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Five people are now reported dead due to vaping-related lung illnesses. Three¬†new deaths were reported Friday by Minnesota, Indiana and Los Angeles County¬†health officials.¬†
The Centers for Disease Control and Prevention said 450 cases of vaping-related lung illnesses in 33 states and one territory are now under investigation by state and federal health officials, with the majority of the 58 cases most closely examined involving THC oil.
The Minnesota patient was over 65 years old and died in August after “a long and complicated hospitalization,” the Minnesota health department said, and investigators said the injury “was associated with vaping illicit THC products.”¬†
Los Angeles County announced¬†the “recent death of a Los Angeles County resident potentially related to the use of e-cigarettes.”
The Indiana State Department of Health reported a death involving a person older than 18 and said it was providing no additional details because of privacy laws.
Indiana said it is investigating another 30 cases of “severe lung¬†injury linked to vaping.” Eight have been confirmed, with the majority involving people ages 16-29.¬†Minnesota has 17 patients who have been classified as confirmed or probable cases and an additional 15 potential cases under investigation.
Of people involved who have been interviewed, all reported vaping illicit THC products, health officials said, while “many also reported vaping other products including those that contain nicotine.”
CDC, the Food and Drug Administration, and other state officials also updated reporters Friday on investigations into cases of pulmonary disease among people who use e-cigarettes.
The CDC confirmed investigators have narrowed their focus and that the additive Vitamin E¬†acetate is a chemical involved in many of the cases, but emphasized it is not in all of the cases being reviewed.
Officials also said because of the time required to interview patients involved in the hundreds of cases, it can only say many of the cases involve people who vaped both nicotine and THC oil but not whether it is a majority of cases.¬†
A state investigation in New York found¬†at least one vitamin E acetate vape product¬†linked to each patient who submitted a product for testing. The substance is not approved as an additive for the state’s medical marijuana program and officials said it was not seen in the nicotine-based products that were tested.
Vitamin E acetate is a “sticky greasy oil” that some¬†marijuana includes, said Devin Alvarez, CEO and founder¬†of Straight Hemp CBD products.¬†“Not all oils are the same. Thick and greasy seem to be the culprits.”¬†
Vegetable oils such as the medium-chain triglyceride or MCT oils popularized with the keto diet and Bulletproof coffee is used in some commercially-sold marijuana and, like¬†Vitamin E oil may sound healthier,¬†said Alvarez. But they aren’t when inhaled.¬†
Alvarez said he worked at marijuana companies that were “keenly aware of lipoid pneumonia issues. That is why we chose to formulate without those.”¬†¬†
Lipoids are oils or fats that enter¬†the lungs making it difficult to breathe, causing a rare form of pneumonia.¬†
In North Carolina, health officials reported Friday on five cases involving¬†18 to 35-year-olds who were short of breath and had nausea, vomiting and fevers but did not have infections. Dr. Daniel Fox, a pulmonologist with WakeMed Health Pulmonary & Critical Care Medicine, said on the call with reporters that “all vaped THC. That seemed to be a common feature. Some also smoked THC. Most used nicotine containing products as well.”
In Utah, the most serious of six¬†cases included in an New England Journal of Medicine¬†letter to the editor discussed “a¬†previously healthy 21-year-old man who had been vaping nicotine and tetrahydrocannabinol (THC) daily.”¬†
Dr. Jennifer Layden,¬†chief medical officer and state epidemiologist at the Illinois Department of Public Health, said most of the people affected by vaping-related lung illness in her state have been healthy young men. Nearly all were hospitalized but about three-quarters were treated on an out-patient basis.¬†Illinois and Wisconsin published¬†details of 53 cases Friday, of which 84% reported vaping THC oil.¬†
Dr. Jack Coleman, senior medical director at¬†the Lung Health Institute in Nashville, Tennessee, said¬†“in¬†a young lung, they are going to be more vulnerable to THC¬†than anything they vape.”¬†
Health officials ask anyone who experiences lung illnesses related to vaping like those under investigation to report them on the FDA’s portal.¬†¬†
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