As the number of vaping-related lung injuries soars, federal officials are continuing their investigation into the cause and are urging physicians to ask patients with respiratory illness if they use e-cigarettes.
The Centers for Disease Control and Prevention (CDC) reported Thursday that the number of people with vaping-related illnesses had reached 805, up from 530 last week. The number of deaths also increased from seven to 12.
The CDC still is unsure of the specific cause of the lung injuries. However, two reports released today in Morbidity and Mortality Weekly Reportsuggest that products containing tetrahydrocannabinol (THC) play a role, Anne Schuchat, M.D., principal deputy director of CDC, said in a telebriefing.
“We are in the midst of a complex investigation that spans nearly all states involving serious, life-threatening disease in young people who report a wide variety of products used,” she said.
The overall investigation is complicated by many factors: There is a diverse number of products and brands, and they contain a wide mix of ingredients. In addition, the packaging and supply chains are complex. Investigators also are limited by self-report of what substances were used.
“Users don’t know what’s in the solutions, and many substances can be modified,” Dr. Schuchat said.
As of Sept. 26, 370 samples had been tested from 16 states. Of the 145 vaping liquid products that have completed testing, 65% of the products contained THC (14%-76% concentration), and 55% of the THC-containing products also contained vitamin E acetate (31%-88% concentration).
The CDC recommends people consider not using vaping products, particularly if they contain THC, while the investigation continues. Those who do use them should not purchase products off the street.
Youths, young adults and pregnant women should never use e-cigarettes. In addition to containing toxic chemicals, they are addictive and harmful to developing brains.
Due to the serious threat, physicians caring for patients with respiratory illness should ask about smoking and any vaping use, Dr. Schuchat said.
Illnesses have been reported in 46 states and one territory. The deaths have occurred in California, Florida, Georgia, Illinois, Indiana, Kansas, Minnesota, Mississippi, Missouri and Oregon.
Thirty-eight percent of patients with lung injury associated with e-cigarette use are 21 years or younger, and 16% are under 18, according to the CDC.
Patients have complained of difficulty breathing, shortness of breath and/or chest pain. Some also experienced diarrhea, vomiting, fever and fatigue, according to the CDC.
The CDC encourages clinicians to consider vaping-related illnesses in patients with lung disease, collect detailed information on the products patients were using and report suspected cases to their state health department. Detailed guidance from the CDC is available at https://emergency.cdc.gov/han/han00421.asp. Federal officials are accepting biological specimens collected from cases and are updating the shipping procedures. For information about the collection of e-cigarette products for possible testing by the Food and Drug Administration, email FDAVapingSampleInquiries@fda.hhs.gov.
The CDC also encourages the public to report any unexpected tobacco or e-cigarette-related health or product issues to the FDA’s online Safety Reporting Portal, http://www.safetyreporting.hhs.gov.