A nationwide epidemic of severe lung injuries tied to vaping now encompasses 450 reported cases, and at least three deaths, in 33 states, federal health officials reported on Friday.
“While this investigation is ongoing, people should consider not using using e-cigarettes,” said CDC’s Dana Meaney-Delman in a briefing on the outbreak. A “chemical agent” in vaping liquids is seen as the most likely culprit in the cases, she suggested, responsible for causing the lung injuries.
Indiana’s public health agency announced a third death in the outbreak on Friday morning, of an adult, and the Oregon Health Authority announced the second one on Wednesday. That patient died in July after vaping “cannabis purchased from a cannabis dispensary,” according to the state agency. The first death reported in the outbreak was announced last month by Illinois health officials, and a fourth suspected death is now under investigation, according to federal health officials.
The fast-moving outbreak also led Michigan Gov. Gretchen Whitmer to ban flavored e-cigarettes this week.
Federal health officials said that no one ingredient in over 100 vaping liquids tested stands out definitively as the culprit for the cases. On Thursday, the New York Department of Health reported that Vitamin E acetate, an oily chemical found in some foods and lotions, was “now a key focus” of its investigation of cases after it turned up in at least one vape liquid that each of 34 patients seen by the agency has used. That investigation has been linked to the FDA’s testing efforts.
Daniel Fox of WakeMed Health & Hospitals in North Carolina warned e-cigarette users against “vaping cartridges purchased off the street where the substances in them are unclear,” or where the ingredients are not ones intended by manufacturers, based on cases in that state.
A series of reports from Wisconsin and Illinois, where the initial cases of the sudden onset of difficult breathing, fever, and nausea — pneumonia-like symptoms — in teens and young adults first appeared this summer, as well as Utah and California, were released in the New England Journal of Medicine on Friday as well. The reports described almost 80 patients with similar lung injuries tied to sudden damage in their lungs following vaping. Around 80% acknowledged vaping liquids containing THC, the high-inducing ingredient in marijuana, bought on the black market.
“Although more investigation is needed to determine the vaping agent or agents responsible, there is clearly an epidemic that begs for an urgent response,” David Christiani of the Harvard T. H. Chan School of Public Health wrote in a New England Journal of Medicine editorial on the cases released on Friday.
State health officials described suspected cases beginning as early as April of this year.
Ted Kwong, a spokesman for Juul, which sells about 80% of e-cigarette products in the US stressed the illness reports were tied to black market vapes of THC, which the company doesn’t sell. “We also must ensure illegal counterfeit and copycat products which may be made with unknown ingredients and under unknown standards and those that deliver controlled substances, stay out of the market.”