Jake Zimmerman initially thought he had a cold.
The 21-year-old Gilbert man said he felt “super cold,” was shivering, sweating and had a low-grade fever.
He decided to ride it out by resting and drinking fluids but after five days his temperature shot up, prompting him to go to urgent care.
A pulse oximeter read his blood-oxygen level at 80 percent. A normal reading ranges from 95 to 100 percent, meaning Zimmerman’s body was starved of oxygen.
“They said I had bad pneumonia in both lungs,” said Zimmerman of the initial diagnosis in a hospital emergency room. “It was very hard for me to breathe. I was put on lots of oxygen. I’m talking about 50 liters.”
The pneumonia turned out to be a more severe form of respiratory illness for Zimmerman, who recently returned home 20 pounds lighter after an eight-day hospital stay.
He is one of six suspected cases of severe lung illness linked to vaping reported so far in Arizona – five in Maricopa County and one in Tucson. Three cases were confirmed last week in the state, all in Maricopa County, according to the Arizona Department of Health Services.
All three patients in their 20s were hospitalized and have since been released from the hospital, according to Chris Minnick, a state health department spokesman.
ADHS is working with county health departments, medical providers and the Arizona Poison and Drug Information Center to identify cases in Arizona. But neither county nor state health officials will release any information about the identities of the confirmed vaping cases.
Nationwide, 530 confirmed and probable cases of the mysterious vaping illness were reported in 38 states since Sept. 17 and seven deaths so far have occurred in California, Illinois, Indiana, Kansas, Minnesota and Oregon, according to the Centers for Disease Control and Prevention.
The first reported death was on Aug. 23 and the most recent was last week.
Vaping is inhaling an aerosol that is produced when an electronic cigarette heats a liquid that usually contains nicotine, flavorings and other chemicals.
In all the reported cases, the patients have a history of vaping but there was no link to a specific e-cigarette product or substance, the federal agency said. Patients reported using products containing tetrahydrocannabinol or THC, products containing THC and nicotine and products containing only nicotine.
The CDC on Aug. 1 launched a multi-state investigation into the outbreak, working closely with the Food and Drug Administration, states and other public health partners to identify the cause of the illness.
Vaping has grown exponentially since it entered the U.S. marketplace around 2007, promoted as a safer alternative and a way to quit conventional cigarettes.
However, e-cigarettes are not currently approved by the FDA as a quit-smoking aid, and the available science is inconclusive on whether e-cigarettes are effective for quitting smoking, according to the CDC.
Zimmerman, who exercises regularly, said he began vaping at 18 and never tied his habit to getting sick.
Doctors suspected Zimmerman had something worst after a prescribed round of antibiotics for pneumonia failed to work.
His breathing became so labored that doctors twice considered putting him in deep sedation in order to intubate or insert a tube into his airway, according to Zimmerman’s dad, who declined to be identified.
Doctors ended up putting Zimmerman on a BiPAP machine, a non-invasive ventilation device.
Physicians could not confirm completely that Zimmerman’s respiratory illness was due to vaping unless an invasive lung biopsy was performed and they didn’t want to do that, said the dad, who reported his son’s case to the Arizona Poison and Drug Center at the University of Arizona.
“The only thing we have to go on – and it’s true with all these stories is – number one, they are spending more time in the hospital than a regular pneumonia patient would,” the dad said.
He noted that doctors administered antibiotics and prednisone until his son eventually recovered.
There is no one test that is currently being used to confirm if a patient’s lung injury is due to vaping, according to Dr. Ayrn D. O’Connor, a toxicologist at Banner University Medical Center.
If a person has a history of vaping and has clinical symptoms such as shortness of breath, cough, fever and fatigue and some may have nausea and vomiting, physicians first have to rule out other possible causes such as bacterial, viral, fungal, autoimmune and cancer, O’Connor said.
The onset of the symptoms generally occurred over several days to several weeks before hospitalization.
If vaping is suspected, health-care providers are following CDC guidelines that include taking a detailed history of the substance used, the sources and obtaining any remaining product, devices and liquids that were used for testing.
O’Connor said the majority of the reported cases in the country are in the age group 18-35.
She said everything from antibiotics and cortisone to ventilation machines and ECMO machines, which pumps and oxygenates the blood outside a body were used on the patients.
In severe acute lung injury patients no longer can get oxygen into their blood and develop hypoxia, where the brain, heart and other organs are deprived of oxygen and can lead to death.
“In other parts of the country hundreds of cases are being investigated and now we are starting to see cases here in Arizona,” O’Connor said. “Until we sort out the source and the cause we expect those numbers to increase. So, the only way to combat this effectively is to stop the exposure to these products.”
Her advice for people who vape is to stop now.
“This is a dangerous behavior,” she said. “You are taking chemicals and burning it and inhaling it on purpose. It’s not a healthy and wise thing to do.”
She said people who want to stop should see their primary care providers and ask for help.
“Whether it’s nicotine gum or the patch or counseling, there are resources to help,” she said.
Zimmerman has sworn off vaping. He had his dad disposed of his vaping equipment and cartridges while he was in the hospital.
“If you are thinking about vaping – don’t,” Zimmerman said. “If you think nothing bad can happen to you, it can and it won’t be good at all.”