niman

Interviews on vaping epidemic will be posted on this thread

Kevin Boclair The 19-year-old Pennsylvania teen became dependent on a heart and lung machine at Hospital of the University of Pennsylvania in September after suffering from an unknown lung illness that is likely due to vaping. At the time, doctors worked to identify Boclair’s lung problems and devise a treatment plan, but they’ve struggled with exactly how to help him. “They know it’s vaping, but this is even new to the doctors,” Boclair’s mom Debbie told ABC 6 on Sept. 3, 2019. “They told me outright, we’re treating all the things he has. When he came in he had double pneumonia — they treated that with antibiotics. They’re treating all the different things. But there’s parts they don’t even know what’s going on.” Debbie said then that doctors are unsure whether Kevin will recover on his own, require lung surgery — or even survive. “I don’t know how we can get parents to stop the kids, so I want to tell the kids right out, you’re smart kids — just don’t do it,” she said. “No parent should ever have to see that of their kid,” Boclair’s father Len added.

Anthony Mayo The 19-year-old Pennsylvania teen’s father was “kicking himself for not asking more questions” about his son’s vaping habit after doctors discovered that Mayo’s lungs were almost entirely blocked with solidified vaping oils, which they compared to bacon grease. Mayo was admitted into the intensive care unit on Sept. 15, 2019 at Millcreek Community Hospital, where doctors found his lungs were quickly depleting. Mayo’s parents, Tanya and Keith, were told that their son “has the lungs of a 70-year-old lifetime heavy smoker” and that “a full recovery is uncertain.” “The pulmonary doctor said he had seen dead people with a higher O2 level!” Tanya wrote beside two photos of Anthony’s lungs on Facebook. “Now we pray that the ‘good’ lung doesn’t develop a mucus plug which would cause him to not be able to breathe at all.” Anthony recovered enough to leave the hospital on Sept. 27, but his mom said “there’s still a long road ahead.” https://people.com/health/vaping-related-illness-stories/

This thread will provide details on Pennsylvania vaping cases.

Adam Hergenreder The Illinois teen and student athlete was hospitalized with severe lung damage caused by e-cigarettes, according to CNN, who reported the story on Sept. 13, 2019. Hergenreder, 18, was told by doctors at Advocate Condell Medical Center that his “lungs were that of a 70-year-old’s” and that “if his mom had not brought him to the hospital within the next two to three days, his breathing could have worsened to the point that he could have died if he didn’t seek medical care.” Hergenreder’s mother Polly told the outlet that her son was “going through a pod and a half every other day, or a day and a half.” “If I had known what it was doing to my body, I would have never even touched it, but I didn’t know,” Hergenreder said, adding that “it was scary to think about” the damage “that little device” did to his lungs. After being released from the hospital, Hergenreder still finds it “difficult to even do normal activities, like going up stairs,” which leaves him winded. His future with sports is also in jeopardy. “I was a varsity wrestler before this and I might not ever be able to wrestle because that’s a very physical sport and my lungs might not be able to hold that exertion,” he said. “It’s sad.”

Kevin Boclair The 19-year-old Pennsylvania teen became dependent on a heart and lung machine at Hospital of the University of Pennsylvania in September after suffering from an unknown lung illness that is likely due to vaping. At the time, doctors worked to identify Boclair’s lung problems and devise a treatment plan, but they’ve struggled with exactly how to help him. “They know it’s vaping, but this is even new to the doctors,” Boclair’s mom Debbie told ABC 6 on Sept. 3, 2019. “They told me outright, we’re treating all the things he has. When he came in he had double pneumonia — they treated that with antibiotics. They’re treating all the different things. But there’s parts they don’t even know what’s going on.” Debbie said then that doctors are unsure whether Kevin will recover on his own, require lung surgery — or even survive. “I don’t know how we can get parents to stop the kids, so I want to tell the kids right out, you’re smart kids — just don’t do it,” she said. “No parent should ever have to see that of their kid,” Boclair’s father Len added.

Sherie Canada This Texas mom wrote a candid testimonial about how her experience with vaping landed her in a medically-induced coma and nearly killed her after she contracted multifocal pneumonia, severe sepsis and acute respiratory failure with hypoxemia (ARDS). “I got very sick around June 9th with stomach flu like symptoms,” she wrote on Facebook on Sept. 6, 2019. “I couldn’t hold any fluids down, I took everything you could imagine over the counter, tried drinking fluids but couldn’t keep them down, I was severely dehydrated.” Days later, on June 12, 2019, she was rushed to the hospital with low oxygen and blood pressure levels. “[Doctors] did a cat scan and [it] showed my lungs were full of fluid and [my] blood [tested] positive for blood clots,” Canada said. “I was so scared but more than anything in so much pain.” Her condition continued to deteriorate, and on June 18, doctors made the decision to put her in a medically-induced coma. “I was absolutely terrified that I was never going to wake back up and see my boys, family or friends again! I remember leaning over to my mom telling her just how tired I was of fighting and just couldn’t fight no more,” she said. While she was sedated, doctors removed four liters of fluid from her lungs and she was brought out of the coma two days later. Canada was placed on a ventilator for three days afterwards and wrote that she “woke up a whole new woman with a whole new perspective in life.” She promised she would live life differently and “never take advantage of my lungs, a breath, again.”

Piper Johnson The Colorado teen’s parents, Ruby and Tim, thought they would be taking her to college for her freshman year. But they instead had to be by Johnson’s side in the hospital because of her vaping habit. Johnson, who had been vaping for over two years, was diagnosed with the state’s first case of severe lung illness linked to vaping and now feels “lucky to be alive” after a fever and rapid heart rate landed her in the hostpital. “We’re parents who are mad that these things are out there, and we’re mad that they’re easily accessible,” Ruby told CBS This Morning, who reported the story on Sept. 9, 2019. “Targeting a younger audience happened, and then when Juul was called on it, they went, oh, sorry, we didn’t mean to do that.” After her near-death experience, Johnson is done with vaping forever. “It’s not worth it,” she said. “And it’s not worth the risk, and it’s not worth seeing your parents cry as you’re in a hospital bed.”

Tryston Zohfeld Neither Zohfeld nor his parents knew just how severely damaged the Texas teen’s lungs were until they suddenly failed on July 26, 2019. “I woke up just throwing up everywhere, and my heart was beating out of my chest going 100 miles an hour,” Zohfeld told ABC affiliate WFAA. His family rushed him to the Cook Children’s Hospital in Fort Worth, where he was eventually hooked up to an oscillatory ventilator that kept him alive for 10 days while doctors searched for a diagnosis. It wasn’t until a family member revealed that Zohfeld had been vaping regularly since the 8th grade that doctors were able to connect the dots. Dr. Karen Schultz, a specialist in pediatrics and pulmonology, told WFAA that she believed the chemicals Zohfeld was inhaling from the vape pen caused his lungs to inflame to a point where they couldn’t exchange oxygen and carbon dioxide anymore. She added that his habit had scarred his lungs, according to CBS. After 18 days in the hospital, Zohfeld was able to go home. He believes he was “definitely given a second chance.” “This is really what could happen [from vaping] and it’s not something to look over,” he told WFAA. “They’re not as safe as you think.” His family has started a GoFundMe page to help with the costs of his hospital stay, and with his upcoming rehabilitation program.

Maddie Nelson The Utah teen vowed to “never touch a vape again” after nearly dying as a result of vaping every day for three years. “I thought vaping was fine,” she told Fox 13. “I did all the tricks, all the time. I used all sorts of different products, like from all sorts of vape shops across Utah county.” However, things took a turn in July 2019. Barely conscious, she was admitted to the hospital, where x-rays showed that she had severe lung damage. Her family elected to put her in a medically induced coma. “We were scared we may never be able to talk to our sister again,” her siblings said on the GoFundMe page they created to help with medical costs. After running several tests, doctors determined that Nelson had acute eosinophilic pneumonia, a rare lung illness, that “was definitely from vaping.” After a course of steroids, Nelson immediately started to improve and was brought back out of the coma three days later. She has been recovering from home, but still needs to use an oxygen machine at night and often experiences sudden chest pains.

Whitney Livingston After making the switch to vaping in order to try and quit cigarettes, the 17-year-old Texas teen decided to ditch both — but not soon enough. The night she put down her vape for good, Livingston started to run a fever that eventually developed into pneumonia in both lungs. Livingston was put on life support at Children’s Medical Center Dallas, where her mother, Jennifer Audas, told Fox 4 News on Sept. 10, “she could have almost died.” “The doctor said it looked like no pneumonia he’d ever seen,” she continued. Audas said at the time that there has been no major progress with her daughter’s condition, but she is showing some improvement. They are not sure what long-term damage she may have.

Anthony Mayo The 19-year-old Pennsylvania teen’s father was “kicking himself for not asking more questions” about his son’s vaping habit after doctors discovered that Mayo’s lungs were almost entirely blocked with solidified vaping oils, which they compared to bacon grease. Mayo was admitted into the intensive care unit on Sept. 15, 2019 at Millcreek Community Hospital, where doctors found his lungs were quickly depleting. Mayo’s parents, Tanya and Keith, were told that their son “has the lungs of a 70-year-old lifetime heavy smoker” and that “a full recovery is uncertain.” “The pulmonary doctor said he had seen dead people with a higher O2 level!” Tanya wrote beside two photos of Anthony’s lungs on Facebook. “Now we pray that the ‘good’ lung doesn’t develop a mucus plug which would cause him to not be able to breathe at all.” Anthony recovered enough to leave the hospital on Sept. 27, but his mom said “there’s still a long road ahead.”

The national death toll has risen to 18 as people across the country continue to face severe illnesses linked to vaping By Diane J. Cho October 04, 2019 03:40 PM https://people.com/health/vaping-related-illness-stories/

https://www.renseradio.com/listenlive.php

Interview tonight 9 PM ET FRIDAY Dr. Henry Niman PhD More Dead In Breaking News On The Vaping Crisis

Date: Fri 27 Sep 2019 9:29 AM ETSource: The Daily Beast [edited]https://www.thedailybeast.com/vaping-marijuana-cartridges-test-positive-for-hydrogen-cyanide-nbc-news-test-reportBlack-market marijuana vape cartridges have been found to contain hydrogen cyanide in laboratory testing commissioned by NBC News. The network reports it asked a California cannabis testing facility to examine a sample of 18 cartridges containing THC [tetrahydrocannabinol], the psychoactive ingredient in marijuana. The 3 purchased from legal dispensaries found no toxins, such as heavy metals or pesticides, but the other 15 samples from black-market THC cartridges gave troubling results. They all contained myclobutanil, a fungicide capable of transforming into hydrogen cyanide when burned. 13 out of the 15 contained vitamin E acetate, which some health officials have blamed for the deaths and lung illnesses linked to vape pens. 10 of the unregulated cartridges also tested positive for pesticides. "You certainly don't want to be smoking cyanide," Antonio Frazier, the vice president of operations at testing lab CannaSafe, told NBC News. "I don't think anyone would buy a cart that was labeled hydrogen cyanide on it."The Centers for Disease Control and Prevention reported [Thu 26 Sep 2019] that 12 people have now died from mysterious illnesses believed to be related to vaping, with the number of confirmed cases at 275.[Byline: Jamie Ross]--Communicated by:ProMED-mail from HealthMap Alerts<[email protected]>[There is information in these articles eliciting both hope and questions. Regarding the fungicide myclobutanil decomposing or breaking down under correct circumstances to hydrogen cyanide could make sense as hydrogen cyanide in proper concentrations could produce death. There is no information regarding the concentrations possibly inhaled or even if the concentrations have been measured above the level of 'present'. So clearly there are more questions here and a lot more room for work on this issue.Vitamin E has been mentioned several times in these and other articles. Why would vitamin E be vaped? It is an oily substance and burned oil (oil heated to high temperatures, as in vaping) may have other changes, some or all possibly being unhealthy in the lungs.Clearly the main cause of these vaping deaths is not yet evident and work is ongoing. With the possibility of cyanide being involved, it is likely other substances in relationship to the high temperatures of vaping may be more thoroughly examined. - Mod.TG

Date: Thu 3 Oct 2019Source: The New York Times [edited]https://www.nytimes.com/2019/10/02/health/vaping-illnesses.htmlDoctors at the Mayo Clinic examined samples of lung tissue from 17 patients, all of which looked as if the people had been exposed to toxic chemicals, the researchers said.The lung damage in some people who have become ill after vaping nicotine or marijuana products looks like that seen in people exposed to some chemical weapons, a pathologist said.The lung damage in some people who have become ill after vaping nicotine or marijuana products resembles a chemical burn, doctors from the Mayo Clinic reported on [Wed 2 Oct 2019].Their findings are based on samples of lung tissue from 17 patients around the country whose biopsy specimens were sent to Mayo to be examined under the microscope by experts in lung pathology. 2 samples came from patients who died."All 17 of our cases show a pattern of injury in the lung looking like a toxic chemical exposure, a toxic chemical fume exposure, or a chemical burn injury," said Dr Brandon T Larsen, a surgical pathologist at the Mayo Clinic in Scottsdale, Arizona. "To be honest, they look like the kind of change you would expect to see in an unfortunate worker in an industrial accident where a big barrel of toxic chemicals spills, and that person is exposed to toxic fumes and there is a chemical burn in the airways."The injuries also look like those seen in people exposed to poisons like mustard gas, a chemical weapon used in World War I, he said.The findings were published on [Wed 2 Oct 2019] in The New England Journal of Medicine [1] and involved samples from 13 men and 4 women whose ages ranged from 19 to 67. About 70 percent had a history of vaping marijuana or cannabis oils. 11 were in Arizona, 5 in Minnesota, and 1 in Florida.More than 800 cases of lung illness in 46 states have been linked to vaping, and 16 people have died. The majority have vaped THC, the psychoactive ingredient in marijuana, but some say they have vaped only nicotine.Medical investigators have been unable to identify exactly what is causing the lung damage, or even how many harmful substances are involved. They do not know whether the source is the liquids being vaped, or a toxin released from the materials used to make vaping devices. It is also unclear whether some devices used in vaping may be defective.Initial concerns have focused on the possibility that the lungs were clogged by oils being vaped, like THC oil itself, or other oils like vitamin E acetate being used sometimes to dilute or "cut" THC for sale.But Dr Larsen said the Mayo researchers saw no signs of oil accumulating in the lung tissue. Instead, they saw many immune cells called macrophages with what he described as "the fine, foamy-looking appearance that is characteristic of chemical injuries.""So maybe we need to look more closely at the chemical compounds, and not just oils, but the chemical constituents, to figure out which ones are injurious," Dr Larsen said.He said patients with lung illness from vaping had tissue damage and cell death in the lining of their airways, and in the lungs themselves. As the body reacts and tries to heal, the tissue swells and can narrow the airways. Dead cells slough off into the airways, blocking them further, and fluids leak into the lungs' air sacs.The swelling, tissue damage, and fluid buildup can make it impossible to breathe."The lung is not very functional when it's been damaged and is trying to repair itself," Dr Larsen said, adding that the lungs and airways have essentially been "torched.""There's no reserve left while the body tries to heal itself, so people will be really sick, on a ventilator because they can't get enough oxygen in, or carbon dioxide out," he said. "Some patients will not recover, and will end up dying."He said it was too soon tell whether the survivors' lungs would fully recover."Based on the severity of injury we see, at least in some of these cases, I wouldn't be surprised if we wind up with people down the road having chronic respiratory problems from this," Dr Larsen said. "Some seem to recover. I don't think we know what the long-term consequences will be."Two of the cases included in the Mayo Clinic report occurred before 2019, and Dr Larsen said he suspected the condition had existed for some time, years perhaps, but the cases were scattered and the cause was not recognized.For decades, doctors have asked patients whether they had a history of smoking traditional cigarettes, but until very recently, not about vaping. "As we become more attuned, I think we'll see more and more of this, and we may see more risks than we initially realized," he said.The patients described in the Mayo report included a 31-year-old woman who died, despite extensive treatment with steroids and even a machine to pump oxygen directly into her bloodstream. Her lungs were so damaged even a ventilator could not give her enough air. She had a history of vaping, but there was no information about what she vaped. Another patient was a 21-year-old man who reported vaping nicotine for 5 years, and who became ill shortly after adding marijuana to it for the 1st time. He recovered well enough to leave the hospital.A 28-year-old man listed in the report had, for a year, been vaping 20 to 30 cartridges a day and also vaping THC.Last [27 Sep 2019], the Centers for Disease Control and Prevention identified several names of THC-related products in prefilled cartridges they said patients had reported using before becoming ill. Dank Vapes, Moon Rocks, Off White, and TKO were among those listed by health officials who interviewed patients in Wisconsin and Illinois.But officials said they did not know if vaping illnesses or deaths in other parts of the country were related to the same THC labels identified in those 2 states.Officials also said Dank Vapes was not an actual brand, but just a label and packaging anyone selling THC vaping liquid could buy and stick on a product.The extensive use of prefilled THC cartridges suggests they might play an important role in the outbreak, the CDC said.According to the CDC report last week [week of 23 Sep 2019], of 771 patients nationwide in the outbreak, 91 percent had been hospitalized; 69 percent were male; and a little more than 60 percent were between the ages of 18 and 34. Of the 13 known deaths at the end of last week, the CDC said nearly 60 percent were of men, and the median age was 50 years old.Nebraska, Virginia, and New Jersey reported deaths this week, bringing the total to 16. Many of the patients who died were older with underlying illnesses, although few details about them have been released.[Byline: Denise Grady][Reference---------1. Butt YM, Smith ML, Tazelaar HD, et al. Pathology of vaping-associated lung injury. N Engl J Med. 2019; https://www.nejm.org/doi/full/10.1056/NEJMc1913069.]--Communicated by:ProMED-mail<[email protected]>[The substance, be it liquid nicotine, THC, flavors, or oils could certainly burn a lung or look like chemical damage, as the vapor is essentially a hot liquid minute particle being inhaled. It is warmer by some degrees than the body temperature and the lungs are sensitive organs. - Mod.TG]

Date: Thu 3 Oct 2019Source: The New York Times [edited]https://www.nytimes.com/2019/10/03/health/vaping-illnesses-cdc.htmlIllnesses and deaths linked to vaping continue to increase around the country, now totaling 1080 cases and 19 deaths, health officials said on [Thu 3 Oct 2019]. The Centers for Disease Control and Prevention said that cases had occurred in 48 states and the United States Virgin Islands. This week, Nebraska, Alabama, Delaware, Connecticut, Virginia, and New Jersey reported deaths, which brought the total to 19 in 16 states. The new case count reflects an increase of 275 in just the past week. About half of the 275 were hospitalized in the past 2 weeks, and the rest were older cases whose link to vaping was just recognized, Dr Anne Schuchat, principal deputy director of the CDC, said during a news briefing.She described the outbreak as "continuing at a brisk pace," emphasized that the illnesses were serious and life-threatening and called the proportion of patients hospitalized and in intensive care "just terrible." "We know that additional deaths are under investigation," Dr Schuchat said. About 70 percent of the patients were male, 80 percent under 35 years old, and 16 percent younger than 18, she said. Among the patients who died, the median age was about 50, and the proportion of women was higher than in the overall group of patients.In response to the outbreak of illnesses as well as the increasing rate of teenage vaping, several states have ordered bans on flavored e-cigarettes. The Trump administration has said that it would draft a ban on flavored e-cigarettes, too. But on [Thu 3 Oct 2019], a New York appeals court ordered a temporary stay of a statewide flavor ban that was to take effect on [Fri 4 Oct 2019]. Vaping groups had filed suit against the ban, contending that it would hurt retailers and adults who use the products. The vaping industry is also battling a more extensive ban of all vaping products in Massachusetts.Dr Howard Zucker, the New York state health commissioner, called the outbreak a "public health emergency," adding: "It is undeniable that the vaping industry is using flavored e-cigarettes to get young people hooked on potentially dangerous and deadly products. While the court's ruling temporarily delays our scheduled enforcement of this ban, it will not deter us from using every tool at our disposal to address this crisis."Symptoms of the illness include coughing and breathing trouble that can become severe enough to require that patients be attached to ventilators. Some also have nausea, vomiting, and fever. Many have vaped THC, the psychoactive ingredient in marijuana; some have vaped both THC products and nicotine. Some say they have vaped only nicotine.It is not yet possible to tell whether the illness comes on quickly or is the cumulative effect of long-time vaping.The exact cause of the illness is still not known, although CDC officials have been referring to "chemical exposure." The culprit could be one or more ingredients in the vaping fluids, or a toxin released from the materials used to make vaping devices, which contain heated coils that vaporize fluids or other substances. Many of the ingredients in the products are unknown. "I wish we had more answers regarding the specific harmful products or components that are causing these illnesses," Dr Schuchat said. She added: "I think we have the feeling right now that there may be a lot of different nasty things in e-cigarettes or vaping products, and they may cause different harms in the lungs."In some cases, the injury to the lung tissue looks like a chemical burn, the same kind of damage that occurs from industrial accidents where chemicals spill and people inhale poisonous fumes, experts in lung pathology from the Mayo Clinic reported on [Wed 2 Oct 2019]. Their findings were based on studying samples of lung tissue from 17 patients, ages 19 to 67, who became ill after vaping. Most reported vaping THC.Medical investigators are scrambling to find the cause of the illnesses, a task made more difficult by the booming market in vaping products, some legal and many not, from sources unknown. Some are concocted at home by users themselves. All the products are a stew of chemicals, often including flavorings, oils, and solvents that may react with one another when heated, to produce still more molecules that have yet to be identified.The Food and Drug Administration is testing vaping products, and has obtained more than 440 samples from 18 states, Judy McMeekin, the agency's deputy associate commissioner for regulatory affairs said at the briefing on [Thu 3 Oct 2019]. So far, she said, no single product or substance has been identified as the source of the trouble. She said that the agency was particularly concerned about black-market sources, but that it was too soon to rule out other products.During the briefing, Dr Schuchat was asked if THC vaping products could be considered safe if purchased from dispensaries in states that license them. She replied: "With all the data I've been seeing, I don't know what safe is now."[Byline: Denise Grady, Andrea Salcedo]--Communicated by:ProMED-mail<[email protected]>

Media reports and comments on CDC Telebriefing, Mayo Clinic on chemical burns, and Black-market marijuana vape cartridges https://www.promedmail.org/post/6708832

Latest Outbreak Information Updated every Thursday As of October 1, 2019, 1,080* lung injury cases associated with the use of e-cigarette, or vaping, products have been reported to CDC from the following states and 1 U.S. territory: AL, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, ME, MD, MI, MN, MO, MT, MS, NC, ND, NE, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY, and USVI. Eighteen deaths have been confirmed in 15 states: Alabama, California (2), Delaware, Florida, Georgia, Illinois, Indiana, Kansas (2), Minnesota, Mississippi, Missouri, Nebraska, New Jersey, Oregon (2), and Virginia. More deaths are under investigation. The median age of deceased patients was 49.5 years and ranged from 27-71 years. Among 889 patients with data on age and sex: 70% of patients are male. The median age of patients is 23 years and ranges from 13-75 years. 81% of patients are under 35 years old. By age group category: 16% of patients are under 18 years old; 21% of patients are 18 to 20 years old; 18% of patients are 21 to 24 years old; 26% of patients are 25 to 34 years old; and 19% of patients are 35 years or older. The latest findings from the investigation into lung injuries associated with e-cigarette use, or vaping, suggest products containing THC play a role in the outbreak. All patients have a reported history of e-cigarette product use, or vaping, and no consistent evidence of an infectious cause has been discovered. Therefore, the suspected cause is a chemical exposure. The specific chemical exposure(s) causing lung injuries associated with e-cigarette product use, or vaping, remains unknown at this time. No single product or substance has been linked to all lung injury cases. More information is needed to know whether a single product, substance, brand, or method of use is responsible for the outbreak. Among 578 patients with information on substances used in e-cigarette, or vaping, products in the 3 months prior to symptom onset: About 78% reported using THC-containing products; 37% reported exclusive use of THC-containing products. About 58% reported using nicotine-containing products; 17% reported exclusive use of nicotine-containing products. This complex investigation spans many states, involves hundreds of patients, and involves a wide variety of substances and e-cigarette, or vaping, products. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

How to Report a Problem: CDC and the FDA encourage the public to provide detailed information related to any unexpected tobacco- or e-cigarette-related health or product issues to the FDA via the online Safety Reporting Portal.