Public Health Commissioner Monica Bharel said Wednesday any suspected cases of unexplained e-cigarette or vaping-associated pulmonary disease must be immediately reported to the Department of Public Health for the next 12 months. Last month, the agency sent an alert to 25,000 Massachusetts health care providers asking them to voluntarily report pulmonary-related disease associated with vaping. “Today’s action establishes the legal framework for health care providers to report cases and suspected cases so that we can get a better sense of the overall burden of disease in Massachusetts,” Bharel said in a written statement. She said the reporting will also help the state provide case counts to the US Centers for Disease Control and Prevention as they to try to understand the nationwide impact of vaping. U.S. health officials are investigating what might be causing hundreds of serious breathing illnesses in people who use e-cigarettes and vaping devices. They have identified about 450 possible cases in 33 states, including six deaths. Massachusetts is actively investigating several suspected vaping-associated pulmonary cases. There have been no confirmed Massachusetts cases. The last time the state health commissioner issued a similar mandate was two years ago. That mandate required providers to report cases of amnesia associated with intravenous drug use. The new mandate was sent to all clinicians — including internal medicine, family practice, general practice, emergency medicine, and clinical care — in Massachusetts as well as pediatricians, pulmonologists, and nurse practitioners. It asks providers to report any case of a person experiencing otherwise unexplained progressive symptoms of shortness of breath, fatigue, chest pain, cough, or weight loss, of any severity, and an abnormal chest imaging study associated with vaping. In the cases reported to the CDC, patients experienced coughing, shortness of breath, and fatigue. Symptoms worsened days or weeks before they were admitted to a hospital. Other symptoms reported by some patients included fever, anorexia, pleuritic chest pain, nausea, and diarrhea. All the patients had reported vaping in the weeks and months before going to the hospital. No specific product has been identified in all cases, nor has any product been conclusively linked to the clinical syndrome. According to the state health department, 41% of Massachusetts high school students have tried e-cigarettes at least once. About 20% of them reported using e-cigarettes in the past 30 days — a rate six times higher than adults. Nearly 10% of middle school students say they have tried e-cigarettes. A 2018 law signed by Gov. Charlie Baker includes e-cigarettes into the definition of tobacco, making it illegal to vape where it is illegal to smoke. The law also raised the minimum legal sale of tobacco products — including e-cigarettes — to 21.
Massachusetts collecting data on possible vaping illnesses.