5th e-Cigarette Death Reported As Illnesses Double

Five deaths from a severe lung illness have now been linked to e-cigarettes. Since an article on the first death was published on Allnurses.com, the number of mystery lung illnesses connected to e-cigarettes has increased to 450, more than doubling from the previous week.

On Friday, September 6, 2019, the Center for Disease Control (CDC) warned Americans on the dangers of e-cigarettes after the fifth death from an illness linked to vaping was reported. The five CDC verified deaths occurred in Minnesota, Illinois, Indiana, Oregon and California. In a briefing, the CDC also reported the number of severe lung illnesses connected to e-cigarette increased to 450, more than doubling from 200 in the previous week. The illnesses have occurred in 33 states across the U.S. and the majority were in between the ages of 18 and 25. Read about the first reported death linked to e-cigarettes here.

Narrowing Investigation

Public health officials are finding it a challenge to pinpoint the exact cause of the mysterious vaping illness. However, Dana Meaney-Delman, CDC incident manager, made the following statement during Friday’s press conference, “We believe that; a chemical exposure is likely associated with these illnesses, but more information is needed.” In addition to the harmful substances contained in e-cigarettes, there is also concern surrounding vape products brought on the street or that have been altered by consumers.

Delivery of Illicit Substances

Some e-cigarette products are used to deliver illegal substances and may be obtained from unknown or “street” sources. The products may be modified, increasing the risk of user harm. For example:

Single use e-cigarette pods or cartridges can be refilled with illicit or unknown substances.
Some e-cigarette products are used for “dripping” or “dabbing”.
Dripping: dropping e-cigarette liquid directly into the hot coils of an e-cigarette resulting in high concentrations (i.e. THC and cannabinoid [CBD]).
Dabbing: super-heating substances that contain high concentrations of THC and other plant compounds (butane hash oil [BHO], “710” and CBD).
The director of the Center for Tobacco Products at the FDA, Mitch Zeller, reports particular concern is also developing around products that have been modified by vaping retailers.

Vitamin E Acetate

New York health officials have identified vitamin E acetate as a potential link between vaping and the recent severe lung illnesses. Laboratory tests conducted at the Wadsworth Center in Albany, New York, discovered very high levels of the chemical in nearly all cannabis-containing vaping products that were analyzed. Each person in New York who became ill with the lung illness and submitted a product to the state has been linked to at least one vaping product containing vitamin E acetate. Some of the vaping products containing the chemical are candy-flavored vapes. In a statement released by the New York State Health Department, a link was provided to images of some of the products found to contain vitamin E acetate (view images here). Vitamin E acetate is not an approved additive for the state’s Medical Marijuana Program-authorized vape products and was not seen in the nicotine-based products tested.

Vitamin E acetate is not known to have adverse effects when ingested as a nutritional supplement or applied to the skin. The chemical is an oil-like substance when inhaled and this is thought to be a contributing factor in the development of lung symptoms.

What is Being Done

The CDC, FDA and state health departments are continuing to investigate whether the illnesses can be linked to specific devices, ingredients or contaminants associated with e-cigarette product use. States are submitting data to the CDC about lung illnesses associated with vaping, as well as the types of e-cigarettes used.

Health providers are being asked to immediately report any possible cases of vaping associated lung illness to their local or state health department for further investigation. Providers should also provide a detailed history of the substances and devices used and when possible, any product devices and liquids should be submitted for testing.

What the Public Should Do

The CDC recommends people consider not using e-cigarettes while the investigation is continued. People who do use these products should consider the following:

Monitor themselves for respiratory symptoms, such as cough, shortness of breath, chest pain, nausea, vomiting, abdominal pain and fever.
Promptly seek medical attention for any health concerns
Do not buy products off the street and never modify devices or add substances not intended by the manufacturer
Products should never be used by youth, young adults, pregnant women or adults who don't currently use tobacco products.

If you would like more information regarding the outbreak of severe lung illness linked to vaping, visit this CDC website.