Doctors have issued a warning over vaping after a teenager in the UK almost died from serious respiratory failure linked to e-cigarettes.
Ewan Fisher, who turns 19 on Tuesday, ended up on life support. He was under age when he purchased vaping equipment over the counter from a shop and had been vaping for four to five months before he was taken ill aged 16.
Ewan was treated for hypersensitivity pneumonitis – a type of allergic reaction to something breathed in which results in inflammation of the lung tissue.
He became so ill that an exterior artificial lung was used to put oxygen into his blood and pump it around his body.
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Jayesh Mahendra Bhatt at Nottingham University Hospitals NHS Trust, who treated Ewan, said: “The evidence we gathered showed that it was [vaping] that was to blame.”
Ewan, a previous smoker, was admitted to hospital following a week of fever, a persistent cough and increasing difficulty with breathing. His condition deteriorated rapidly and he developed respiratory failure and was put on life support plus intravenous antibiotics and steroids.
Ten days later, his condition became critical and he developed severe muscle weakness, requiring a long period of rehabilitation.
The teenager told medics “he had recently started to use e-cigarettes fairly frequently, using two different liquids, purchased over the counter”.
The listed ingredients for both vaping liquids were the same apart from the unnamed flavourings. After two months, he was still suffering and underwent skin tests with vaping fluid, which made his symptoms worse.
Blood samples also showed that he had more antibodies to one of the two liquids, raising the possibility this might have been the source of his reaction. After 14 months, Ewan eventually recovered.
The doctors said: “There are two important lessons here. The first is always to consider a reaction to e-cigarettes in someone presenting with an atypical respiratory illness. The second is that we consider e-cigarettes as ‘much safer than tobacco’ at our peril.”
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British Lung Foundation medical director Nick Hopkinson said the findings showed it was “possible the patient’s illness could have been due to an allergic response to a component of e-cigarette vapour”.
However, he said it can often be difficult to make an accurate diagnosis for this condition.
“In Britain, 3.6 million people vape and youth use remains low,” he added. “If this was a common problem or a significant risk we would expect many more cases.”
Rosanna O’Connor at Public Health England said: “We continue to keep the evidence under review, including all safety and health concerns reported to the e-cigarette regulator, the Medicines and Healthcare products Regulatory Agency.
“However, smoking kills half of life-long smokers and accounts for almost 220 deaths in England every day. Our advice remains that, while not completely risk free, UK regulated e-cigarettes carry a fraction of the risk of smoked tobacco.”
Journal reference: Archives of Disease in Childhood, DOI: 10.1136/archdischild-2019-317889
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