What Is Vaping-Related Illness? What Is the U.S. Vaping Illness Outbreak?
What is vaping-related illness, and what happened in the United States? A serious outbreak of lung illnesses associated with vaping began in 2019, with nearly all reported cases concentrated in the U.S. Today we look at the possible reasons behind it. Wha
What is vaping-related illness? What is the U.S. vaping illness outbreak? A severe outbreak of vaping-related lung disease began in 2019. Nearly all cases associated with the use of vaping products occurred in the United States. Today, let’s explore the reasons behind it.
What is vaping-related illness? The cause is still unknown
In August 2019, a sudden outbreak of “vaping illness” occurred in the United States, with confirmed cases peaking in September. As of February 18, 2020, the U.S. Centers for Disease Control and Prevention had reported 2,807 cases of e-cigarette or vaping product use-associated lung injury (EVALI), including 68 deaths. However, the CDC has still not officially identified the exact cause of the EVALI outbreak, stating only that “laboratory data show that vitamin E acetate in THC-containing vaping products is strongly linked to the outbreak; however, the possible contribution of other chemicals cannot yet be ruled out.”
Experts still do not know the exact cause of the illness, but patients shared one common factor: they all had a history of using vaping products.
Symptoms in patients included coughing, shortness of breath, and fatigue, and some also experienced vomiting or diarrhea. There is currently no evidence that this illness is spread by a virus or bacteria. U.S. health officials began testing samples of vaping liquids they collected to determine whether they contained harmful substances.
What is the U.S. vaping illness outbreak?
As of September 5, 2019, the New York State Department of Health had reported 34 cases of severe lung disease in patients who were reported to have used different vaping products. Testing conducted by the Wadsworth Center found very high levels of vitamin E acetate in most cannabis vaping products. The New York State Department of Health stated: “At least one vape product containing vitamin E acetate has been linked to every patient who submitted products for testing.” The nicotine-free base product samples described also contained vitamin E acetate. According to reports from Illinois and Wisconsin, the onset of respiratory symptoms appeared to occur within days to weeks before hospitalization. As of September 5, 2019, the Illinois Department of Public Health had reported 42 cases of lung illness, including 7 still under investigation, along with 1 death. In Wisconsin, 11 cases of severe lung disease requiring hospitalization were identified among young people and young adults using vaping products, while additional cases were under investigation in August 2019. Symptoms included difficulty breathing, fatigue, chest pain, coughing, and weight loss. Some patients required breathing assistance.
On August 9, 2019, the California Department of Public Health issued a statement regarding a cluster of seven healthy adults in Kings County, California, all of whom required hospitalization. Since June 2019, a hospital in Kings County, California, had reported at least seven cases of severe acute lung disease in previously healthy adults. The cases involved residents of multiple counties. Patients presented with progressive respiratory distress, sometimes initially diagnosed as pneumonia or bronchitis, and some had prior fever and gastrointestinal symptoms. None of the cases responded to initial courses of antibiotic treatment. All patients required hospitalization and significant respiratory support, including high-flow oxygen, bilevel positive airway pressure (BIPAP), or intubation for mechanical ventilation. Diagnoses included pneumonitis and acute respiratory distress syndrome (ARDS). In California, several cases of vaping-associated pulmonary injury (VAPI) and acute respiratory distress syndrome (ARDS) were linked to cannabis vaping products traced to pop-up retailers. Patients improved after systemic corticosteroid treatment. To date, all patients had negative evaluations for infectious causes.[25] All patients reported vaping in the weeks prior to admission, and the common exposure among them was reported use of cannabis or CBD oil products.
On November 8, 2019, CDC Principal Deputy Director Dr. Anne Schuchat said: “For the first time, we have detected a potential toxin of concern—vitamin E acetate—in biological samples from patients with lung injuries associated with the use of e-cigarette or vaping products.” The sample type was bronchoalveolar lavage (BAL) fluid, which is fluid collected from the lungs. The chemical was found in samples collected from 29 patients across 10 different states. “These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lungs,” Dr. Schuchat said. The CDC tested for a range of substances that may be found in e-cigarette or vaping products, including plant oils, petroleum distillates (such as mineral oil), medium-chain triglyceride oil (MCT oil), and terpenes (compounds found in or added to THC products). So far, no other potential toxic substances have been identified in the testing conducted. The CDC has not ruled out other compounds or ingredients that may have caused lung injury. So far, no single compound or ingredient has been identified as the sole cause of these illnesses. There may be more than one cause behind this outbreak.#p#Page Title#e#
Many samples tested by state authorities or the U.S. FDA as part of the 2019 investigation were identified as vaping products containing tetrahydrocannabinol (THC), the psychoactive component of cannabis. In addition, most of the samples tested for THC also contained significant amounts of vitamin E acetate. Vitamin E acetate is a substance used in topical consumer products or dietary supplements, but there is limited data on its effects when inhaled. Although the U.S. FDA currently does not have sufficient data to conclude that vitamin E acetate caused the lung injuries in these cases, the agency believes it is prudent to avoid inhaling this substance. The FDA’s Forensic Chemistry Center, the agency’s national laboratory, played a key role in gathering facts and analyzing lung disease cases following the use of vaping products.
In summary, although the exact cause remains unknown, extensive research suggests that vaping illness may have been caused by vitamin E acetate in vaping products. Of course, this is the latest hypothesis at present.
What is vaping-related illness? The cause is still unknown
In August 2019, a sudden outbreak of “vaping illness” occurred in the United States, with confirmed cases peaking in September. As of February 18, 2020, the U.S. Centers for Disease Control and Prevention had reported 2,807 cases of e-cigarette or vaping product use-associated lung injury (EVALI), including 68 deaths. However, the CDC has still not officially identified the exact cause of the EVALI outbreak, stating only that “laboratory data show that vitamin E acetate in THC-containing vaping products is strongly linked to the outbreak; however, the possible contribution of other chemicals cannot yet be ruled out.”
Experts still do not know the exact cause of the illness, but patients shared one common factor: they all had a history of using vaping products.
Symptoms in patients included coughing, shortness of breath, and fatigue, and some also experienced vomiting or diarrhea. There is currently no evidence that this illness is spread by a virus or bacteria. U.S. health officials began testing samples of vaping liquids they collected to determine whether they contained harmful substances.
What is the U.S. vaping illness outbreak?
As of September 5, 2019, the New York State Department of Health had reported 34 cases of severe lung disease in patients who were reported to have used different vaping products. Testing conducted by the Wadsworth Center found very high levels of vitamin E acetate in most cannabis vaping products. The New York State Department of Health stated: “At least one vape product containing vitamin E acetate has been linked to every patient who submitted products for testing.” The nicotine-free base product samples described also contained vitamin E acetate. According to reports from Illinois and Wisconsin, the onset of respiratory symptoms appeared to occur within days to weeks before hospitalization. As of September 5, 2019, the Illinois Department of Public Health had reported 42 cases of lung illness, including 7 still under investigation, along with 1 death. In Wisconsin, 11 cases of severe lung disease requiring hospitalization were identified among young people and young adults using vaping products, while additional cases were under investigation in August 2019. Symptoms included difficulty breathing, fatigue, chest pain, coughing, and weight loss. Some patients required breathing assistance.
On August 9, 2019, the California Department of Public Health issued a statement regarding a cluster of seven healthy adults in Kings County, California, all of whom required hospitalization. Since June 2019, a hospital in Kings County, California, had reported at least seven cases of severe acute lung disease in previously healthy adults. The cases involved residents of multiple counties. Patients presented with progressive respiratory distress, sometimes initially diagnosed as pneumonia or bronchitis, and some had prior fever and gastrointestinal symptoms. None of the cases responded to initial courses of antibiotic treatment. All patients required hospitalization and significant respiratory support, including high-flow oxygen, bilevel positive airway pressure (BIPAP), or intubation for mechanical ventilation. Diagnoses included pneumonitis and acute respiratory distress syndrome (ARDS). In California, several cases of vaping-associated pulmonary injury (VAPI) and acute respiratory distress syndrome (ARDS) were linked to cannabis vaping products traced to pop-up retailers. Patients improved after systemic corticosteroid treatment. To date, all patients had negative evaluations for infectious causes.[25] All patients reported vaping in the weeks prior to admission, and the common exposure among them was reported use of cannabis or CBD oil products.
On November 8, 2019, CDC Principal Deputy Director Dr. Anne Schuchat said: “For the first time, we have detected a potential toxin of concern—vitamin E acetate—in biological samples from patients with lung injuries associated with the use of e-cigarette or vaping products.” The sample type was bronchoalveolar lavage (BAL) fluid, which is fluid collected from the lungs. The chemical was found in samples collected from 29 patients across 10 different states. “These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lungs,” Dr. Schuchat said. The CDC tested for a range of substances that may be found in e-cigarette or vaping products, including plant oils, petroleum distillates (such as mineral oil), medium-chain triglyceride oil (MCT oil), and terpenes (compounds found in or added to THC products). So far, no other potential toxic substances have been identified in the testing conducted. The CDC has not ruled out other compounds or ingredients that may have caused lung injury. So far, no single compound or ingredient has been identified as the sole cause of these illnesses. There may be more than one cause behind this outbreak.#p#Page Title#e#
Many samples tested by state authorities or the U.S. FDA as part of the 2019 investigation were identified as vaping products containing tetrahydrocannabinol (THC), the psychoactive component of cannabis. In addition, most of the samples tested for THC also contained significant amounts of vitamin E acetate. Vitamin E acetate is a substance used in topical consumer products or dietary supplements, but there is limited data on its effects when inhaled. Although the U.S. FDA currently does not have sufficient data to conclude that vitamin E acetate caused the lung injuries in these cases, the agency believes it is prudent to avoid inhaling this substance. The FDA’s Forensic Chemistry Center, the agency’s national laboratory, played a key role in gathering facts and analyzing lung disease cases following the use of vaping products.
In summary, although the exact cause remains unknown, extensive research suggests that vaping illness may have been caused by vitamin E acetate in vaping products. Of course, this is the latest hypothesis at present.
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