Latest U.S. Vaping Illness Data: 1,604 Reported Cases, 34 Deaths

Early on October 25, according to the latest update posted on the CDC’s official website, as of October 22, there had been 1,604 reported cases of vaping-related illness in the United States, with 34 deaths.
 
The main points are as follows:

What We Know

As of October 22, 2019, the U.S. Centers for Disease Control and Prevention (CDC) had reported 1,604 cases of e-cigarette, or vaping, product use-associated lung injury (EVALI) from 49 states (every state except Alaska), the District of Columbia, and 1 U.S. territory. A total of 34 deaths had been confirmed in 24 states.

All EVALI patients reported a history of using e-cigarette or vaping products. So far, the FDA has tested most samples for THC, and most patients reported a history of using THC-containing products.

Recent findings from federal and state investigations suggest that THC-containing products, especially those obtained from the street or other informal sources (for example, friends, family members, or illicit dealers), are linked to most cases and play a major role in the outbreak.

What We Don’t Know

At present, the FDA and CDC have not identified the cause of lung injury in these cases. The only common factor among all cases is that patients reported using e-cigarette or vaping products.

So far, no single compound or ingredient has been identified as the cause of these illnesses. There may be more than one cause of this outbreak, and many different substances and product sources remain under investigation. The specific chemical exposure associated with e-cigarette or vaping product use that causes lung injury is still unknown.

Latest Outbreak Information

This complex investigation now spans nearly every state and involves more than a thousand patients, as well as a wide variety of brands, substances, and e-cigarette or vaping products. The number of cases continues to rise, and new cases are still being reported, making it even more difficult to determine the cause of the outbreak.

A total of 34 deaths have been confirmed in 24 states: Alabama, California (3), Connecticut, Delaware, Florida, Georgia (2), Illinois (2), Indiana (3), Kansas (2), Massachusetts, Michigan, Minnesota (3), Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, Oregon (2), Pennsylvania, Tennessee, Texas, Utah, and Virginia. Additional deaths remain under investigation.

The median age of those who died was 49 years, ranging from 17 to 75 years old.

Laboratory Testing

The CDC and FDA are expanding the range of available laboratory testing.

The CDC is currently testing bronchoalveolar lavage (BAL) fluid samples, as well as paired blood or urine samples collected alongside BAL fluid samples.

The CDC is also testing pathology specimens associated with patients, including lung biopsy or autopsy samples.

The CDC is conducting aerosol emissions testing on case-related product samples from e-cigarettes, vaping products, and e-liquids. Analysis of aerosol emissions will complement the FDA’s ongoing work to characterize e-liquids and will improve understanding of the exposures experienced by patients linked to the lung injury outbreak. The CDC is coordinating with the FDA on e-cigarette and vaping product analysis.

The results may help provide further insight into the nature of the chemical exposures causing this outbreak.