Oklahoma Running Totals

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First Oklahoma Case of Vaping-Associated Lung Injury Confirmed

The Oklahoma State Department of Health (OSDH) has confirmed the first case in the state associated with a national occurrence of serious lung injuries related to e-cigarette and vaping product use. The patient is a Tulsa County resident under the age of 18.

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FOR RELEASE: September 26, 2019 MEDIA CONTACT: Jamie Dukes Public Information Manager Office of Communications (405) 271-5601 [email protected]   STAY CONNECTED! #HealthyOklahoma       MEDIA QUESTIONS? Contact the Office of Communications (405) 271-5601 [email protected]   Business Hours:  8 a.m. - 5 p.m. Creating a State of Health www.health.ok.gov

First Oklahoma Case of Vaping-Associated Lung Injury Confirmed The Oklahoma State Department of Health (OSDH) has confirmed the first case in the state associated with a national occurrence of serious lung injuries related to e-cigarette and vaping product use. The patient is a Tulsa County resident under the age of 18. State health officials began the investigation in early September when they issued an advisory to health care providers requesting them to report any cases of severe pulmonary disease of unknown origin and a history of recent e-cigarette use. Since then, OSDH officials continue to review medical records, gather data and conduct patient interviews. “We are committed to working with our state and federal partners to learn everything we can about this investigation in order to prevent further injury and potential death,” said Commissioner of Health Gary Cox. “E-cigarettes are unregulated, and of great concern is the significant number of young people using the products. The public is advised to consider refraining from using all e-cigarette and vaping products while the investigation is ongoing.” Regardless of the investigation, health officials advise strongly against buying e-cigarette and vaping products off the street and modifying products or adding substances not intended by the manufacturer. At no time are e-cigarette or vaping products recommended for use by youth, young adults, pregnant women or adults who do not currently use tobacco products. There is no safe amount of nicotine exposure, and there is no e-cigarette product or vape device recommended by the Food and Drug Administration (FDA) as a cessation device. People who are using e-cigarette or vaping devices as a method for quitting tobacco are urged not to return to smoking cigarettes. Adult smokers who are attempting to quit should use evidence-based treatments including counseling and FDA-approved medications. Those who need help quitting tobacco products, including e-cigarettes and vaping products, should contact a health care provider or the Oklahoma Tobacco Helpline at 1-800-QUIT-NOW (784-8669). According to the Centers for Disease Control and Prevention (CDC), e-cigarette or vaping products are also called vapes, e-hookahs, vape pens, tank systems, mods, and electronic nicotine delivery systems (ENDS). Using an e-cigarette or vapor product is commonly called vaping. Vaping can also refer to using an e-cigarette or vaping product to inhale many substances, including nicotine and THC or CBD oils. Preliminary data from the 2019 Oklahoma Youth Risk Behavior Survey shows a 70% increase from 2017 to 2019 in the current electronic vapor products (EVPs) use by Oklahoma high school students. In particular, the 2019 preliminary data shows that more than a quarter of high school students in Oklahoma currently use EVPs. Among Oklahoma adults, data from the 2018 Behavioral Risk Factor Surveillance System shows that 1 in 12 adults in Oklahoma were current e-cigarette users. Oklahoma had the highest prevalence of current e-cigarette use among adults in the nation for two years in a row (2016-2017).   Patients involved in the nationwide investigation have reported symptoms such as prolonged cough, shortness of breath, chest pain, nausea, vomiting, fatigue, fever and abdominal pain. Individuals who have a history of e-cigarette use or vaping in the last 90 days, and are experiencing any of these symptoms should contact a health care provider as soon as possible. For more information visit, https://go.usa.gov/xVvFg.

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Weekly Update: Outbreak of Lung InjuryAssociated with E-Cigarettes/Vaping

The Oklahoma State Department of Health (OSDH) is participating in a national investigation of an outbreak of severe lung injury associated with e-cigarette product (devices, liquids, refill pods, and/or cartridges) use. The purpose of this page is to provide weekly updates on the number of confirmed and probable cases in Oklahoma as well as information regarding the status of the national investigation. Please see below for updated case counts and outbreak information. We are asking health care providers to report suspected cases based on symptoms and a history of e-cigarette use. Providers are encouraged to visit the information for health care professionals page for recommendations, reporting instructions, and clinical resources.

Number of Reported Cases of Severe Lung Injury Associated with E-Cigarette Use or Vaping, Oklahoma 

Number of new confirmed or probable cases between 9/19/2019 and 9/25/2019	Cumulative number of confirmed or probable cases	Number of new confirmed or probable deaths between 9/19/2019 and 9/25/2019	Cumulative number of confirmed or probable deaths
1	1	0	0

Symptoms

Symptoms have resulted in hospitalizations lasting from days to weeks, with some patients admitted to intensive care units. Symptoms included shortness of breath, fever, cough, chest pain, vomiting, abdominal pain, and diarrhea. Some patients have reported that their symptoms developed over a few days, while others have reported that their symptoms developed over several weeks. A lung infection does not appear to be causing the symptoms.

Background

• Electronic cigarettes – or e-cigarettes — are also called vapes, e-hookahs, vape pens, and electronic nicotine delivery systems (ENDS).
• Using an e-cigarette product is commonly called vaping.
• E-cigarettes work by heating a liquid to produce an aerosol that users inhale into their lungs.
• The liquid can contain: nicotine, tetrahydrocannabinol (THC) and cannabinoid (CBD) oils, and other substances and additives.

What we know

• There have been 805* cases of lung injury reported from 46 states and 1 U.S. territory. Twelve deaths have been confirmed in 10 states.
• CDC has received complete sex and age data on 373 cases.
  • Nearly three fourths (72%) of cases are male
  • Two thirds (67%) of cases are 18 to 34 years old
  • 16% of cases are under 18 years
  • 38% of cases are in people under 21 years
  • 17% are 35 years or older
• All reported cases have a history of e-cigarette product use or vaping.
• Based on initial data from certain states we know: Most patients have reported a history of using e-cigarette products containing THC. Many patients have reported using THC and nicotine. Some have reported the use of e-cigarette products containing only nicotine.
• The OSDH is in the process of investigating suspected cases reported by health care providers. We expect that clinicians may look back for older cases.

*The increase in cases from last week represents both new cases and recent reporting of previously-identified cases to CDC.

What we don't know

• We do not yet know the specific cause of these illnesses. The investigation has not identified any specific e-cigarette or vaping product (devices, liquids, refill pods, and/or cartridges) or substance that is linked to all cases.
   

What the OSDH recommends

• The CDC released interim recommendations for health care providers, health departments, and the public.
• Until we know more, if you are concerned about these specific health risks, the OSDH recommends that you consider refraining from using e-cigarette or vaping products.
  • For help quitting e-cigarettes/vaping, contact your health care provider or the Oklahoma Tobacco Helpline at 1-800-QUIT-NOW (784-8669) or utilize the resources included at the bottom of the page.
• If you are an adult who used e-cigarettes containing nicotine to quit cigarette smoking, do not return to smoking cigarettes.
• People experiencing lung symptoms after vaping should seek clinical care and avoid e-cigarettes or other vaping products, as continued use may lead to worsening symptoms. People should avoid vaping non-medical cannabis-based products, as the ingredients in these products are unknown.
• Regardless of the ongoing investigation:
  • Anyone who uses an e-cigarette or vaping product should not buy these products (e.g., e-cigarette or vaping products with THC, other cannabinoids) off the street, and should not modify or add any substances to these products that are not intended by the manufacturer.
  • Youth and young adults should not use e-cigarette products.
  • Women who are pregnant should not use e-cigarette products.
  • Adults who do not currently use tobacco products should not start using e-cigarette products.
• Submit detailed reports of any unexpected health or product issues related to tobacco or e-cigarette products to the FDA via the online Safety Reporting Portal.

 Resources

• Centers for Disease Control and Prevention Response
• U.S. Food and Drug Administration Response
• E-Cigarette Microlearning Video - Long Version (Tobacco Control Network)
• Exchange Lab: Evidence-Based Tobacco Education Print Materials, Web Content, and Video for Your Organization (U.S. Food and Drug Administration)
• Talk with Your Teen About E-Cigarettes: A Tip Sheet for Parents (Centers for Disease Control and Prevention)
• How FDA is Regulating E-Cigarettes (U.S. Food and Drug Administration)
• Smokefree.gov (U.S. Department of Health and Human Services)

https://www.ok.gov/health/Prevention_and_Preparedness/Injury_Prevention_Service/Vaping-related_Lung_Injury/index.html

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Number of Reported Cases of Severe Lung Injury Associated with E-Cigarette Use or Vaping, Oklahoma 

Number of new confirmed or probable cases between 9/26/2019 and 10/2/2019	Cumulative number of confirmed or probable cases	Number of new confirmed or probable deaths between 9/26/2019 and 10/2/2019	Cumulative number of confirmed or probable deaths
3	4	0	0

Case details

Of the four patients,

• One is under the age of 18, two (50%) are 18 to 34 years of age, and one is 35 years of age or older.
• Patients are residents of: Oklahoma County (2), Tulsa County (1), and Region 2 in northeast Oklahoma (1). 
  • For regions, see map at the bottom of the page.

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Number of Reported Cases of Severe Lung Injury Associated with E-Cigarette Use or Vaping, Oklahoma 

Number of new confirmed or probable cases between 10/3/2019 and 10/9/2019	Cumulative number of confirmed or probable cases	Number of new confirmed or probable deaths between 10/3/2019 and 10/9/2019	Cumulative number of confirmed or probable deaths
0	4	0	0

Case details

Of the four patients,

• One is under the age of 18, two (50%) are 18 to 34 years of age, and one is 35 years of age or older.
• Patients are residents of: Oklahoma County (2), Tulsa County (1), and the Northeast region of the state (1). 
  • For regions, see map at the bottom of the page.
  • https://www.ok.gov/health/Prevention_and_Preparedness/Injury_Prevention_Service/Vaping-related_Lung_Injury/index.html

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Number of Reported Cases of Severe Lung Injury Associated with E-Cigarette Use or Vaping, Oklahoma 

Number of new confirmed or probable cases between 10/10/2019 and 10/16/2019	Cumulative number of confirmed or probable cases	Number of new confirmed or probable deaths between 10/10/2019 and 10/16/2019	Cumulative number of confirmed or probable deaths
0	4	0	0

Case details

Of the four patients,

• One is under the age of 18, two (50%) are 18 to 34 years of age, and one is 35 years of age or older.
• Patients are residents of: Oklahoma County (2), Tulsa County (1), and the Northeast region of the state (1). 
• https://www.ok.gov/health/Prevention_and_Preparedness/Injury_Prevention_Service/Vaping-related_Lung_Injury/index.html

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Number of Reported Cases of Severe Lung Injury Associated with E-Cigarette Use or Vaping, Oklahoma 

Number of new confirmed or probable cases between 10/17/2019 and 10/23/2019	Cumulative number of confirmed or probable cases	Number of new confirmed or probable deaths between 10/17/2019 and 10/23/2019	Cumulative number of confirmed or probable deaths
0	4	0	0

Case details

Of the four patients,

• One is under the age of 18, two (50%) are 18 to 34 years of age, and one is 35 years of age or older.
• Patients are residents of: Oklahoma County (2), Tulsa County (1), and the Northeast region of the state (1). 
  • For regions, see map at the bottom of the page.
  • https://www.ok.gov/health/Prevention_and_Preparedness/Injury_Prevention_Service/Vaping-related_Lung_Injury/index.html