United States

Official: White House didn’t want to tell seniors not to fly By MIKE STOBBEMarch 7, 2020 NEW YORK (AP) — The White House overruled health officials who wanted to recommend that elderly and physically fragile Americans be advised not to fly on commercial airlines because of the new coronavirus, a federal official told The Associated Press. The Centers for Disease Control and Prevention submitted the plan as a way of trying to control the virus, but White House officials ordered the air travel recommendation be removed, said the official who had direct knowledge of the plan. Trump administration officials have since suggested c…

Presser ongoing would rather over react than under react

What are the implications for public health practice? These data further support a potential role for vitamin E acetate in EVALI. While potential toxicants continue to be evaluated, vitamin E acetate should not be added to e-cigarette, or vaping, products. https://www.cdc.gov/mmwr/volumes/68/wr/mm6847e1.htm?s_cid=mm6847e1_w

Forty-seven deaths have been confirmed in 25 states and the District of Columbia (as of November 20, 2019): Alabama, California (4), Connecticut, Delaware, District of Columbia, Florida, Georgia (3), Illinois (5), Indiana (4), Kansas (2), Louisiana, Massachusetts (3), Michigan, Minnesota (3), Mississippi, Missouri (2), Montana, Nebraska, New Jersey, New York (2), Oregon (2), Pennsylvania, Tennessee (2), Texas, Utah, and Virginia The median age of deceased patients was 53 years and ranged from 17 to 75 years (as of November 20, 2019). More deaths are under investigation. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease…

EVALI patients aged 18–44 years had higher odds of reporting exclusive and frequent use of THC-containing products and obtaining these products from informal sources, such as a dealer, off the street, or from a friend, and of using Dank Vapes, a class of largely counterfeit THC-containing products. https://www.cdc.gov/mmwr/volumes/68/wr/mm6845e1.htm?s_cid=mm6845e1_w

This is the first reported identification of a potential toxicant of concern (vitamin E acetate) in biologic specimens obtained from EVALI patients. These findings provide direct evidence of vitamin E acetate at the primary site of injury among EVALI patients and are consistent with FDA product testing and media reports of state public health laboratory testing documenting vitamin E acetate in product samples used by EVALI patients (2,3) (Personal communication, D.T. Heitkemper, FDA Forensic Chemistry Center, November 2019). Other diluents and additives of concern (e.g., plant oils, MCT oil, petroleum distillates, and diluent terpenes) were notably not detected in BAL flu…

CDC Vaping EVALI update increases cases from 1888 to 2051 and deaths from 37 to 39 https://www.cdc.gov/media/releases/2019/s1107-lung-injury-cases.html

Teen receives double lung transplant after vaping-related illness CDC says vitamin E acetate could be to blame By Jen Christensen, CNN Posted: 7:43 PM, November 12, 2019Updated: 7:43 PM, November 12, 2019 https://www.news4jax.com/health/teen-receives-double-lung-transplant-after-vapingrelated-illness

Patients with Lung Injury As of October 29, 2019, 1,888 confirmed and probable lung injury cases associated with use of e-cigarette, or vaping, products were reported by 49 states (all except Alaska), the District of Columbia, and the U.S. Virgin Islands. Data on age, sex, and substances used in e-cigarette, or vaping, products was updated in the MMWR report released on Monday, October 28, 2019. Deaths 37 deaths have been confirmed in 24 states and the District of Columbia: Alabama, California (3), Connecticut, Delaware, Florida, Georgia (3), Illinois (2), Indiana (3), Kansas (2), Massachusetts, Michigan, Minnesota (3), Mississippi, Missouri, Mont…

The first Nebraska vaping death (68M) died in May. Long tern smoker who switched to vaping 5 years ago was classified as a vaping death because CT scan showed Ground Glass Opacity. https://www.ketv.com/article/this-isnt-as-safe-as-it-seems-family-of-nebraska-man-who-died-from-vaping-send-a-message/29313158

Early release MMWR describing EVALI patients, including deaths.

Media Advisory For Immediate Release: Friday, October 25, 2019, 1:00 p.m. ET Contact: Media Relations (404) 639-3286

Interviews on vaping epidemic will be posted on this thread

34 deaths have been confirmed in 24 states: Alabama, California (3), Connecticut, Delaware, Florida, Georgia (2), Illinois (2), Indiana (3), Kansas (2), Massachusetts, Michigan, Minnesota (3), Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, Oregon (2), Pennsylvania, Tennessee, Texas, Utah, and Virginia. The median age of patients who have died is 49 years, ranging from 17 to 75 years old https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#latest-outbreak-information

In the majority of aerosol samples analyzed, the researchers found levels of carcinogenic metals in fumes above the minimal risk levels for safe air set by the Department of Health and Human Services. Those levels are not contained in regulations for the devices, and manufacturers trying to cut corners might be using lead or cadmium-based solder and other dangerous metals, experts consulted by USA TODAY said. https://www.usatoday.com/story/news/nation/2019/10/23/vaping-devices-under-scrutiny-outbreak-lung-illnesses-continue/4009350002/ 'Something has changed': People have been vaping for years but now they're dying. Could it be the devices? Trevor Hugh…

The Centers for Disease Control and Prevention is starting to study lung tissue and chemicals from electronic cigarette vapor to track down the root cause of lung damage caused by vaping. https://www.npr.org/2019/10/22/772368792/cdc-studying-tissue-to-try-and-track-down-root-cause-of-vaping-related-lung-dama

Lung biopsies from eight men vaping THC had ground glass opacity in CT scan and absence of lipoid pneumonia, consistent with lung injury due to chemical burns. https://academic.oup.com/ajcp/advance-article/doi/10.1093/ajcp/aqz182/5588493?searchresult=1

none of our cases showed histologic evidence of exogenous lipoid pneumonia and no radiologic evidence thereof has been found2; this calls into question the diagnostic utility of identifying lipid-laden macrophages or performing oil red O staining on bronchioloalveolar lavage fluid as a marker of vaping-associated lung injury https://www.nejm.org/doi/full/10.1056/NEJMc1913069?query=featured_home

Recent question at Quora about cause of lung pain linked to vaping. Answer included description of vaping methods - mouth to lung was more like smoking cigarettes, while huffing sucked vape directly to lungs.

E-cigarette Use, or Vaping, Practices and Characteristics Among Persons with Associated Lung Injury — Utah, April–October 2019 Early Release / October 22, 2019 / 68 https://www.cdc.gov/mmwr/volumes/68/wr/mm6842e1.htm?s_cid=mm6842e1_w

NY Times report detailing the history of Marijuana / THC vaping. Marijuana and Vaping: Shadowy Past, Dangerous Present A technology initially promoted to help cigarette smokers has transformed marijuana use, too. Now, with cases of severe lung illness rising, health investigators are warning people to stop vaping cannabis. By Matt Richtel Oct. 21, 2019, 3:00 a.m. ET https://www.nytimes.com/2019/10/21/health/marijuana-and-vaping-shadowy-past-dangerous-present.html?smid=tw-nytimesscience&smtyp=cur

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html As of October 15, 2019, 1,479* lung injury cases associated with e-cigarette use, or vaping, have been reported to CDC from the District of Columbia, 1 U.S. territory (USVI), and 49 states (all except Alaska). Thirty-three deaths have been confirmed in 24 states: Alabama, California (3), Connecticut, Delaware, Florida, Georgia (2), Illinois, Indiana (3), Kansas (2), Massachusetts, Michigan, Minnesota (3), Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, Oregon (2), Pennsylvania, Tennessee, Texas, Utah, and Virginia. More death…

Early release MMWR embargoed until 1 PM

House Appropriations hearing 10 AM 10/16/19 https://appropriations.house.gov/events/hearings/e-cigarettes-an-emerging-threat-to-public-health

Part II of Colorado Green Lab blog on role of solder in EVALI (#vaping lung injury) http://www.coloradogreenlab.com/blog/vape-pen-vivisection-preview