What are the symptoms of vaping illness? Doctors warn about e-cigarettes

Doctors are seeing otherwise healthy young people complain of coughing and shortness of breath, with signs of inflammation in both lungs.
Justin Wilson, 25, vaped for about a year and then suddenly collapsed, unable to breathe, on Sept. 1. He had to spend a week in a hospital in Portland, Oregon.
Justin Wilson, 25, vaped for about a year and then suddenly collapsed, unable to breathe, on Sept. 1. He had to spend a week in a hospital in Portland, Oregon.Courtesy Jake Wilson

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/ Source: TODAY
By A. Pawlowski

Jake Wilson was relieved when his 25-year-old son Justin started vaping last year as a way to quit smoking.

“I thought it was a great idea. I was so happy that he wasn’t smoking anymore. Now, there was this healthier vaping,” Wilson, who lives in Portland, Oregon, told TODAY.

That all changed on Sept. 1 when Justin suddenly collapsed while eating dinner with friends, unable to breathe. It was the start of a frightening ordeal that left him unconscious for days and had doctors puzzled until they arrived at the official diagnosis: vaping toxicity.

Justin’s case is part of a vaping crisis that now includes hundreds of incidents of vaping-related illnesses across the country, according to the Centers for Disease Control and Prevention. At least six deaths have been reported.

After Justin’s nightmare, the father and son just want others to be careful about vaping.

“The experience was just insanity for me,” Justin Wilson, also of Portland, Oregon, told TODAY. “It’s all so new that nobody really knows long-term effects on it.”

“I would strongly urge anyone to stop [vaping]. Until the medical world can figure out what causing this, to just stop,” his father added. “We thought this was a safer alternative, but I don’t think it is anymore.”

Justin had been using a Juul device and mint-flavored nicotine pods, his favorite. He bought mostly Juul products, plus the occasional off-brands available at stores. He would puff on the mint vapes constantly, draining about two pods a day.

They found e-juice in my lungs. It was starting to fill my lungs with liquid, like pneumonia.

“I liked the flavor. I liked the product in itself,” Justin said. “I really enjoyed the act of smoking.”

Recreational marijuana is legal in Oregon, so he would also buy THC cartridges from dispensaries and go through them at a much slower pace — about once a month, he estimated. He bought nothing off the street, he said.

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There were some concerns along the way: Justin had been diagnosed with asthma when he was 5, but he’d never had an asthma attack or needed an inhaler until after he started vaping, his father said.

Justin Wilson was unable to breathe on his own for days and even the regular ventilator wasn't enough to keep him alive, his family said. He finally recovered with the help of a special ventilator that delivered quick bursts of air and helped clear out his lungs.Courtesy Jake Wilson

Just before he suddenly collapsed this month, Justin felt a pressure on his chest that left him unable to breathe. His friends told him his face had turned purple, his lips were blue and he passed out.

Doctors thought it was an asthma attack, but Justin didn't respond to any asthma medication. At one point, his family was told Justin would die if he didn't improve quickly. Doctors discovered his lungs were coated with oil, leading to the diagnosis of vaping toxicity.

Vitamin E oil found in some products has been part of the vaping-related illnesses investigation.

“They found e-juice in my lungs,” Justin said. “It was starting to fill my lungs with liquid, like pneumonia.”

He finally got better with the help of a special ventilator and regained consciousness about five days later. Justin believes the coils in his vaping device weren’t as hot as they should have been to fully vaporize the e-liquid, so he was breathing in small fragments of it into his lungs. Another theory is that the heated vapor returned to oil form inside the cooler human body, his father said.

“There’s no way” Justin will go back to vaping, he said. Family friends are now throwing away their vape pens after learning about the ordeal, Jake Wilson added.

What a doctor wants parents to know:

Vaping is not as safe as people thought it was, said Dr. Humberto Choi, a pulmonologist and critical care specialist at the Cleveland Clinic. Choi has treated several of the vaping-related illnesses and has recently been inundated by calls from parents worried their children are exhibiting worrisome symptoms.

“The best advice I could give to anyone is to stop vaping all together,” Choi said.

“We’re seeing young people with no other medical problems who come with coughing and shortness of breath, and when we do an X-ray and CT scan, we see signs of inflammation in both lungs.”

Some have been sick enough to be put on oxygen. Some require a ventilator.

In the past, such cases would have been diagnosed as possible bronchitis or pneumonia, but they’re now being evaluated for suspected vaping-related lung disease. The illness is challenging to diagnose so doctors basically have to exclude other causes like infection, Choi said.

Part of the spike in possible cases is heightened awareness, and part of it is that more people are vaping, he added.

Because the e-liquids can contain oils, there’s concern about the potential for lipoid pneumonia — an inflammation of the lungs caused by oils — but that’s not the pattern Choi has seen at the Cleveland Clinic. Nor are black-market products necessarily to blame: Some of Choi's patients have only used a regular branded vaping device, not something tainted or bought on the street.

The CDC is still looking for a common pattern or substance that could explain the crisis, but for now, the only common pattern is the act of vaping, Choi noted.

Any new respiratory symptom should be reason for concern, including:

  • coughing
  • shortness of breath
  • chest tightness
  • wheezing
  • general symptoms like extreme fatigue or fever are also warning signs.

“If someone is vaping and has these symptoms, they should probably be seen,” Choi said.

“Most of the symptoms, when they’re mild, probably can be seen in the office. When they’re severe or showing up very fast, they should be seen in the ER, especially shortness of breath and chest tightness.”