Update: CDC Narrows Number of Respiratory Cases Related to Vaping Illness

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UPDATE: September 13, 2019 – 3:30 p.m. – In a statement released yesterday, the Centers for Disease Control and Prevention has altered its number of confirmed cases of vaping-related lung illness. In place of the 450 suspected cases it was reviewing last week, the agency now cites, “380 cases of lung illness reported from thirty-six states and one U.S. territory.”

The statement went on to say CDC does “not yet know the specific cause of these illnesses.”


UPDATE: September 11, 2019 – 9:45 a.m. – In a statement from the Kansas Department of Health and Environment on Tuesday, officials announced the sixth vaping-related death in the epidemic currently sweeping the nation. The decedent was a Kansas resident over the age of 50 whose name has not yet been released.

According to the KDHE announcement, Kansas State Epidemiologist Dr. Farah Ahmed said “the patient had a history of underlying health issues and was hospitalized with symptoms that progressed rapidly.”

The CDC, FDA, and state health departments continue to investigate the VAPI outbreak.

UPDATE: September 7, 2019 – 10:25 a.m. – Public health officials in Minnesota have announced the fifth death related to vaping.

The in a media release, officials confirmed, “According to Minnesota State Epidemiologist Dr. Ruth Lynfield, the patient had a history of underlying lung disease and was hospitalized with a severe lung injury that progressed to include other conditions. Investigators looking into the case after the patient died found the lung injury was associated with vaping illicit THC products.”

In related news, NBC4 Los Angeles yesterday reported that officials have referred to the new medical condition as “vaping-associated pulmonary injury,” or VAPI, for short.

UPDATE: September 6, 2019 – 3:09 p.m. – The Los Angeles County Department of Public Health today announced the first death in Los Angeles attributed to the vaping-related respiratory condition sweeping the nation. It is the fourth fatality officially confirmed to have been caused by the mysterious illness.

“The Los Angeles Department of Public Health takes this threat seriously and today we’re issuing a warning about the use of these devices as potentially harmful to lung function. We join the Centers for Disease Control to advise people to stop vaping now, until information about what is causing lung damage and death can be understood,” said the Department at a press conference held at 2 p.m. PST on Friday.

Limited information was given about the deceased; only that they were an “older adult,” and then it was clarified the patient was over 55 years of age. They confirmed the Los Angeles patient had vaped THC products.

Officials also made clear that investigations are ongoing, so there has not been “one substance, one product, or a device” that can be singled out. All of those components are currently being examined, they said, with samples of vape products collected from patients.

WASHINGTON, D.C. – Federal and public health officials in several states expressed growing concern today about hundreds of patients that have been affected by a potentially deadly respiratory condition related to vaping e-cigarettes and, apparently, cannabis vape cartridges.

Media reports this morning said federal officials have announced the number of patients affected by “vaping illness” has virtually doubled overnight to a possible total of 450 patients, across thirty-three states.

Public health officials in Indiana today also revealed a third fatality attributed to the vaping-related condition. Their announcement had no information about the patient, except that they were over the age of 18. Indiana officials also told media that there are eight confirmed cases of the condition in the state, and twenty more being investigated.

Associated Press stated in its report on the Indiana fatality, “Health officials said no single vaping device, liquid or ingredient has been tied to all the illnesses. Many of the sickened—but not all—were people who had been vaping THC, the chemical that gives marijuana its high.”

A report today in the New England Journal of Medicine, by Dr. David C. Christiani, M.D., M.P.H., titled Vaping-Induced Lung Injury, said in part, “Mixing of multiple ingredients with primary compounds and potential contaminants may result in in vitro (or even in vivo) production of new agents that may be toxic. E-cigarette fluids have been shown to contain at least six groups of potentially toxic compounds: nicotine, carbonyls, volatile organic compounds (such as benzene and toluene), particles, trace metal elements according to flavor, and bacterial endotoxins and fungal glucans.”

While Dr. Christiani’s report was not focused on cannabis vaping materials only, he did comment that, “The effect of adding ingredients such as THC or CBD to this mix needs to be investigated.” He also referred to the growing numbers of vaping-related cases an “epidemic.”

Yesterday, federal and state officials were reported to be focusing on a common substance, Vitamin E acetate, which had been found in analyzed cannabis vape cartridge samples used by patients in several states. In New York State, which also has seen a recent rash of vaping-related respiratory cases, all the samples collected from patients apparently contained the substance.

U.S. Food and Drug Administration (FDA) investigators in a Thursday phone conference with state public health officials focused on Vitamin E acetate, as described by the Washington Post.

While an innocuous substance, officials said the heating that occurs during the vaping process may change the molecular structure of Vitamin E acetate, resulting in unknown, potentially harmful effects when vaped as an ingredient in liquid vape products.

Oils rich in vitamin E include those derived from nuts, sunflower, wheat germ, safflower, corn, and soybeans. Vitamin E acetate also is an ingredient used in topical skin applications and nutritional supplements.

According to media reports, the FDA sampled twelve nicotine and eighteen cannabis vape products, collected from patients in several states. Vitamin E acetate was allegedly found in ten of the cannabis products.

The Washington Post and other media outlets displayed a photo, sourced form the New York Department of Health, of some of the cannabis vape cartridge products that had been sampled by the FDA. They included packaging for Chronic Carts, Dank Vapes, and a Snoop Dogg G Pen attached to an unidentified vape oil cartridge.

No information was given as to whether the products had been verified as legitimate or where they had been purchased. Officials also cautioned that it is too early in their investigation to make a determination as to the cause of the recent respiratory cases.

FDA comments quickly followed news out of Oregon on Thursday that a second death had been confirmed by officials as vaping-related. The male patient, who died in July, told doctors he had vaped cannabis products purchased at a legal dispensary.

OregonLive.com reported on Wednesday that state health officials are focused on “cannabis oil from two marijuana retail stores and investigators are now trying to find leftover product to analyze it.” They also said that this is the second death in Oregon related to “e-cigarettes.”

Investigators in the Oregon fatality also said it is unknown if the patient used products from both retailers, or if the cannabis oil had been “altered” or mixed with another “homemade” substance.

In Michigan on Wednesday, Democratic Governor Gretchen Whitmer ordered a ban on all flavored e-cigarettes, in an effort to curb vaping among underage users. Michigan is the first to take statewide action, motivated by reports of what Whitmer called a “public health crisis,’” related to vaping.

On August 30, public health officials in the city of Milwaukee, Wisconsin, issued a health alert advisory recommending that residents avoid vaping, especially “THC products containing e-liquid.”

Public health officials in Illinois reported the first vaping-related death on August 23. In the week previous to their announcement, they noted that vaping-related respiratory cases in the state had doubled, with patients all between 17 to 38 years of age.

Several of the Illinois patients also reported to doctors that they had used cannabis vape products, though officials said no specific products had been linked to the cases. Officials in Illinois said also that they had requested assistance from the Centers for Disease Control in investigating the rash of cases, and CDC investigators had arrived in the state.

Symptoms of the condition include cough, shortness of breath, fatigue, fever, anorexia, pleuritic chest pain, nausea, and diarrhea.

Ed. Note: This is a developing news story, more information will be added as it becomes available.