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CDC Vaping Update 10/17/19

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niman Grand Master

niman

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    • 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 deaths are under investigation.
      • The median age of deceased patients was 44 years and ranged from 17 to 75 years.
    • Among 1,358 patients with data on age and sex:
      • 70% of patients are male.
      • The median age of patients is 23 years and ages range from 13 to 75 years.
      • 79% of patients are under 35 years old.
      • By age group category:
        • 15% 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;
        • 25% of patients are 25 to 34 years old; and
        • 21% of patients are 35 years or older.
  • To date, national and state data suggest that products containing THC, particularly those obtained off the street or from other informal sources (e.g., friends, family members, or illicit dealers), are linked to most of the cases and play a major 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 exposure to a chemical or chemicals.
  • The specific chemical exposure(s) causing lung injuries associated with e-cigarette use, or vaping, remains unknown at this time.
  • Among 849 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; 31% reported exclusive use of THC-containing products.
    • About 58% reported using nicotine-containing products; 10% reported exclusive use of nicotine-containing products.
  • This complex investigation spans almost all states, involves over a thousand patients, and involves a wide variety of brands and substances and e-cigarette, or vaping, products.  Case counts continue to increase and new cases are being reported, which makes it more difficult to determine the cause or causes of this outbreak.
What CDC is Doing
  • CDC is working 24/7 to identify the cause or causes of this outbreak through partnerships with states and other federal agencies.
  • CDC has activated the Emergency Operations Center (EOC) to coordinate activities and provide assistance to states, public health partners and clinicians around the nation.
  • CDC’s Lung Injury response efforts are committed to:
    • Identify and define the risk factors and the source for lung disease associated with e-cigarette product use, or vaping.
    • Detect and track confirmed and probable cases in the US.
    • Communicate actionable recommendations to state, local, and clinical audiences.
    • Establish lab procedures that can assist with the public heath investigation and patient care.
  • CDC continues to work closely with FDA, states, public health partners, and clinicians on this investigation by providing consultation and technical assistance to states on communication, health alerts, public outreach, and surveillance.
  • CDC is maintaining an outbreak webpage with key messages and weekly updates on case counts, deaths, and resources.
  • CDC is holding congressional briefings, media telebriefings, and regular calls with health departments, clinicians to provide timely updates.
  • CDC worked with states to create primary and out-of-hospital case definitions to classify confirmed and probable cases in a consistent way. States are in the process of classifying patients. We expect that states and clinicians may look back for past lung injury cases based on CDC’s case definition CDC will report numbers of confirmed and probable lung injury cases once states have finalized their classification of cases.
  • By invitation, CDC has deployed Epidemic Intelligence Service (EIS) officers and other CDC staff to support states.
  • CDC is offering additional laboratory testing.
    • CDC is currently validating targeted methods to test chemicals in bronchoalveolar lavage (BAL) fluid, blood, or urine and has received initial samples.
    • CDC is testing pathologic specimens, including lung biopsy or autopsy specimens, associated with patients.
    • CDC is also validating methods for aerosol emission testing of case-associated product samples from e-cigarette, or vaping, products and e-liquids. Initial data from product sample testing has guided the need for these additional assays.
    • Results may provide insight into the nature of the chemical exposure(s) contributing to this outbreak.
  • CDC developed guidance documents for were created to assist public health laboratories, healthcare providers, and pathologists, and others, with specimen collection, storage, and submission.
  • For more information and resources visit For the Public, For Healthcare Providers and For State and Local Health Departments as well as our Publications and Resources page.

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

** Based on complete reports received.

Dates of symptom onset and hospital admission for patients with lung injury associated with e-cigarette use, or vaping — United States, March 31–October 12, 2019
Dates of symptom onset and hospital admission for patients with lung injury associated with e-cigarette use, or vaping — United States, March 31–October 12, 2019
niman Grand Master

niman

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By Erika Edwards

The number of people sickened from vaping rose again Thursday, with the Centers for Disease Control and Prevention reporting 1,479 cases of what officials are now calling EVALI, short for "e-cigarette or vaping product use associated lung injury."

That's an increase of nearly 200 cases since this time last week. All states except Alaska have reported cases.

 

The numbers are sure to rise even more as the CDC confirms cases. State health departments tell NBC News they've either confirmed or are investigating nearly 1,900 such ca

nn_cbe_cdc_vaping_guidelines_191011_1920

 
 

So far, 33 people have died, and additional deaths are under investigation. Tennessee reported its first vaping-related death on Thursday.

"We are extremely saddened by this loss of life," Dr. Lisa Piercey, health commissioner for the state of Tennessee, said in a statement. "We are working with partners across the country to investigate these cases of vaping-associated illness in Tennessee, and recommend Tennesseans consider refraining from using e-cigarettes or vaping while this investigation is underway."

According to the CDC, the outbreak of vaping-related illnesses and deaths has largely occurred in people who vaped THC, marijuana's psychoactive ingredient.

In an in-depth look at 849 of the 1,479 patients, the CDC said 78 percent reported using THC vapes, either alone or in addition to nicotine.

However, 10 percent reported using only vaping products with nicotine. One of those individuals was John Steffen.

 

Image: John SteffenJohn Steffen, 68, turned to e-cigarettes as a way to quit smoking. This past spring, he became the first person in the state of Nebraska to die of a vaping-related lung injury.Dulcia Steffen

Steffen, who had smoked cigarettes since he was a teenager in the 1960s, turned to vaping about five years ago as a way to quit, according to his family.

"He never used THC. And he never bought it off the street," said Kathleen Fimple, Steffen's wife. "He bought it strictly at retail big box stores."

This past May, most of the family came down with a bad respiratory illness. They all eventually recovered, except for Steffen, 68, who also had smoking-related emphysema.

He was hospitalized with pneumonia, and died within a week. His family was devastated, but understood his decades of tobacco use likely contributed to his death.

 

"Knowing that he had compromised lungs, it made sense to say that this had become pneumonia," Fimple said.

They had no idea at the time his death that vaping also played a role.

On Sept. 30, the Nebraska Department of Health and Human Services announced that state's first vaping-related death: Steffen, who'd died four months earlier.

When doctors took a closer look at Steffen's lung scans, the images weren't typical of a lifelong smoker. They looked more like a person with an extreme lung injury, like that of a chemical burn.

"I hope that people become aware of the potential dangers of vaping," Fimple told NBC News. "They tell me they don't know exactly what it is in the vaping process that's causing this illness, but there is clearly an outbreak of something."

Despite an ongoing investigation, neither the CDC nor the Food and Drug Administration have been able to pinpoint any one ingredient or product responsible for all of the vaping illnesses.

Steffen's daughter, Dulcia Steffen, urges smokers to quit, but to also think twice about using nicotine vapes.

"This was perceived as the safe alternative," she said. "Clearly, it's not."

https://www.nbcnews.com/health/vaping/vaping-illnesses-continue-rise-no-cause-sight-n1068351

 

Edited by niman

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