USA: Outbreak of Lung Illness Associated with Using E-cigarette Products - 2,668 hospitalized cases, 60 fatalities

[Emily]

https://www.wtsp.com/article/news/health/teen-survives-double-lung-transplant-after-vaping-illness/67-d168c9c9-4adc-49b4-a0f9-1ca25906faa4

Teen survives double-lung transplant after vaping illness

Daniel Ament remembers going to the hospital, then he woke up a month later with a giant scar wrapped around his body.

Author: Dale Greenstein (WTSP)
Published: 12:10 PM EST February 7, 2020
Updated: 12:10 PM EST February 7, 2020



GROSSE POINTE, Mich. — He used to be a runner. Then, after an knee injury, Daniel Ament’s competitive spirit slowed down – and he began vaping.


...
But his mother knows all too well it can be incredibly tough to kick the habit.

Tammy Ament told CBS News her other son – Daniel’s twin brother – still vapes every day and says he just can’t stop

[Emily]

https://wgntv.com/2020/01/23/from-healthy-prep-athlete-to-hospital-bed-fight-for-his-life-suburban-teen-warns-of-dangers-of-vaping/

From healthy prep athlete to hospital bed fight for his life, suburban teen warns of dangers of vaping

Posted 10:22 PM, January 23, 2020, by Dana Rebik

GURNEE, Ill. — He went from an otherwise healthy teenager to wrestling with an addiction that nearly cost him his life.

A varsity athlete at Warren Township High School in Gurnee, Adam Hergenreder started vaping when he was 16 using the popular Juul e-cigarette.

“I would say 80% of the school was doing it already,” he said. “I just hopped on the bandwagon. The flavors were appealing too. The first one I tried was mint. … I found out about mango, cucumber.”...

[Ronan Kelly]

Vaping illnesses: NY reports new deaths, including in Ontario County, connected to vaping

By David Robinson, New York State Team, USA TODAY NETWORK
Posted Jan 17, 2020 at 12:09 PM
UPDATE: A woman in her fifties from Ontario County and another woman from NYC died related to vaping, according to Gov. Andrew Cuomo. This brings the total NY vaping-related deaths to four.

Health officials on Friday confirmed two more deaths in New York due to vaping-related illness, bringing the total to four.

A woman in her twenties from New York City and a woman in her fifties from Ontario County died related to vaping, according to Gov. Andrew Cuomo. It was unclear if the cases involved vaping nicotine, marijuana or both.
...

https://www.mpnnow.com/news/20200117/vaping-illnesses-ny-reports-new-deaths-including-in-ontario-county-connected-to-vaping

[Ronan Kelly]

Latest Outbreak Information

• This complex investigation spans all states, involves over 2,600 patients, and a wide variety of brands and substances and e-cigarette, or vaping, products.
• As of December 3, 2019, CDC is only reporting hospitalized EVALI cases and EVALI deaths regardless of hospitalization status. CDC has removed nonhospitalized cases from previously reported case counts. See Public Health Reporting for more information.
• As of January 14, 2020, a total of 2,668 hospitalized e-cigarette, or vaping, product use-associated lung injury (EVALI) cases or deaths have been reported to CDC from 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands).
• Sixty deaths have been confirmed in 27 states and the District of Columbia (as of January 14, 2020):
  • Alabama, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, and Virginia
  • The median age of deceased patients was 51 years and ranged from 15 through 75 years (as of January 14, 2020).
  • More deaths are currently under investigation.
• Data suggest the outbreak peaked in September 2019. However, states continue to report new cases, including deaths, to CDC on a weekly basis.
• Among the 2,602 hospitalized EVALI cases or deaths reported to CDC with available data (as of January 7, 2020):
  • 67% were male
  • By age group category:
    • 15% of patients were under 18 years old;
    • 37% of patients were 18 to 24 years old;
    • 24% of patients were 25 to 34 years old; and
    • 24% of patients were 35 years or older.
• 1,979 hospitalized patients had data on substance use, of whom (as of January 7, 2020):
  • 82% reported using THC-containing products; 34% reported exclusive use of THC-containing products.
  • 57% reported using nicotine-containing products; 13% reported exclusive use of nicotine-containing products.
• 50% of EVALI patients who reported using THC-containing products provided data on product source.
  • 16% reported acquiring products only from commercial sources (recreational and/or medical dispensaries, vape or smoke shops, stores, and pop-up shops).
  • 78% reported acquiring products only from informal sources (family/friends, dealers, online, or other sources).
  • 6% reported acquiring products from both commercial and informal sources.
• 54% of EVALI patients who reported using nicotine-containing products provided data on product source.
  • 69% reported acquiring products only from commercial sources.
  • 17% reported acquiring products only from informal sources.
  • 15% reported acquiring products from both commercial and informal sources.
• Younger patients, aged 13–17 years, were significantly more likely to obtain THC and nicotine products from informal sources.
  • 94% of EVALI patients aged 13–17 years acquired THC-containing products only from informal sources versus 62% of those aged 45 years or older.
  • 42% of EVALI patients aged 13–17 years acquired nicotine-containing products only from informal sources versus 12% of those aged 45 years or older.

...

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#latest-outbreak-information

[Ronan Kelly]

First known vaping-related death in Wichita Co.

January 14, 2020 at 11:44 AM CST - Updated January 14 at 6:13 PM
WICHITA FALLS, Texas (TNN) - The Wichita Falls Wichita County Public Health District has reported the first death in the county of an individual that was diagnosed with a probable case of E-cigarette or Vaping product use Associated Lung Injury (EVALI).

This was a male in his thirties.

There have only been four probable cases of EVALI reported in all of Wichita County.

According to the Texas Department of State Health Services (DSHS), this is the fourth EVALI death in Texas since Oct. 2019.
...

https://www.newschannel10.com/2020/01/14/first-known-vaping-related-death-wichita-co/

[Ronan Kelly]

MDHHS reports state’s third vaping-related lung injury death
6 hrs ago

LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) is announcing the third death associated with the outbreak of vaping-related lung injuries in the state.

MDHHS was notified about the death of an adult male on Dec. 19. No other information about the individual will be released due to confidentiality reasons.

“The tragic death of yet another Michigan resident is a reminder that this outbreak continues,” said Dr. Joneigh Khaldun, chief medical executive and chief deputy for health for MDHHS.
...

http://www.shorelinemedia.net/white_lake_beacon/news/mdhhs-reports-state-s-third-vaping-related-lung-injury-death/article_b0c2d7bc-5634-5dfb-b848-f2c6d2dd246a.html

[Ronan Kelly]

Texas 15-Year-Old Becomes the Youngest to Die from Vaping-Related Lung Injury
The teenager's death is one of 57 confirmed deaths across 27 states related to an E-cigarette or vaping associated lung injury

By Ashley Boucher January 09, 2020 07:00 PM

The ongoing vaping crisis has claimed its youngest-ever victim.

A 15-year-old died in Texas in December, marking Dallas County’s first death related to an E-cigarette or vaping associated lung injury (EVALI), Dallas County Health and Human Services announced on New Year’s Eve. The teenager’s identity has not been revealed.
...

https://people.com/health/texas-teenager-youngest-vaping-death/

[Ronan Kelly]

Latest Outbreak Information
This complex investigation spans all states, involves over 2,500 patients, and a wide variety of brands and substances and e-cigarette, or vaping, products.
As of December 3, 2019, CDC is only reporting hospitalized EVALI cases and EVALI deaths regardless of hospitalization status. CDC has removed nonhospitalized cases from previously reported case counts. See Public Health Reporting for more information.
As of January 7, 2020, a total of 2,602 cases of hospitalized e-cigarette, or vaping, product use-associated lung injury (EVALI) or deaths have been reported to CDC from 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands).
Fifty-seven deaths have been confirmed in 27 states and the District of Columbia (as of January 7, 2020):
Alabama, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, and Virginia
The median age of deceased patients was 51 years and ranged from 15 through 75 years (as of January 7, 2020).
More deaths are currently under investigation.
Data suggest the outbreak peaked in September 2019. However, states continue to report new cases, including deaths, to CDC on a weekly basis.
Among cases of hospitalized EVALI patients reported to CDC with available data (as of December 3, 2019):
67% were male (among 2,155 patients with data on sex)
78% were under 35 years old, with a median age of 24 years and age range from 13 to 77 years (among 2,159 patients with data on age)
By age group category:
16% of patients were under 18 years old;
38% of patients were 18 to 24 years old;
24% of patients were 25 to 34 years old; and
23% of patients were 35 years or older.
1,782 hospitalized patients had complete information* on substances used in e-cigarette, or vaping, products in the 3 months prior to symptom onset, of whom (as of December 3, 2019):
80% reported using THC-containing products; 35% reported exclusive use of THC-containing products.
54% reported using nicotine-containing products; 13% reported exclusive use of nicotine-containing products.
12% reported using cannabidiol (CBD)-containing products; 1% reported exclusive use of cannabidiol (CBD)-containing products.
40% reported both THC- and nicotine-containing product use.
5% reported no THC-, nicotine-, or CBD-containing product use.
Among hospitalized EVALI patients who reported using THC-containing e-cigarette, or vaping product brands:
The most commonly reported product brand included Dank vapes (56%), followed by TKO (15%), Smart Cart (13%), and Rove (12%). However, regional differences in THC-containing product use were noted.
* Based on complete reports received.
...

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#latest-outbreak-information

[Ronan Kelly]

Galveston County confirms first death related to using vaping products, health officials say
Michelle Iracheta Jan. 6, 2020 Updated: Jan. 6, 2020 9:32 a.m.


A Galveston County woman has died following her use of e-cigarettes or vaping products, according to county health officials.

The woman, who was between 30 and 35 years of age, is the first death associated with e-cigarette, or vaping, associated lung injury (EVALI), according to a Galveston County Health District news release. The woman was being treated at a local hospital for EVALI, officials said. The health district said it would not release any additional information about the woman.
...

https://www.houstonchronicle.com/news/houston-texas/houston/article/Galveston-County-woman-is-first-to-die-in-county-14952717.php

[Emily]

This family in Georgia went through hell trying to get an autopsy performed on their family member. The husband is a doctor and the daughter is studying journalism and they suspect a lot more middle-aged women are dying from vaping than we know about. The Georgia police said they knew that there was a THC product in the state that was causing serious health issues.

http://pepperdine-graphic.com/breath...led-my-mother/

Breath is Precious: The Vaping Disease Killed My Mother

By Mary Margaret Davis

...
Later, X-rays revealed a white substance infiltrating her lungs, clouds as silky as the puffs of vape she would exhale. Those clouds weren’t there when she had an X-ray two days before her death; they had developed as rapidly as an unexpected thunderstorm, unleashing an onslaught of destruction on her system and ultimately killing her. Relentless. No mercy given....

[Ronan Kelly]

What We Know
Laboratory Findings Reported December 20, 2019:

Laboratory data show that vitamin E acetate, an additive in some THC-containing e-cigarette, or vaping, products, is closely associated with EVALI.
A recent studyexternal icon analyzed samples from 51 EVALI cases from 16 states and a comparison group of samples from 99 healthy people for vitamin E acetate, plant oils, medium chain triglyceride (MCT) oil, coconut oil, petroleum distillates, and diluent terpenes.
Vitamin E acetate was identified in bronchoalveolar lavage (BAL) fluid samples (fluid samples collected from the lungs) from 48 of the 51 EVALI patients, but not in the BAL fluid from the healthy comparison group.
No other toxicants were found in BAL fluid from either group, except for coconut oil and limonene (1 EVALI patient each).
This study built upon a previously released CDC report, using a large number of BAL fluid samples from EVALI patients, and added healthy controls, and yielded the same finding.
These findings complement the ongoing work of FDAexternal icon and some state public health laboratories to characterize e-liquid exposures and inform the ongoing multistate outbreak.
...
Latest Outbreak Information

• This complex investigation spans all states, involves over 2,500 patients, and a wide variety of brands and substances and e-cigarette, or vaping, products.
• As of December 3, 2019, CDC is only reporting hospitalized EVALI cases and EVALI deaths regardless of hospitalization status. CDC has removed nonhospitalized cases from previously reported case counts. See Public Health Reporting for more information.
• As of December 27, 2019, a total of 2,561 cases of hospitalized e-cigarette, or vaping, product use-associated lung injury (EVALI) or deaths have been reported to CDC from 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands).
• Fifty-five deaths have been confirmed in 27 states and the District of Columbia (as of December 27, 2019):
  • Alabama, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, and Virginia
  • The median age of deceased patients was 52 years and ranged from 17 through 75 years (as of December 27, 2019).
  • More deaths are currently under investigation.
• Data suggest the outbreak peaked in September 2019. However, states continue to report new cases, including deaths, to CDC on a weekly basis.
• Among cases of hospitalized EVALI patients reported to CDC with available data (as of December 3, 2019):
  • 67% were male (among 2,155 patients with data on sex)
  • 78% were under 35 years old, with a median age of 24 years and age range from 13 to 77 years (among 2,159 patients with data on age)
  • By age group category:
    • 16% of patients were under 18 years old;
    • 38% of patients were 18 to 24 years old;
    • 24% of patients were 25 to 34 years old; and
    • 23% of patients were 35 years or older.
• 1,782 hospitalized patients had complete information* on substances used in e-cigarette, or vaping, products in the 3 months prior to symptom onset, of whom (as of December 3, 2019):
  • 80% reported using THC-containing products; 35% reported exclusive use of THC-containing products.
  • 54% reported using nicotine-containing products; 13% reported exclusive use of nicotine-containing products.
  • 12% reported using cannabidiol (CBD)-containing products; 1% reported exclusive use of cannabidiol (CBD)-containing products.
  • 40% reported both THC- and nicotine-containing product use.
  • 5% reported no THC-, nicotine-, or CBD-containing product use.
• Among hospitalized EVALI patients who reported using THC-containing e-cigarette, or vaping product brands:
  • The most commonly reported product brand included Dank vapes (56%), followed by TKO (15%), Smart Cart (13%), and Rove (12%). However, regional differences in THC-containing product use were noted.

* Based on complete reports received.

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#latest-outbreak-information

[Ronan Kelly]

Latest Outbreak Information

• This complex investigation spans all states, involves over 2,500 patients, and a wide variety of brands and substances and e-cigarette, or vaping, products.
• As of December 3, 2019, CDC is only reporting hospitalized EVALI cases and EVALI deaths regardless of hospitalization status. CDC has removed nonhospitalized cases from previously reported case counts. See Public Health Reporting for more information.
• As of December 17, 2019, a total of 2,506 cases of hospitalized e-cigarette, or vaping, product use-associated lung injury (EVALI) have been reported to CDC from 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands).
• Fifty-four deaths have been confirmed in 27 states and the District of Columbia (as of December 17, 2019):
  • Alabama, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, and Virginia
  • The median age of deceased patients was 52 years and ranged from 17 through 75 years (as of December 17, 2019).
  • More deaths are currently under investigation.
• Data suggest the outbreak might have peaked in mid-September. However, states continue to report new cases, including deaths, to CDC on a weekly basis.
• Among cases of hospitalized EVALI patients reported to CDC with available data (as of December 3, 2019):
  • 67% were male (among 2,155 patients with data on sex)
  • 78% were under 35 years old, with a median age of 24 years and age range from 13 to 77 years (among 2,159 patients with data on age)
  • By age group category:
    • 16% of patients were under 18 years old;
    • 38% of patients were 18 to 24 years old;
    • 24% of patients were 25 to 34 years old; and
    • 23% of patients were 35 years or older.
• 1,782 hospitalized patients had complete information* on substances used in e-cigarette, or vaping, products in the 3 months prior to symptom onset, of whom (as of December 3, 2019):
  • 80% reported using THC-containing products; 35% reported exclusive use of THC-containing products.
  • 54% reported using nicotine-containing products; 13% reported exclusive use of nicotine-containing products.
  • 12% reported using cannabidiol (CBD)-containing products; 1% reported exclusive use of cannabidiol (CBD)-containing products.
  • 40% reported both THC- and nicotine-containing product use.
  • 5% reported no THC-, nicotine-, or CBD-containing product use.
• Among hospitalized EVALI patients who reported using THC-containing e-cigarette, or vaping product brands:
  • The most commonly reported product brand included Dank vapes (56%), followed by TKO (15%), Smart Cart (13%), and Rove (12%). However, regional differences in THC-containing product use were noted.

* Based on complete reports received.
...

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#latest-outbreak-information

[Ronan Kelly]

Updated December 12, 2019, at 1:00 PM EST

What is New
CDC has analyzed national data on use of THC-containing product brands by e-cigarette, or vaping, product use-associated lung injury (EVALI) patients.
Overall, 152 different THC-containing product brands were reported by EVALI patients.
Dank Vapes, a class of largely counterfeit THC-containing products of unknown origin, was the most commonly reported product brand used by patients nationwide, although there are regional differences. While Dank Vapes was most commonly reported in the Northeast and South, TKO and Smart Cart brands were more commonly reported by patients in the West and Rove was more common in the Midwest.
The data further supports that EVALI is associated with THC-containing products and that it is not likely associated with a single THC-containing product brand.
CDC and FDA recommend that people should not use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online sellers.
Vitamin E acetate should not be added to e-cigarette, or vaping, products. Additionally, people should not add any other substances not intended by the manufacturer to products, including products purchased through retail establishments.
CDC, FDA, and state health authorities have made progress in identifying substances of concern in EVALI. However, there are many different substances and product sources that remain under investigation, and there may be more than one cause.
The latest national and state data from patient reports and product sample testing suggest THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online sellers, are linked to most of the cases and play a major role in the outbreak.
While it appears that vitamin E acetate is associated with EVALI, there are many different substances and product sources that are being investigated, and there may be more than one cause.
Therefore, the best way for people to ensure that they are not at risk while the investigation continues is to consider refraining from the use of all e-cigarette, or vaping, products.CDC will continue to update guidance, as appropriate, as new data become available from this complex outbreak.
CDC will continue to update guidance, as appropriate, as new data emerges from this complex outbreak.
,,,



Latest Outbreak Information

• This complex investigation spans almost all states, involves over 2,400 patients, and a wide variety of brands and substances and e-cigarette, or vaping, products.
• As of December 3, 2019, CDC is only reporting hospitalized EVALI cases and EVALI deaths regardless of hospitalization status. CDC has removed nonhospitalized cases from previously reported case counts. See Public Health Reporting for more information.
• As of December 10, 2019, a total of 2,409 cases of hospitalized e-cigarette, or vaping, product use-associated lung injury (EVALI) have been reported to CDC from 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands).
• Fifty-two deaths have been confirmed in 26 states and the District of Columbia (as of December 10, 2019):
  • Alabama, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, and Virginia
  • The median age of deceased patients was 52 years and ranged from 17 through 75 years (as of December 10, 2019).
  • More deaths are currently under investigation.
• Data suggest the outbreak might have peaked in mid-September. However, states continue to report new cases, including deaths, to CDC on a weekly basis.
• Among cases of hospitalized EVALI patients reported to CDC with available data (as of December 3, 2019):
  • 67% were male (among 2,155 patients with data on sex)
  • 78% were under 35 years old, with a median age of 24 years and age range from 13 to 77 years (among 2,159 patients with data on age)
  • By age group category:
    • 16% of patients were under 18 years old;
    • 38% of patients were 18 to 24 years old;
    • 24% of patients were 25 to 34 years old; and
    • 23% of patients were 35 years or older.
• 1,782 hospitalized patients had complete information* on substances used in e-cigarette, or vaping, products in the 3 months prior to symptom onset, of whom (as of December 3, 2019):
  • 80% reported using THC-containing products; 35% reported exclusive use of THC-containing products.
  • 54% reported using nicotine-containing products; 13% reported exclusive use of nicotine-containing products.
  • 12% reported using cannabidiol (CBD)-containing products; 1% reported exclusive use of cannabidiol (CBD)-containing products.
  • 40% reported both THC- and nicotine-containing product use.
  • 5% reported no THC-, nicotine-, or CBD-containing product use.
• Among hospitalized EVALI patients who reported using THC-containing e-cigarette, or vaping product brands:
  • The most commonly reported product brand included Dank vapes (56%), followed by TKO (15%), Smart Cart (13%), and Rove (12%). However, regional differences in THC-containing product use were noted.

* Based on complete reports received.
...
https://www.cdc.gov/tobacco/basic_in...ak-information

[Ronan Kelly]

Second vaping-related death reported in Florida
THE ASSOCIATED PRESS
DECEMBER 11, 2019 08:46 AM
TALLAHASSEE, FLA.
The Florida Department of Health says a second person in Florida has died due to complications from vaping.

The Orlando Sentinel reported Wednesday that the department also reported a slight increase in the number of vaping-associated illnesses, which rose from 99 to 103 cases.
...

https://www.sunherald.com/news/health/article238267053.html

[Ronan Kelly]

First vaping related death reported in South Carolina
Dec 7, 2019 12:23 AM EST abccolumbiasitestaff


COLUMBIA, SC (WOLO) – The South Carolina Department of Health and Environmental Control has reported the state’s first vaping related death.

Officials say the death came out of the upstate where someone 65 years or older, who already had health conditions, died.

The Centers for Disease Control and Prevention has identified vitamin e acetate as a possible common factor among e-cig users who have fallen ill.
...

https://www.abccolumbia.com/2019/12/07/first-vaping-related-death-reported-in-south-carolina/