A sixth person has died from an outbreak of lung disease linked to vaping in the United States, as hundreds of cases of the illness have been reported across the country.
The victim, a woman from Kansas over the age of 50, had a series of underlying health issues but became seriously ill after using e-cigarettes, the Kansas Department of Health and Environment confirmed on Tuesday. The patient, who has not been named, was hospitalised with symptoms that progressed rapidly.
“She had some underlying medical illnesses, but nothing that would have foretold the fact that within a week after starting using e-cigarettes for the first time, she developed full-blown acute respiratory distress syndrome and died,” Dr Lee Norman, secretary of the Kansas Department of Health and Environment, told NBC News.
In what is becoming a national issue, the Centers for Disease Control and Prevention (CDC) has said 450 possible cases of lung disease related to vaping have been reported across 33 states and the US Virgin Islands. As many as six cases nationwide have ended in death, including the now confirmed Kansas death.
Patients are coming into hospitals with coughs, chest pain, shortness of breath, fatigue and vomiting. Many of the reports involve severe, life-threatening illnesses in previously healthy people, with many patients receiving oxygen, and some needing to be put on breathing machines before they recovered. Antibiotics didn’t work, and it’s not clear yet whether steroid drugs helped those affected.
The CDC says no evidence of infectious diseases have been identified, meaning the illnesses are likely associated with chemical exposure.
It says no specific substance or product has been linked to all cases, though many cases involve people who reported vaping THC, marijuana’s high-inducing chemical. Health officials said they do not have detailed information on what specific e-cigarette products were used by the deceased patient in Kansas.
Public health officials in the US are attempting to understand the developing epidemic, with the CDC, Food and Drug Administration (FDA) and state health departments making investigations into the illness.
“It is time to stop vaping,” Dr Norman said in a statement. “If you or a loved one is vaping, please stop. The recent deaths across our country, combined with hundreds of reported lung injury cases continue to intensify.”
A US problem?
Advice from experts in the US is to avoid vaping until investigations are complete, however Public Health England (PHE) told i that users should use UK-regulated e-liquids as, to its knowledge, many of the US-cases were related to homemade or illicit substances.
According to the NHS, an estimated 2.9 million adults in Great Britain currently use e-cigarettes and of these, 1.5 million people have completely stopped smoking cigarettes.
The recent wave of illness and deaths has mostly been concentrated in the US, with the other five deaths confirmed in California, Illinois, Indiana, Minnesota and Oregon, with all smoking either nicotine, cannabinoid-based products or a combination of the two.
Last month, a patient death in the US was the first to be linked to vaping, as the CDC said the Illinois-based individual was suffering from pulmonary illness from the use of e-cigarettes.
UK products ‘tightly regulated’
Last year the British Medical Journal reported a woman was hospitalised for respiratory failure related to smoking an e-cigarette.
Regulation around vaping ingredients is fairly strict in the UK. One example of this is the ingredient diacetyl, which gives a buttery-flavour in vaping liquids – very high levels of exposure of the substance has been associated with the serious lung disease bronchiolitis obliterans, but it has been banned in the UK since 2016.
Martin Dockrell, Head of Tobacco Control at PHE told i: “A full investigation is not yet available but we’ve heard reports that most of these [US] cases were linked to people using illicit vaping fluid bought on the streets or homemade, some containing cannabis products, like THC, or synthetic cannabinoids, like Spice.
“Unlike the US, all e-cigarette products in the UK are tightly regulated for quality and safety by the Medicines and Healthcare products Regulatory Agency and they operate the Yellow Card Scheme, encouraging vapers to report any bad experiences.
“Our advice remains that e-cigarettes are a fraction of the risk of smoking, and using one makes it much more likely you’ll quit successfully than relying on willpower alone. But it’s important to use UK-regulated e-liquids and never risk vaping home-made or illicit e-liquids or adding substances, any of which could be harmful.”
Investigation into Vitamin E
Health officials have no definitive answer as to why these illnesses and deaths are happening and are looking into whether this is a result of heavy usage or harmful ingredients in vaping liquids.
Last week, the New York health state department confirmed that vitamin E was “a key focus of the Department’s investigation of potential causes of vaping-associated pulmonary illnesses”. The ingredient, Vitamin E acetate, which recently has been used as a thickener, particularly in black market vape cartridges, was shown to be in very high levels in nearly all cannabis vaping samples but not in the nicotine samples during the investigation.
Suppliers say it dilutes vape oils without making them look watery. Vitamin E is not known to cause harm when ingested or applied to skin, but the department is examining its impacts when inhaled.
New York officials are issuing subpoenas to three companies that sell vaping additives made from vitamin E acetate. The state wants to know more about the ingredients, the quality of the raw materials, any safety testing performed, sales of the products during the past three years and what other additives the companies sell.Read More