnesses and deaths do not compare to the numbers caused by other products.

“But they are being marketed wrong,” he said. “They are sending the wrong message.”

Hasan is concerned that young people who use a vaping liquid with nicotine will transition to cigarettes.

“Overall I think vaping, in general, has increased tobacco use in high school aged children,” he said.

While he has not personally seen any patients presenting with a vape-related illness or injury, what he has been told is the majority of those seen are connected to THC liquids.

Maryland now has a website where the most recent information and statistics can be found; https://phpa.health.maryland.gov/OEHFP/EH/Pages/VapingIllness.aspx. Health professionals are being instructed to educate patients on the dangers and how to prevent illnesses associated with vaping.

“By having mandatory reporting, we’ll have a sense of where this is coming from,” Taylor said. “We’ll be able to look at who’s getting sick and we’ll be able to look at the devices.”

Cecil County’s vape businesses maintain that the dangers being seen are as a result of black market products, not those sold by legitimate stores.

“They are adding a chemical called ‘Vitamin E Oil’ as a filler or a thickener,” Joe Brown, owner of Cloud 9 Vape Shop in Rising Sun, said of these black market pre-filled pods purported to contain THC. Also known as tetrohydrocannabinol, THC is the ingredient in marijuana that creates the high, or the hallucinations. “When it’s (vitamin E oil) heated it becomes toxic. This is not in regulated E-juice, period. Never has been, never will.”

Collin McIlvried, district manager of Wesley’s Vape Shops in Elkton, Fair Hill and Havre de Grace, agreed that the wrong group is under attack.

“Instead of targeting the problem they’ve demonized the entire industry,” McIlvried said.

Taylor said there appears to be a need to educate the public about the dangers of doing any kind of damage to one’s lungs.

“Lungs have the surface area about the size of a tennis court,” he explained. “They are a very good way to get medicine into the blood stream.”

For instance, he pointed to the inhalers used by those with asthma or chronic obstructive pulmonary disease.

“And with Narcan it’s the best way to get the medicine into the blood stream in an overdose,” he said, referring to the fast acting nasal spray used on a person suffering an opioid overdose. “People are being a little bit casual thinking you can put anything into your body.”

“Taking oil and perfume and heating it up and breathing it into the lungs ... you get a build up of oils and lipids in the lung tissue,” Taylor said.

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