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Lung illness tied to vaping has killed 5 people as new case reports surge

A fifth person has died of a mysterious lung illness related to vaping. There are currently 450 possible cases in 33 states and one territory, including the five deaths, health officials said Friday.

Physicians and health officials published specific information about the acute lung disorder in people who vape in a series of articles in the New England Journal of Medicine. They called the trend as “worrisome.”

The definitive cause remains uncertain, but a report by health department officials in Wisconsin and Illinois conducted a joint investigation of 53 patients, and stated that: 

“..the severity of the illness and the recent increase in the incidence of this clinical syndrome indicates that these cases represent a new or newly recognized and worrisome cluster of pulmonary disease related to vaping.”1

According to the Washington Post, The Centers for Disease Control and Prevention warned that no consistent e-cigarette products have yet been linked to the disorder. Some victims used THC-based products, some reported using marijuana and nicotine products, and a smaller group reported using nicotine products only. Ileana Arias, acting deputy director for noninfectious diseases at CDC stated:

“We are getting clearer about the things we should be looking at to understand the situation. The focus of our investigation is narrowing, and that is great news, but we are still faced with complex questions in this outbreak that will take time to answer.”1

No specific device or substance is tied to all the cases at this point, officials said. Dana Meaney-Delman, who is heading CDC’s lung injury response, said:

“Based on the clinical and laboratory evidence to date, we believe that a chemical exposure is likely associated with these illnesses.”1 

Vitamin E acetate, an oil derived from vitamin E, has been found in samples of marijuana products collected from patients who had been sickened by vaping. The FDA and New York state have indicated the oil is a key focus of the state’s investigation. 

The Indiana State Department of Health this week announced the state’s first vaping-related death. The death was confirmed on Thursday and the patient, who died due to severe lung injury related to vaping, was identified only as being over the age of 18, according to health officials. 

The Minnesota health department said on Friday that a patient over 65 died in August due to lung damage associated with vaping.

Also on Friday, Los Angeles County health government officials reported the county’s first known death associated with vaping, in an older adult with lingering health issues. Oregon and Illinois have each declared a vaping-related death as well.

An angry tweet from Sen. Dick Durbin, (D-Ill) in response to the rising deaths threatened to call for the resignation of acting FDA chief Norman “Ned” Sharpless. He tweeted:

The vaping epidemic has now reached the point where multiple people have died and over 450 have been hospitalized, but @FDACommissioner is sitting on his hands. If Dr. Sharpless doesn’t take action in the next 10 days, I plan to call for his resignation. Enough is enough.1

Even though the actual cause remains unknown, the mysterious lung illness has some similar characteristics, according to the Washington Post:

Most patients have been young and healthy. They had similar symptoms, including cough, chest pain or shortness of breath that appeared to take place over several days to several weeks before hospitalization, according to a CDC report released Friday. All patients reported using e-cigarettes, which officials define as battery-operated devices that heat a liquid and deliver an aerosolized product. Some patients had the presence of abnormal immune cells in their lungs.1 

Daniel Fox, a pulmonologist and critical care physician at WakeMed Health and Hospitals in North Carolina, indicated that the abnormal immune cells could occur when either oils or lipid-containing substances enter the lungs.

Officials have said that e-cigarette aerosol generally contains less toxic chemicals than conventional cigarette smoke. But e-cigarette aerosol is still dangerous and can expose users to substances known to damage health, including ultra-fine particles, heavy metals, volatile organic compounds and other harmful ingredients.

Most of the chemical compounds in e-cigarette liquids likely “undergo thermal degradation” when they are heated, which produces new compounds with potentially harmful consequences. The disorders could include lipoid pneumonia and could result in severe lung injury and a critical condition known as acute respiratory distress syndrome.

E-cigarettes are commonly used to inhale nicotine but can also be used to deliver THC, CBD, and butane hash oils known as “dabs.” 

After officials compared emergency room visits for complaints about severe respiratory illnesses, they found an uptick of cases starting in May and June of 2019. Jennifer Layden, chief medical officer at the Illinois health department, said:

“That would suggest that it’s a new phenomenon.”1