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Number of confirmed or probable cases: 61Number of people under review: 34Updated Thursday, 03-Oct-2019 13:53:26 CDT

KDHE Update 10/3/2019: As of October 3, Kansas has had two confirmed deaths related to vaping. Kansas currently has 14 probable/confirmed vaping related cases, including the two deaths. Of the cases, 71% are male and age from 15-67 years old. 12 of the 14 were hospitalized and one remains hospitalized. Regarding the types of vaping products used, there was a combination or those reporting using only nicotine, only THC, only CBD and a combination of THC and nicotine. Due to the small numbers of those affected, KDHE is not releasing locations of those affected or information about specific cases. http://www.kdheks.gov/vaping/index.htm

2019 Respiratory Illnesses in Illinois Cases* Individuals needing more investigation Deaths ** 102 19 1 Updated October 3, 2019 *Case means evidence of respiratory illness, with no other cause identified, and report vaping in the last 90 days. ** Death included in the number of cases Anonymous Survey on Vaping Habits - Illinois Residents Are you an Illinois resident and have a few minutes to share with us some information on your vaping habits? Public health departments across the U.S. are trying to understand why people are becoming seriously ill after vaping. We are trying to understand if vaping habits are different between people who have become ill after vaping, and those who have not. Any information you provide on the survey will be anonymous. Thank you for helping the Illinois Department of Public Health. Survey Here Cases in Chicago, Bureau, Champaign, Cook, DeKalb, DuPage, Henry, Kane, Kendall, Knox, Lake, Macoupin, Madison, McHenry, Peoria, Perry, Rock Island, St. Clair, Tazewell, Vermilion, Wabash, Whiteside, Will, Winnebago, and Woodford counties. Ages - 13-56 years. Median age - 22 years. Updates will be posted by end of day on Thursdays.

Confirmed and probable cases in Colorado since August 2019 Values Number Percentage Age Mean 24.8 Median 18 Sex Male 7 78% Female 2 22% Total 9 100% County Boulder 2 22% Arapahoe 1 11% Denver 4 44% Jefferson 1 11% Weld 1 11% Total 9 100% Hospitalized Yes 7 78% No 2 22% Total 9 100% Substances vaped Marijuana only 3 33% Nicotine only 3 33% Both nicotine and marijuana 2 22% Unknown 1 11% Total 9 100% At a glance As of Oct. 02, 2019 9 outbreak cases 7 hospitalizations 0 deaths

There have been 7 cases reported in Arizona. No deaths have been reported in Arizona.

As of 10/03/2019, 42 cases have been reported in individuals in North Carolina ranging in age from 16 to 72 years. Patients experienced severe respiratory symptoms including cough and shortness of breath. Patients also reported experiencing fever, fatigue, chest pain, nausea, vomiting, and diarrhea. Most cases have been hospitalized and have required respiratory support. No deaths have been reported.

DHSS' Division of Public Health (DPH) announced today that one of 11 vaping-related lung injury cases in Delaware includes an individual who died. “The Division of Public Health is saddened to announce the first death in Delaware associated with this outbreak,” said DPH Director Dr. Karyl Rattay. “Our thoughts and prayers are with the individual’s family. This death is a harsh reminder that these illnesses are serious and life-threatening. We continue to recommend that individuals consider refraining from vaping or using e-cigarette products. At this time, no vaping is safe.”

What: The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) will give updates on the investigation into cases of lung injury associated with e-cigarette use, or vaping. Who: Anne Schuchat, MD (RADM, USPHS, RET), principal deputy director, CDC Judy McMeekin, PharmD, deputy associate commissioner for regulatory affairs, FDA When Thursday, October 3, at 4:00 p.m.. ET Dial-In Media: 888-795-0855 Non-Media: 888-972-6892 INTERNATIONAL: 1-517-308-9298 PASSCODE: CDC Media Important Instructions If you would like to ask a question during the call, press *1 on your touchtone phone. Press *2 to withdraw your question. You may queue up at any time. You will hear a tone to indicate your question is pending. TRANSCRIPT A transcript and audio will be available following the briefing at CDC’s web site: www.cdc.gov/media. ### U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESexternal icon CDC works 24/7 protecting America’s health, safety and security. Whether disease start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

CDC Telebriefing: Update on Lung Injury Associated with E-cigarette Use, or Vaping - 10-03-2019 Media Advisory For Immediate Release: Thursday, October 3, 2019 Contact: Media Relations (404) 639-3286 https://www.cdc.gov/media/releases/2019/a1003-lung-injury.html

As of October 2, 2019, the Alabama Department of Public Health (ADPH) has received 19 reports of lung disease associated with e-cigarette product use, or vaping. Alabama information will be included in the CDC national counts updated Thursday, October 3. Please see the breakdown of current cases in Alabama below: Total Reports Confirmed Probable Not a Case Under Investigation 19 1* 3 6 9 *Deceased

Since June 2019, CDPH has received reports that 104 people in California who have a history of vaping were hospitalized for severe breathing problems and lung damage, and two people have died.

Cases of Vaping-Associated Lung Illness (as of October 1, 2019): 23 https://phpa.health.maryland.gov/OEHFP/EH/Pages/VapingIllness.aspx

As of 10/02/2019, the Michigan Department of Health and Human Services has identified 25 (15 confirmed and 10 probable) cases of severe lung disease associated with vaping. The department is investigating an additional nine possible cases that have been reported by health care providers.

Total reported patients statewide: 102 (Updated: 10/2/2019) Breakdown of reported patients by region: Western New York: 28 Central New York: 9 Capital Region: 18 Northern New York: 1 Metropolitan Region (outside of NYC): 23 New York City: 20 Out of State: 3* *Patients treated at hospitals in NYS but are residents of another state.

Virginia Situational Update As of October 1, 2019, there have been 33 cases including 1 reported death, associated with this outbreak in Virginia. Region Confirmed Probable Total Central Region 1 0 1 Eastern Region 5 3 8 Northern Region 8 7 15 Northwest Region 2 4 6 Southwest Region 2 1 3 Total 18 15 33 These case counts are based on the September 18, 2019 CDC case definition.

Wisconsin Case Counts As of October 3, 2019 We plan to update case counts by 10 a.m. on Thursdays. More Information about the lung disease and vaping investigation can be found on the Lung Disease and Vaping Investigation webpage. Media requests should go to the DHS media(link sends e-mail) or 608-266-1683. Number of Cases Confirmed and Probable Cases* 69 Additional Patients Under Investigation 17

Public Health Warning: People should stop vaping immediately Watch the recorded livestream of OHA officials discussing the state’s response to the vaping-associated illness outbreak. September 26, 2019 Second vaping-related death in state confirmed; people who vape are at risk, officials say PORTLAND, Ore.—The Oregon Health Authority is issuing a public health warning urging people to immediately stop using all vaping products. Today, the agency confirmed a second vaping-related death in the state. This is the second death among the five previously reported cases. Oregon’s first fatality was announced on Sept. 3. All five cases are part of a national outbreak of severe lung injury linked to vaping and e-cigarette use. “People should stop vaping immediately,” said Dean Sidelinger, MD, state health officer. “If you vape, whether it’s cannabis, nicotine or other products, please quit. These are addictive substances, and we encourage people to take advantage of free resources to help them quit.” He added: “If you haven’t started vaping, don’t start.” OHA officials say the most recent death was an individual who had been hospitalized with respiratory symptoms after vaping cannabis products. Nationally, there have been more than 800 cases, primarily among youths and young adults, in 46 states and one U.S. territory. A total of 12 additional deaths, including Oregon’s first fatality, have been reported in 10 states. Those who have fallen ill in Oregon have been hospitalized after experiencing worsening symptoms, including shortness of breath, cough or chest pain. CDC and the FDA have not identified a cause, but all cases have reported e-cigarette use or vaping. OHA investigators and local public health authorities continue to urge clinicians to be on alert for signs of severe respiratory illness among patients and report any cases. Before the new illness reports, OHA was already concerned about the health risks of vaping products. A recent report by the agency details the health risks for the products including nicotine addiction, exposure to toxic chemicals known to cause cancer and increases in blood pressure. Individuals who have recently vaped and are having difficulty breathing should seek medical attention immediately. If you or someone you know smokes or vapes, we urge you to quit now. Free help is available from the following resources: 1-800-QUIT-NOW (1-800-784-8669), www.quitnow.net/Oregon Español: 1-855-DEJELO-YA (1-855-335356-92), https://www.quitnow.net/oregonsp/. www.thisisquitting.com (youth quit resource for vaping) Those who want help quitting cannabis or other substance use can call 1-800-662-HELP. Switching to cigarettes or other combustible products is not a safer option. Public Health Warning: Stop using vaping products Public health officials have now linked a second Oregon death to the use of vaping products. The Oregon Health Authority urges Oregonians to stop using all vaping products until federal and state officials have determined the cause of serious lung injuries and deaths linked to the use of both cannabis and nicotine vaping products. No vaping products should be considered safe. Until health experts can identify why people who have used these products have become seriously ill, and in some cases died, no vaping product should be used. State health officials will continue to work closely with the federal Centers for Disease Control and Prevention and the Food and Drug Administration to determine the cause of deaths and illnesses in Oregon and across the nation. See also: Oregon Response to Vaping Illnesses https://www.oregon.gov/oha/ERD/Pages/Public-Health-Warning-Stop-Vaping.aspx

This is the second death among the five previously reported cases. Oregon’s first fatality was announced on Sept. 3. All five cases are part of a national outbreak of severe lung injury linked to vaping and e-cigarette use. “People should stop vaping immediately,” said Dean Sidelinger, MD, state health officer. “If you vape, whether it’s cannabis, nicotine or other products, please quit. These are addictive substances, and we encourage people to take advantage of free resources to help them quit.” He added: “If you haven’t started vaping, don’t start.” OHA officials say the most recent death was an individual who had been hospitalized with respiratory symptoms after vaping cannabis products. https://www.oregon.gov/oha/ERD/Pages/Public-Health-Warning-Stop-Vaping.aspx

September 3, 2019 The Oregon Health Authority is investigating the recent death of an individual who had severe respiratory illness following use of an e-cigarette, which is also known as a vaping device. Investigators at the OHA Public Health Division say they received reports that the individual, who died in July, had recently used an e-cigarette or vaping device containing cannabis purchased from a cannabis dispensary. OHA officials say the individual’s symptoms were consistent with those of more than 200 similar cases in a national cluster of respiratory illness, mostly affecting teenagers and young adults, in at least 25 states. "We don’t yet know the exact cause of these illnesses — whether they’re caused by contaminants, ingredients in the liquid or something else, such as the device itself," said Ann Thomas, M.D., public health physician at OHA’s Public Health Division. Those who have fallen ill have been hospitalized after experiencing worsening symptoms including shortness of breath, cough, chest pain, vomiting, diarrhea, fatigue, fever or weight loss. The U.S. Centers for Disease Control and Prevention (CDC) and the affected states have not identified a cause, but all cases have reported e-cigarette use or vaping. OHA investigators and local public health authorities are urging clinicians to be on alert for signs of severe respiratory illness among patients who recently used vaping products, including e-cigarettes, and report any cases. Clinicians can contact the on-call epidemiologist at 971-673-1111. Before the new illness reports, OHA was already concerned about the health risks of vaping products. A recent report by the agency details the health risks for the products including nicotine addiction, exposure to toxic chemicals known to cause cancer and increases in blood pressure. Individuals who have recently used vaping products such as e-cigarettes and are having difficulty breathing should seek medical attention immediately. If you or someone you know is ready to quit using tobacco, including vaping products such as e-cigarettes, free help is available from the following resources: 800-QUIT-NOW (800-784-8669), quitnow.net. Español: 855-DEJELO-YA (855-335-35692), quitnow.net/oregonsp. www.thisisquitting.com (quit resource for youth). For more information about OHA’s investigation, visit healthoregon.org/acd.

Investigators at the OHA Public Health Division say they received reports that the individual, who died in July, had recently used an e-cigarette or vaping device containing cannabis purchased from a cannabis dispensary. https://www.oregon.gov/oha/ERD/Pages/State-Investigating-Death-Severe-Lung-Illness-Link-Vaping.aspx

A first case in Quebec of severe pulmonary disease associated with vaping Québec, September 27, 2019 The Ministry of Health and Social Services (MSSS) confirms a first case in Quebec of a person with severe pulmonary disease associated with vaping. In this wake, the MSSS wishes to remind the public that vaping is not without risk and that its long-term effects are not yet known. As with tobacco products, young people, pregnant women and non-smokers should refrain from using electronic cigarettes. Users who choose to vapote must: monitor for symptoms of lung disease, such as coughing, shortness of breath, or chest pain seek medical attention promptly, as needed. Institutions in the health and social services network have been asked to be vigilant and a process for reporting cases of severe pulmonary disease potentially related to vaping is being deployed. Quote: "Following the confirmation of this first case in Quebec, it is necessary to reiterate the importance of remaining vigilant. People with health concerns should tell their healthcare professional if they are vaping or have been vaping, as well as the devices and substances used. Every case is taken seriously and the Department of Health and Social Services continues to monitor developments in Quebec closely. " Horacio Arruda, National Director of Public Health Highlights: It should be noted that products from illegal or unregulated sources are particularly avoidable as they carry additional risks. It is important to note, however, that legal products should not be considered risk free. Finally, vaping devices and liquids should also not be modified or used in a manner not intended by the manufacturer. Related link: To consult the warning concerning the risk of severe pulmonary disease associated with vaping : https://www.msss.gouv.qc.ca/professionnels/tabagisme/produits-du-tabac-et-cigarette-electronique/documents-et -Publications /

Québec, September 27, 2019 The Ministry of Health and Social Services (MSSS) confirms a first case in Quebec of a person with severe pulmonary disease associated with vaping. In this wake, the MSSS wishes to remind the public that vaping is not without risk and that its long-term effects are not yet known.

First case of severe lung injury associated with vaping has been announced https://www.msss.gouv.qc.ca/ministere/salle-de-presse/communique-1927/

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